HomeMy WebLinkAboutPermit Demolition 1995-05-01RESIDENT'AL
PERMIT APPLICATION
lns-pections: 726-3769uilice: 726-gt59 JoB NUMBEa ?*>+-.>
225 Fifrh StreerSpringftetd, Oregon 97472
SP rl LD
LOCATION OF PROPOSED WORK:
ASSESSOFIS MAP:
LOr
BLOCK:TAX LOI:
SUBDIVISION:
ZIP:
STATE
PHONE:,/z
OWNERT
ADDRESS:
CITY:
ADDITION DEMOLISH OTHER
DESCBIBE WORK:
NEW- REMODEL
EXPIRES
coN ST.
co NTBACTOR'NAME
MECHANICAL:
ELECTRICAL:
RACIOB *
PHONE
e
GENEFIAL:
PLUMBING
_ OFFICE USE -
LAND USE:
, OF BDFIMS
r OF UNITS:
WATEB HEATEFI:
ZONING CODE:
FLOOD PLAIN
RANGE:
QUAD AFEA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
,I OF STORTES;
CONSTR. TYPE:
HEAT SOURCE;
To reguest an lnspec
made the same work
tlon, you must call 726-3rng day, lnspectlons req
769.
R
Tht s
u ested af ter 7:00 a.m wi be m ad e e o owl n s wor d ay.
S a 24 h o UT recordl ng.AI pec o NS req UES ted be o re 7:OO a.m.be
n
h
EQUIRED INSPECTION
I::^n-,, Mechantcar _ prtor tocover.
k lt
[-l Temporary Etectrtc
SIte lnspectlon _ To
Sim::#,1"#,;,i"0?,?il3o' E I".,1,.t Erecrrrcar - prror to
5lt,*,il;Til,?, ;y,i ;i: tJl
S
H':3i:1 r",, 11?i 3: i 5' ::l.f ",,
L::lltg - After trenches areexcavated.
Masonry - Steel location, bondbeams, grouUng.
I l-o-t11!1r!on - After forms areerected but prlor to concreteptacemenl.
Underground plumbing _ priorto fllllng trench.
Underlloor plumblng / Mechanlcat
- rnor to-. Insulailon or decklng.
Post. bnd Jurrn - prtor to floorlnsulatlon or decking.
n Floor lnsulation 4 prtor tou decklng.
Sanitary Sewer - Prlor to filllng
trench.
Electrica.l Servlce _ Must be
3iJ#tT f'J:l:' " Perm an e n t
l:?ft":" - prtor to faclnsmaterlals and framlng lnspi
Framlng - prlor to cover.
I y_lltt"etlng tnsurailon _ prtor to
-
cover.
l-l orywall - prtor to taptng.
[--l Wood Stovo - Afler lnstaltatlon
ll_"lt : After ftreptace approvalano tnstallauon of unlt.
Curbcut & Approactr - Aftertorms are erected bUt prlor toplacemcnt of concrete.
5,'ii1,,:::"il?fl ,, ;" yj ; i: ill
Flnal Mechanical _ When allmechanical work ls complete.
ii{iid{li:?"'; yx i:,x,,ou unlqgroyed and buildtns rscompleted.
Storm Sewer - Prlor to filllng
trench.
Water LIne - Prlor to fllllng
trench.
Rough Plumblng - Prior to
cover.
Sldewalk & Drlveway - After
excavatlon ls complete, forms
and sub.base materlal ln place.
Fence - When completed.
Street Trees - When all requlred
trees are Planted.
Othor
Final - After all required
lns-pections are approved and
porches, sklrtlng, decks, and
venting have been lnstalled.
w
MOBILE HOME INSPECTIONS
I Alocking and Set.Up _ When all
-
blocklng ls compleie.
PJumb{ng Connectlons _ Whenhome has been connected towater and sewer.
Electrlcal Connection - Whenblocking, set-up, and plumbinglnspections have becn approvedand the home is connected tothe service panel.
ll ti
I]
E
r tlr
tl
tl
n tl
I : r1'+ ! ,ift;r r
!,1 (
Lot faces
Lot sq. ftg.
Lot coverage
TopograPhY
Total helght
Lot
ln te rlor
Corner
Panhandle
Cul-de-sac
(IS THE PROPOSED WORK IN THE -
HISTOBICAL DISTBICT, OR ON
THE HISTORICAL REGISTER?
--lf yes, this appllcatlon must be slgned
and apProved bY the Historlcal
Coordinator prlor to permit issuance.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the expre6s conditlon that the said
consiruction shall, in all respects' conform to the Ordinance
adopted by the City of Springfleld, including the
Development Code, regulating the constructlon and use ol
bulldings, and may be suspended or revoked dt any tlme
upon utlrtion of any provisions of sald oldinances,
APPROVED
Plan Check Fee:
Date Pald:
Receipt Numbe
Recelved By
Date
Systems Development Charge is due on all undeveloped
properties withln the City limlts which are being improved'
ADDITIONAL COMMENTS
GAR ACCP,L.HSE
N
S
E
BUILDING PERMIT
ITEM SO. FT. X S/SQ. FT.VALUE
(A)
Total Value
Building Permit Fee
state surcharge
Total Fee
Main
Garage
Carport
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ITEM
Fixtures
Resldentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
FEE
,19
e/6(c)
No
FT.
FT.
PLUMBING PERMIT
Home
Plumblng Permit
State Surcharge
Total Charge
. FT.
Wood Stove/ lnsert/ Fl roplace Unlt
Dryer Vent
MECHANICAL PERMIT
(D)
No
Mechanlcal Permlt
lssuance
State Surcharge
Total Permlt
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have caref ully examlned
the oompleted appllcatlon and do hereby certlly that all
lnformatlon hereon is true and correct, and I lurther certlfy
that any and all work per(ormed shall be done ln aocordance
wlth the Ordlnances of the Clty of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
heroln, and that NO OCCUPANCY wlll be made of any
structure wlthout permlssion o( the Bulldlng Safety Dlvlslon'
I further certlfy that only contractors and employees who
are ln compllance wlth ORS 701'055 wlll be used on thls
prolect.
I further a0ree to ensuro that all requlred lnepeotlone are
roquested at the proper tlme, that each address ls readable
from tho street, that the permlt card ls located at the front
of the property, and the approved set of plans wlll remaln
on the slte at all times durlng construc
c/r/z<-
2
Date
Slgnature
MISCELLANEOUS PERMITS
Curbcut
--lt
u ---$-"r".',Jli,',,"@7+6a;-(rz7*z
State Surcharge
Total Miscellaneous Permlts (E)
Sldewalk
-
ft
Mobile Home
State lssuance
State Surcharge
TOTAL AMOUNT DUE (excludlng electrlcal)
(A, B, C, D, and E Comblned)
VALIDATION:
FTEoETPT NUMBEB ' ^ ',^ 7
,2?AMOUNT RECEIVED
BECEIVED BY
DATE PAID
Plans Reviewed BY
nfPtifiilEilrOFFIfrEE TlFESAFETT
OPERATIONS
TO:
Oa.
225 F/FTH STRE€r
SPRINGFIELD, OR 97477
(50s) 726-37s7
FAX (s)s) 726.2297
TRAiNING BURN AUTHORIZATION
L9-L
C'ity of Springfield, a Munic'ipa1 Corporation, act'ing by and through its
Department of Fire and Life Safety
You are hereby authorized and permitted to burn under sup
and.instruct'i-on pr.potus that certain house or bu'i'lding'l
ervision and for education
ocated on
Addition to SPringfield'Tax Lot # /z 5
0regon which'is designated as /)eS ,Ut>tl, A P d" Street, SPringfie'ld,0regon'
of Fire and Life SafetY.
'ls to secure the req uired dem olition and Plumbing caP
perm
p
i
roperty
ts from
owner ( s
the Bui
i/lie, expressly warrant and represent to you that I/r/e, the undersigned' are the
owner(s) of said property, anO tnil in. tu*. is iree anO clear of any and all liens'
encumbrances , judgments , ancl uny"lnt..esi, rignt, !'itl e or cl a'im i n any other person
other than the undersigned, and that thjs-conseni is treely and volunta.ily given'
and that we wiil save the city oi"ip.i.giierd harmress from any liab'ility to any
person whomsoever by reason of un,-ltul6ment or *u.ianty conta]ned in this letter'
l/We,theundersigned.gllo}9|eetothefollowingrequirementsimposedbythe
gepartrnent of rirE inO fife Sifety to assure to*fietidn of al1 regulations'
1. The property owner(:l.rlull remove all-debris on the'J9t(:r involved in this
burn with.in sixty (60) days after compl.tifn"oui.-oi tt.'burn by the ,epartment
tl -dC-e.t 1n
2. The )
I ding DePartment when 'ins'ide th e CitY L'imits.
Th'is
4 The proPertY
ection of the structure by an asbestosincludes:a. An interna
b. Removal of a
or environme
1 and external ins
ntal consulting
sbestos contain ing ma
p
f terials, as'indicaled by the inspectingi rm.
-Non-fri abl e ( bound )asbestos maY be removed bY no n-certified P eopl e.firm.
-Fr i ab'le (unbound) as bestos must be removed bY PeoP le certified to do so'.
c. The ProPertY owner(s)shal I subm'it a coPY of the or i g'ina'l asbes tos
i nspect'ion a s written by the insPe cting firm.Troe.Ca c Cc, i-c./J"/d {/ /<
3. 0u ts ide City Lim'its, CountY
owner(s) sha11
regulations a
have the stru cture inspected for asbestos'
t
Pd aat 3 6(/
pplv.
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