HomeMy WebLinkAboutPermit Sidewalk 1992-10-09nBo
225 NORTH FIFTH gTREET
gFRrl.lGFrELD, ORE60hl e'14'l'1
EhI3INEERI|.16 D IVlIlOt l
ffilcENo.12b-)1>9
IN9PECTIO|{ Llt'lE, 12 b -31bA
JOB ADDRE9$:c
A95E990R9l1AF NO.o
IsE,9ll-/E,N I IAL - tvL)f ll-ltr,l=(rlAL
9IDEUJALK / CURBCLIT
APPL ICATIOI.i / PEBIIT
TAX LOT NO.t-7Pm
SPFII,{GFIELO
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9,lBDlvl9lOr.l:
OIINER
ADDFESS 1
(0-
STATE'zt?t
LIJOFK
UJOFK TO BE FEFFOFI-IED BY:
CITY'
Pltotl= NO.
ou,\lER "/' cch,rrRAcroR
'l\
L 7'7
RECEIPT NO:
cA9+{Z tg qqL
CHECK
*
c+lecf,'€D FoR DELNaUENCIE9 +-
9IGNED:
DATE;
CLRS-CIJT: RE9IDENTIAL
-
comlERlCAL
9ECOND DRI\GU,AY ( gEE TRA.FFIC )
F=AUIRE9 AFPL ICAT lOl.{ FoR A SECOi.ID DRIIGLIJAY(T - 4.la )
OR A COI.hITY AFPI.ICATION FOR FACILITY PERI1IT (C Ab-2O3)
tF tN TltE u63.
tD 4 -12-DATE OF APFLICATIC)I.I
SIDE'I,IALK cuRS SIDE _5ET3AC< _
*.EXPIRE9,REGIgTRATIOI.{ NO.
ADDRESS
PFOCEDURE FoR lNgFECTlc[.] RE@UE9T'
CAJL 12f,--1169 (RECORDER ) STATE YOUR CITY DEgIGNATED JOts NI,JI.ItsER, JOB APDRESS,TYPE OF
INgPECTION REOTJEgTED A{D UHEN YOIJ IUILL BE READY FOR IN9PECTIOhI, CONTRACTORg OR OuAlERg NA}.1E AJ.ID
PHOhIE N|FIBER REaUEST9 RECEIVED BEFoRE lzoo *l uJlLL BE HADE Tl{E 9A1E DAY, REaIJE9TS #7ER1o@
Al'1 u,lLL BE I1ADE THE NEXT tuoR<ll.lc DAY
*L -\0 -q2
lz-
tl.{G IT NO, (
TED JOB NO. Igf*gEE tsOOK
L/t -08PL{ONE:
SIDEIUALK / DRI\GI'.JAY
FOR ALL CONCRETE PAVING IIJITHIN
THE gTREET RIGHT OF IUAY, TO BE
IIADE AFTER ALL EXCAVATIN6
19 COHPLETE A!.ID FOtr1 IIJOR<
AID 5UB-BA,* HATERIAL 19
rN tt-AcE
CU@ / AFPROACI-] APRO,l.l:
AFTER F-OR|19 AE EREC?ED
BUT FRIOR TO POURNG
CONCRETE.
FEE9: SiDELUALKg 5o4*cuRB-cuT UJAL< X,
ToTAL FERlllT EE'
IIO.O@ + *O.lb/LF.( X )
OF IUALK
t 11
tlO.OO+t@.ll>/LF.(X)
CO|.II.IERICAL DRI\€IUAYg SHALL
HA\€ 5'TO A'FLAIRg
3.. O" gTA\DARD
I i-]A\G CAREFULLY EXAJ.IIhIED TI-.IE COF1PLETED APPLICATION FOR PEFI1IT, A',ID DO HEREtsY CERTIFY TI..{AT ALLINTRilATICD{ llEREoN l9 TR"IE AND coRREcT, AND I RJRTIIER CERTIFY Ti.lAT ANY AND ALL u/CR< PERFORIIEDg;IALL BE DONE IN ACCORDANCE IIJITI{ TI.{= ORDINA\CEi G TI.1= CITY G SPRING,FIELD, AID THE LAtI}g cr TFIE9TATE 6 oREGoN PERTATNTNo ro rHE l.rJoRK DEscRrtsED lrER=rN. AND TI.{AT No ocCr,qxcy urLL BE HADEd A.iY STRLICTURE IUITIIOJT PER*1I99IOhI OF TI-]= BUILDI}.IG DIVI9IO\T I FURTHER CERTIFY THAT ONLY CONTRACTOR9AN]D EIIPLoYEES u,tlo AR= rN coi"lpLlANcE rutl{ o?s iot-o>> r,rJtLL BE ugED ohl rHis pRo.Jecr.
DATE
REGIJ IRED IN9FECTIC'I.I9
RESID ENTIAL
PERMTT APPLICATION
lnspections: 726'3769
Olfice: 726'3759
SP,lI]{GFI
Rough Mechanlcal - Prlor to
cover.
Rough Electrical - Prlor to
cover
Electrlcal Service - Must be
approved to obtain Permanent
electrical power.
Fireplace - Prlor to faclng
materlals and lramlng lnsP.
Framing - Prlor lo cover.
Wall/Celllng lnsulatlon - Prlor to
cover,
f--] Drywall - Prlor to taning
Wood Stove - After lnstallation'
lnserl - After flrePlace aPProval
and installatlon of unit.
Curbcut & Approach - After
forms are erected but Prlor to
placement of concrete.
Sidewalk & DrivewaY - After
excavation ls complete, forms
and sub-base materlal ln Place.
Fence - When comPleted
Slreel Trees - When all requlred
trees are planted.
JOB NUMBER
225 Flfth Street
Sprlngfleld, Oregon 97 477
Final Plumblng - When all
plumblng work ls comPlete.
Flnal Electrlcal - When all
electrlcal work is complete.
Final Mechanical - When all
mechanical work ls complete.
Flnal Bulldlng - When all
requlred lnspectlons have been
approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When all
blocklng ls complete.
Plumblng Connectlons - When
home has been connected to
water and sewer.
Eleclrical Conneclion - When
blocklng, set-up, and plumblng
lnspections have been approved
and the home ls connected to
the servlce panel.
'Final - After all required
lnspectlons are approved and
porches, skirllng, decks, and
ventlng have been installed.
,Yfv
LOCATION OF PRO
ASSESSORS MAP:::1?_5_&u TAX LOT:
LOT:Bt-OCK:SUBDIVISION
To request an inspecilon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. will be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day'
REOUIRED INSPECTIONS
l-_-l TemporarY Electric
ll
Site lnspeclion - To be made
after excavatlon, but Prior to
setting forms.
Underslab Plumbing/ Eleclrlcal /
Mechanical - Prior to cover'
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, orouting.
Foundatlon - After forms are
erected but Prlor to concrete
placement.
Undergrouncl Plurnbiltg - Prior
to filling trench.
Underlloor Plumbing/ Mechanical
- Prior lo insulation or decking'
Post and Beam - Prlor to floor
insulation or decking'
Floor lnsulation - Prlor to
decki ng.
Sanltary Sewer - Prior to fllling
trench.
torm Sewer - Prlor to fllling
trench
Waler Llne - Prlor to fllling
trench.
Bough Plumblng - Prlor to
cover-
t_l
tl
t_J
PHONE:
ZIP:STATE:
OWNER:
ADDRESS:
CITY:
L z-7DEMOLISH OTHERNEW
-=
REMODEL ADDITION
DESCRIBE WORK
M EC HAN ICAL: ---_-.--
EXPI RES PHONEADDRESS
LEPLUMBING
CONTRACTOR'S NAME
GENERAL:
-
CONST.
CONTRACTOR #
OUAD AREA
r OF BDRMS:
WATER HEATEFI:
_ OFFICE USE _
I--AND USE:FLOOD PLAIN
Y OF UNITS:
FIANGE:
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GFIOUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
ZONING CODE:
tl
tl tl E
tl E
fl
n
E
E
x
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
J'
Cp,lner
-
Panhandle
-
Cul-de'sac
HSE GAR ACCP,L.
N
S
W
E
, S THE PROPOSED WORK IN THE
HISTOFIICAL DISTFIICI, OR ON
THE HISTORICAL BEGISTER?
-
lf yes, this application must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Cocle, regulating the construc)tion and use of
bulldings, and may be suspended or revol<ed at any time
upon violation of any provisions of said ordinances'
Plans Reviewed BY Date
Receipt Numbe
Plan Check Fee:
Date Paid
Received By:
VALUE
(A)
X $/SQ. FT.
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FT.
Main
Systems Development Charge ls due on all undeveloped
properties within the City limits which are being improved'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Resldential Bath(s)
Sanltary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
No
FT.
FT,
FT.
(c)
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace 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, ttrat I have caref ully examined
the completed application and do hereby certify that all
lnformation hereon is true and correct, and I f urther certify
that any and all work performed shall be dorre in accordance
wlth the Ordinances of the Clty of Sprlngfield, and the Laws
of the State of Oregorr pertalnlng to the worl< described
hereln, ancl tlrat NO OCCUPANCY will be rrade of any
structure wlthout pertrrisslon of the Buildlng Safety Division'
I further ct..rtlly that orrly contractors and employees who
are ln compliance witlr OFIS 701'055 wlll be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
lrom the street, that the permlt card ls located at the f ront
of the property, ancl the approved set of plans will remain
on the slte all times during construction
Signatu
Date
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut -.- ft
Demolltion
State Surcharge
Total Miscellaneous Permlts (E)
7
a
lr/t
VALIDATION
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY --
TOTAL AMOUNT DUE (excludlng electrlcal
(A, B, C, D, and E Comblned)
/ o,/ q,/q L
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