HomeMy WebLinkAboutPermit Building 1991-11-22RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PRO
ASSESSORS MAP:
LOT
no\
K:
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97 477
TAX LOT
SUBDIVISION:BLOCK:
OWNER:
ADDR
CITY:
PHON E
ZIP:STATE:
AD ITION
-
DEMOLISH OTHER
DESCRIBE WORK:
NEW X REMODEL
,S NAME ADDRESS EXPIRES PHONE
I
MECHANICAL:
ELECTFIICAL:
CONT
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
RANGEWATER HEATER:
_ OFF]CE USE _
ZONING CODE:
FLOOD PLAIN
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
C OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
LAND USE:
# OF UNITS
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
cover.
Final Plumbing - When allplumbing work is complete.
,K Site lnspection - To be made
after excavation, but prior to
settins forms.fruffAW-
Rough Electrical - Prior to Final Electrical - When atl
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.Electrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When att
mechanical work is complete.
X Footing - After trenches are
excavated.Jd rinat Buitding - When ail
ftrquired inspections have been
approved and building is
completed.
Fireplace - Prior to facing
materials and framing lnsp.Masonry - Steel location, bond
beams, grouting.
(tt'-'ng - Prior to cover'
Foundation - After forms are
erected but prior to concrete
placement.
Other
Wall/Ceiling lnsulation - Prlor to
cover.
Underground Plumbing - Prior
to filling trench.l-l Drywall - Prior to taping
Underf loor Plumbing/ Mechanical
- Prior to insulation or decking.
MOBILE HOME INSPECTIONS
Wood Stove - After installation.
Post and Beam - Prior to floor
insulation or decking.lnsert - After fireplace approval
and installation of unit.
Blocking and Set.Up - When ail
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut &Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected tothe service panel.
Water Line - Prior to filting
trench.l---l Fence - When compteted.
Street Trees - When all required
trees are planted.
Rough Plumbing - Prior to
cover.
7l
I
3RI\\C
\
# OF BDRMS: _
r
tl
E
E
r
I-_l Final - After ail required4 inspections are approved andporches, skirting, decks, andventing have been installed.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
PL.HSE GAR ACC
N
S
E
, THE PROPOSED WOFIK IN THE
HISTORICAL DISTFIICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING PERMIT
ITEM SQ. FT.X $/SQ. FT.VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
qbso
2ps
(A)57., s
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 Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any ton of said ordinances.
Plan Check Fee
Date Paid
Receipt Numbe
Recei
P ewed 1'll^1
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
N0
FT.
FT.
FT.
Plumbing Permit
State Surcharge
Total Charge (c)
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan N0
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
Mechanical Permit
lssuance
State Surcharge
Total Permit (D)
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
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 pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
of the property, and the approved set of plans will remain
on the ufl ruction
Signatu
Date
MlSCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk _- ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
VALIDATION:
RECEIPT NUMBER v/4a
DATE PAID //^7<-7/
AMOUNT RECEIVED
RECEIVED BY
f?.3 ?
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
ta 33
5zF