HomeMy WebLinkAboutPermit Building 1998-03-17SPRIhIGFIELI)
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726-3759
LOCATIO N OF PROPOSED WORK:
Q(e zz--
82.37
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
TAX LOT 0 )-voD
\
t( 0). 0b I 1_ASSESSORS MAP:
LOT BLOCK:SUBDIVISION
HONE:
ZIP:STATE:
OWNER:
CITY:
A
*=* x REMODEL ADDTT|ON DEMOLTSH orHER
DESCRIBE WORK:
EXPIRESDDRESS
CONST.,sRf ONH E
g€CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
ELECTBICAL:
v /F
F
r OF BDRMS:
BANGF.:
ZON,ING CODE:
WATER HEATER
FICE USE _
CONSTFI.
SECONDARY HEAT:
SOUARF. FOOTAGE:
QUAD AREA:
r OF BLDGS:
OCCY GROUP:
* OF STORIES:
To request an inspectlon, you must call 726-3769' Thls ls a 24 hour recording' All
made the same worklng day, lnspections requested after 7:oo a.m' will be made
REOUIRED INSPECTIONS
inspections requested before 7:00 a.m. wlll be
the followlng work daY,
f] remnorary Electrlc Rough Mechanlcal - Prlor to
cover.
al Plumbing - When all
plumbing work is complete.
[-l Site lnsPectlon - To be madelJ after excavation, but Prior to
setting forms.
Rough Electrical - Prior to Final Electrlcal - When all
electrical work is complete.cover.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Electrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Final Mechanlcal - When all
mechanical work ls complete.
E Foollng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
Flnal Buildlng - When all
required lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prior to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Celling lnsulation - Prlor to
cover.
Underground Plumblng - Prior
to filllng trench.I-l Orywall - Prlor to taping
E Underlloor Plumblng / Mechanlcal
- Prior to insulatlon or decklng.
MOBILE HOME INSPE TTONS
Wood Stovo - After lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or decking.lnsert - After flreplace approvql
and lnstallatlon of unlt.
Blocking and Set.Up - When ailblocking ls complete.
Floor lnsulation - Prlor to Plumblng Connectlons - When
home has been connected to
water and sewer.
s.Curbcut & AJrproach - After
forms are erected but prior to
placement of concrete.Sanitary Sewer - Prior to fllling
trench.Electrical Connection - When
blocking, set.up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Stonn Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Llne - Prlor to filling
trench,[-l Fence - When cottpleted
$lreet Trees - When all required
trees are planted.
Flnal - After all required
inspections are approved andporches, sklrtlng, decks, and
ventlng have been lnstalled,
E
Rough Plumblng - Prior to
cover.
FLOOD PLAIN:
HEAT SOURCE: ---
E
L\til. /- a
E
E
fl
E
E
L]
E
tl
E
tl
E tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Tyt
-
lnterior
-
Corner
-
Panhandle I
-
Cul-de-sac
ks
PL.HSE GAR ACC
N
S
E
IS THE PROPOSED WORK TN THE .
HTSToR|CAL DISTR|CT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcailon must be slgnedand approved by the Historlcal
Coordinator prior to permit issuance.
APPFIOVED:
BUILDTNG PERMIT
SO. FT.VALUE
(A)
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
i, .t
x $/sQ. FT.
Py.[D_tNG VALU e, irRrrrAND BUILDING P'ERMIT
This permit is granted on the express condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City . of Springfield, inctuding theDevelopment code, regulating ine Jonstiuciion and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances.
P.lan Check Fee: .-
Dlte paid:
DatePlansReviewed By
Receipt Numbe
Receive<J By
CH ECK
DEVELOPMENT CHARGE (SDC)
(B)
SYSTEMS
Systems Development Charge is due on all undevelopedproperties within the City limits which are being improved.
ITEM
Fixtures
Residentiat Bath(s)
Sanitary Sewer
Waler
Storm Sewer
Moblle Home
PLUMBING PERMIT
N'
&h)e-
FEE
b
FT.
FT.
$TL -l-7Ni-
(c)
40
C:/,I.JD
Total Charge
Plumbing permlt
State Surcharge + C,Ca L
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Un it
Dryer Vent
MECHANICAL PERMIT
(D)
No
Mechanical Permit
lssuance
State Surcharge
Total Permit
Furnace
Exhaust Hood
Vent Fan
By slgnature, r state and agree, that r have carefuily examrnedthe completed application and do hereby certify that allinformation hereon is true ancl correct, and Lurther cerilfy
that any and all work performed shall be done in accordancewith the Ordinanccs of the City of Springfield, and the Lawsof lhe State of Oregon pertaining to the work describedherein, and that NO OCCUPANCy will be made of any
structure wlthout perrnission of the Buildirrg Satety Divislon.I further certify that only contractors and enrployees who
are in compliance with OBS 701.055 will be used on thisproiect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will
on the site at all times during constructi
?7*/'o"t"
n
YSignature
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Perrnits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, g D, and E Combined)
VALIDATION:
RECEIPT NUMBER
DATE PAI[)3-r1-7
AMOUNT BECEIVED
RECEIVED BY