HomeMy WebLinkAboutPermit Building 1995-08-07SPlIINGFIELD
RESIDEMTIAI, PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMT'NITY SERVICES DIVISION
BUILDING SAFETY
Page 1
Job Number: 951108
225 North Fifth Street
Springfj-eld, OR 97477
Location of Proposed Work: 450 S 43RD ST
Assessors Map #: 1-7023234
Lot: Block:
Office:
Inspection Line:
't25-37 59
725 -37 59
Tax Lot #: 02900
Subdivision:
O$,neT: KEVIN CHAPPELL
AddresS: 450 SOUTH 43RD STREET
Phone #: 745-6362
Citylstate/zj-p: SPRINGFIELD, OREGON 97477
Describc WOrK: UTITITY RM ADDITION ADDITION
General:
Plumbing:
Mechanical:
El-ectrical:
ConUractor
OWNER
OWNER
OWNER
OWNER
Const.
Contractor #Expires Phone
7 46 - 5352
QUAD AREA: 3RSC
# OF UNITS: 1
CONSTR. TYPE: VN
SQ FOOTAGE: 158
-- OFFICE USE --
LAND USE: 1111
ZONING CODE: LDR
HEAT SOURCE: FG
# OF BLDGS: 1
OCCY GROUP: R3
WATER HEATER: G
To requests an inepection, call the 24 howr recording aL 725-3759.
A11 inspections requested before 7:00 a.m. will be made the same working day,
j-nspections requested after 7:00 a.m. will be made the foflowing work day.
--- REQUTRED TNSPECTTONS ---
FOOTING - After trenches are excavated.
ITNDERFLOOR DRAIN - Prior to cover or placement of concrete.
STORM SEWER LINE - Prior to filling trench.
ROUGH PLWBING - PriOr IO COvCr.
ROUGH ELECTRICAL - Prior to cover.
ROUGH MECIIAIiIICAL - Prior to cover.
ROUGH cAS - after line is installed and capped if not attached Lo an
appliance
FINAL GAS - When all gas work is complete.
FRAMNG - Prior to cover.
fNSULATION - Fl-oor; prior to decking Wa11/Ceiling; Prior to cover
DRYfiIALL - Prior to taping.
FINAL PLITMBING - When all plumbing work is complete.
FINAL MECHAIiIICAL - When all mechanical work is complete.
FINAL ELECTRICAL - When all electrical work is complete.
FINAL BUILDING - When all required inspections have been approved and
the buil-ding is complete.
--- BUILDTNG PERMIT ---
Square Feet xItem
Main
Garage
Value
0.00
0.00
$/Square Feet
SPRINGFIELE,
Job Number: 951108
CITY OF SPruNGFIELD,
Page 2
158 56.2 9 ,442
9 ,442
00
00
ADDITION
Total Value
Building Permit Fee
Surcharge/admin
TOTAL FEE (A)
80.50
6 .45
86 .95
--- PLI'MBING PERMIT ---
ftem
Fixtures
Storm Sewer
Ptumbing Permit
Surcharge/edmin
TOTAL CHARGE
3
Fee
30.00
2s.00
55.00
4.40
59 .40(c)
--- }IECIIN{ICAI. PER}IIT ---
Furnace
Dryer Vent
Mechanical Permit
Issuance
Surcharge/edmin
TOTAI, PERMIT (D)
0.00
3.00
26.20
15.00
10.00
a.20
--- MISCEI.LAT{EOUS PERMITS ---
Surcharge/admin
SDC
ELECTRICAL
TOTAI. MISCELI,A}IEOUS PERMITS (E)
0.00
9 .25
46.44
55.70
(ExcLuding Electrical )
unless otherwise notsed
.-- TOTAL AI{OI'NT DUE ---
(A, B, C, D, and E courbined)228.2s
-.- BUILDING VAI.UE, PI.AN CHECK NiID BUII,DING PER}TIT ---
This permit is granted on the express condition that the said construction
shall, in afl respects, conform to Ehe Ordinance adopted by the City of
Springfield, including the Development Code, regulaEing 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 Fee: 52.33 Date Paid:
Received BY:
Plans Reviewed By: Date:
Building Site Reviewed By: LISA HOPPER
o7/os/es
08/04/es
Receipt Number: 18189
--- ADDITIONAL COMMENTS
PATH 1
By eignature, I at,ate and agree, that I have earefully examined
tshe completed application and do hereby certify tshat all information hereon
is true and correct, and I further cerLify thaE any and all work performed
shall be done in accordance with the Ordinances of the City of Springfield,
and the Laws of the SEate of Oregon pertaining to the work described herein,
and that NO OCCUPANCY will be made of any structure without permission of the
Communitsy Services Divi-si-on, Building Safety. I further certify that only
contractors and employees who are in compliance with ORS 70L.055 will be
used on this project.
SPFIINGFIELD
,Job Number: 951108
CITY
Page 3
I further agree to ensure that all reguired inspections are request ed at Lhe
proper time, Ehat each address is readabl-e from the street, that the permit
card is located aE the front of the properEy, and Ehe approved set of plans
wil-l- remain on the site at a]l times during construction.
,u4 / -7_ 7f
Signature Date
--- VAI.IDATION ---
Receipt Number:
Date Paid:
Amount Received:
Received By:
&.---4<-
=-'-- =;
^
Address
a
Issued by:
Statemeht: lnformation Notice to Property Owners
About construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
foltowing statement bi1or" o building permit can be issued. This statement is required
"for
resiiential buildiig, electrical, mechanical, and plumbing permits. Licensed
architect and engineer-applicants, exempt from registration under oRS 701'010(7),
need not submit this statement. This statement will be filed with the permit'
Fill in the appropriate blanks and initial boxes I and2, and either box 3A or 38:
B 1. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or uPon comPletion.
3,A'. My general contractor is
Contractor regis' #
structure must be
(Name)
I will instruct my general contractor that all subcontractors who work on the
registered with the Construction Contractors Board'
B 38. I will be my own general contractor
OR
name of the contractor.
I hereby certifY that the above information is correct andthatl have readand dounderstand the Information
Notice to ProPertY Owners about Construction Responsibilities on the reYerse side of this form'
a-
(Signature of Permit applicant)
If I hire subcontractors, I will hire only subcontractors registered with the construction contractors
Board. If I change my mind and hire a general contractor,^I will contract with a contractor who is
registered with the cig ana wil immedira"ty notify the office issuing this building permit of the
(White copy to issuing agency perrnitfile'
Pink coPY to aPPlicant)
(Date)
Permit +, 7-{ -
?-7?2.";