HomeMy WebLinkAboutPermit Building 1994-09-06RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT:
?/a/s/JOB NUMBER
225 Fifth Street
Spri ngfield, Oregon 97 477
TAX LOT:s70u
SUBDIVISION:
k
BLOCK:
PHONE:
ZIP:STATE:D{2-
OWNEFI:
ADDRESS:
CITY:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
PLUMBING:
MECHANICAL:
ELECTRICALi
ADDRESS EXPIRES PHONECONTRACTOR'S NAME
GENERAL:
CONST.
CONTRACTOFI #
- OFF]CE USE -
WATEFI HEATER
FLOOD PLAIN
* OF UNITS:
RANGE:
QUAD AREA:
# OF BLDGS
SECONDABY HEAT:
SQUARE FOOTAGE:
LAND USE:
OCCY GROUP:
# OF STORIES
ZONING CODE:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. Thls ls 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
l-l Temporary ElectricL---J
Site lnspection - To be made
after excavation, but prior to
setting forms.
Underslab P!umbing/ Electrical/
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
Underf loor Plumbing/ Mechanical
- Prior to insulation or decking,
Post and Beam - Prior to floor
insulation or decking.
Floor lnsulation - Prior to
decki ng.
Sanitary Sewer - Prior to f illing
trench.
Storm Sewer - Prior to filling
trench.
Rough Mechanical - Prior to
cover.
Rough Electrical - Prior to
cover.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Fireplace - Prior to facing
materials and framlng lnsp,
Final Plumbing - When allplumbing work is complete.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.
Final Building - When att
required inspections have been
approved and building is
completed.
MOBILE HOME INSPE TIONS
Blocking and Set-Up - When ail
blocking is complete.
Plumbing Connections - When
home has been connected to
water and sewer.
,WFraming - Prior to cover'
Wall/Ceiling lnsulation - Prior to
cover.
[-_l orywal] - Prior to taptng
Wood Stove - After installation.
lnsert - After fireplace approval
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected but prior toplacement of concrete.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base materlal in place.
Electrical Connection - Whenblocking, set-up, and plumbing
Inspections have been approved
and the home is connected tothe service panel.
l--l Water Line - Prior to fiiling
-
trench.l-l fence - When compteted.
Rough Plumbing - prior toCOVer. I i--l Street Trees - When all required
-
trees are planted.
Final - After all requiredinspections are approved andporches, skirting, decks, andventing have been installed.
# OF BDRMS:
-.=..-_-
E
E
fl E
Other
-
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
ks i ,.nT PROPOSED WOfIK IN THE
HISTORICAL DISTRICT, bN OT.I
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
P,L.HSE GAR ACC
N
S
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
constructlon 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.
Plans Reviewed BY Date
Plan Check Fee 2q07
Date Paid:
Receipt Num
Received By:
VALUE
^?ao
(A)
X $/SQ. FT,
2?aoTotal Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanltary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N0
FT.
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
(D)
N0
Mechanical Permit
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certlfy 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 ln compliance with ORS 701.055 will be used on this
project.
I further 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
Date
on the slte at all times duri constructi on.
Slg natu re
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk .- ft
Curbcut
--
ft
Demolltion
State Surcharge
Total Miscellaneous Permits (E)- {o,?J.
ED
BECEIVED BY
AMOUNT R
DATE PAID
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding electrical)
(A, B, q D, and E Comblned)
a
5i)
3