HomeMy WebLinkAboutPermit Demolition 1995-09-20SPRINGFIELE,
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
0ffice: 726'3759
JOB NUMBER 060
225 Fifth Street
Springfleld, Oregon 97477
3 r/u/C'
LOCATION OF PROPOSED WOBK:
ASSESSOBS MAP:
LOT
TAX LOT:
BLOCK:
PHON E:a#
STATE ZIP:5 9 r .l^l B
P..=., I ** l-i ".l'xzq \
CITY:
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH >'- OTHER
DESCiIBE WORK:
PLUMBING:
MECHANICAL:
ELEfiRICAL:
ADDRESS EXPIRES PHONECONTRACTOR'S NAME
GENERAL:
CONST.
CONTRACTOR #
# OF BDFIMS
- OFFICE USE _
ZONING CODE:
FLOOD PLAINQUAD AREA:
, OF BLDGS
SECONDARY HEAT:
SOUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
LAND USE:
# OF UNITS
OCCY GROUP:
* OF STORIES:
To request an lnspection, you must call 726-3769. Thls is a 24 hour recordlng. All inspections requested before 7:00 a.m. wilt be
made the same working day, lnspections requested after 7:00 a.m. will be made the {ollowing work day.
REOUIRED INSPECTIONS
l---l Temporary ElectricL..J Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover
[-_| Underslab Plumbing/ Electrical/U Mechanlcat - Prioi to cover.
fl Footlng - After trenches areU excavated.
Electrical Service - Must be
approved to obtain permanent
electrlcal power.
Final Mechanical - When all
mechanical work ls complete.
Fireplace - Prlor to faclng
materlals and framing lnsp.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prlor to cover.
tl Foundatlon - After forms are
erected but prior to concrete
placement.
,X o*er )& *?1 4'3/ ^
Wall/Celling lnsulatlon - Prlor to
cover.
Underground Plumbing - Prior
to filling trench.Drywall - Prlor to taping
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanical
- Prior to lnsulatlon or decking.
Post and Beam - Prior to floor
lnsulation or decking.lnsert - After fireplace approval
and lnstallatlon of unit.
Blocking and Set.Up - When all
blocking is complete.
Floor lnsulation - Prior to
decking.Curbcut & Approach - After
forms are erected btrt prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the servlce panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & Drivewav - After
excavation ls complete, forms
and sub-base material in place.
Water Line - Prlor to filling
trench.
Fence - When completed
Rough Plumbing - Prior to
cover.
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.E
h-/r)4
SUBDIVISION:
-
O/o_ae
C)o-
RANGE:WATER HEATER:
tl
E
tl
E
E
E
E
r
r
E
tf
tl
l--l Wood Stove - After lnstallatlon,
tl
fl
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typ..
-
lnterlor
-
Corner
_- Panhandle
-
Cul-de-sac
IS THE PROPOSED WORK TN THE
HISTOFIICAL DISTFIICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
PL.HSE GAR ACC
N
S
E
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
VALUEX $/SQ. FT.
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMTT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinanceadopted by the City of Springfield, including the
Development Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any time
upon violation of any provisions of sald ordinances.
DatePans Reviewed By
Plan Check Fee
Date Paid
Fleceived By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
a'?Dfa+raa ry
FT.
N0
>o
)_o
FT.
Plumbing Permit
State Surcharge
Total Charge
t7f t '/'f
(c)
PLUMBING PERMIT
ITEM
Fixtures
ADDITIONAL COMMENTS
Wood Stove/ lnsert/Fireplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certify that all
information hereon is true and correct, and I further cerflfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertalning to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure without permission of the Building Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 7O1.OS5 will be used on thlsprolect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
the permit card ls located at the front
K",u,u
Date
pproved set plans wlll remaln
I ti es du ct
from the street, t
of the property, and
on the site
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
--..-
ft
Curbcut
--
ft
?o r ,Sy'
Total Miscellaneous permits 41(E)
/.
Demolition
State Surcharge
./A d-o
// ?2t
TOTAL AMOUNT DUE (exctuding etectricat)(A, B, C, Q and'E'Combined)
VALIDATION
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
d r'
(A)
Recei pt Number:__=__---
FT.
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