HomeMy WebLinkAboutPermit Building 1991-10-11GFIELE,
RESIDENT!AL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
?//zo
4Co
JOB NUMBER
225 Fifth Street
Spri ngf ield, Oregon 97 477
TAX LOT:
SUBDIVISIONLOT:BLOCK:
/
PHONE:
ZIP:
,
STATE:CITY:
ADDRESS
OWNEFI:
au Ro| Reoa-ttt
DEMOLISH OTHEFI
J-
ADDITION
ADDRESS '?70 EXPIRES
F.,<)
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
PHONE
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
RANGE:
* OF BDRMS:
_ OFFICE USE _
LAND USE:FLOOD PLAIN:
WATER HEATER
* OF UNITS:
SECONDARY HEAT
SQUARE FOOTAGE:
QUAD AREA:
,T OF BLDGS:
OCCY GROUP:
# OF STORIES
CONSTR. TYPE:
HEAT SOURCE:
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.
REOUIRED INSPECTIONS
l---l Temporary Electric
ll
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 /
Mechanical - Prior to cover.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When all
mechanical work is complete.
Footing - After trenches are
excavated.Fireplace - Prior to facing
materials and framing lnsp.
p{ rinat Buildins - When all/A(equired inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.(rr"-ing - Prior to cover.
OtherFoundalion - After forms are
erected but prior to concrete
placement.Wall/Ceiling lnsulation - Prior to
cover
Underground Plumbing - Prior
to filling trench.f_-l Drywall - Prior to taping.
MOBILE HOME !NSPECTIONS
Underf loor Plumbing / Mechanical
- Prior to insulation or decking.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 all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcul & 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.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Line - Prior to filling
trench.l--l Fence - When completed.
Slreet Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.Rough Plumbing - Prior to
cover.
Dt ?an
DESCRIBE WORK:
NEW-. REMODEL
ZONING CODE:
-
E
E
tl
Er
E
r
E
r
E
tf E
E
tl
I
r
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 WORK IN THE
HISTORICAL DISTRICI OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
VALUE
10>*
/{@
/ 5.7s(A)
X S/SO. FT.
,7r
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
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 provisions of said ordinances.
Plan Check ,.., W
Plans Reviewed By Date
Receipt Numbe
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N0
FT.
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood 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
project.
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 site at all times during construction.
?Date
Xsignrt*e
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
7f
? /{LJ
7t0
AMOUNT BECEIVED
RECEIVED BY
DATE PAID
VALIDATION:
RECEIPT NUMBER