HomeMy WebLinkAboutPermit Building 1999-11-02SPRINGFIELO
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Offlce: 726-3759
LOCATION OF PROPOSED WORK:
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afi,
JOB NUMBER
225 Fifth Street
Sprlngf leld, Oregon 97477
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ASSESSORS MAP:t?o
LOT BLOCK:
TAX LOT ooToo
OWNER:PHONE:
STATE:ZIP:CITY:
ADDRESS:
' 71(7
q7 ?7 t
ce(L
TA,a ps/a y
NEW
-
BEMoDEL 1t ADDrrroN DEMoLTSH orHER
b7,(.o Z - 2r^/,rlrac u fl*tsDESCRIBE WORK:
ADDRESS
C/cn,J
zac- (tt/
to
a9
' C/o../r- 4. t A,-
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICALI
ELECTRICAL:
.f PHONE
72 6- SJCa
CONST.
CONTRACTOR # EXPIRES
/o zL, T /y'a,t
THIS
1
tcil
SECONDARY HEAT:to{
ceFl SQUABE. FOOTAGE:
ZONING CODE:
- OFFICE USE -
WATER H
TYPE:* OF BDRMS:
,\o$l\
HEAT SOURCE:
RANGE:
FLOOD I)LAIN
OCCY GROUP:
*,OF STORIES:
OUAD AREA:
* OF BLDGS:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll bemade the same worklng day, lnspectlons reguested af ter 7:00 a.m. wlll be made the followlng work day.
REOUIRED INSPECTIONS
l--l temporary Electrlc Rough Mochanlcat - Prlor to
cover.
Flnal Plurrrblng - When altplumblng worl< is complete.
Slte lnsp€ctlon - To be mado
after excavatlon, but prlor to
setting forms.
l-l Rough Electricat - prtor tot----J cover.Final Electrlcal - When allelectrlcal work is complete.
E Underslab Plumblng/ Electrlcal /
Mechanlcal - Prlor to cover.E Electrlcal Servlce - Must be
approved to obtaln permanent
olectrlcal power,
Final Mechanical - When allmechanlcal work is complete,
- After trenches are
f-l Flreptaoo - prior to facing
-
materlals and framing lnsp.
Buildlng - When all
ulred lnspectlons have been
l-l Masonry - Steel tocatlon, bondu boams, groutlng.
approved and building is
completed.
- Prlor to cover.
n - After forms are Olher
erected but prlor to concreteplacemont./Celllng tnsutatlon - prlor to
l-l Unaerground plqmblng - prior.- to fllllng trench,I - Prlor to taplng
Underlloor Plumblng / Mechanlcat
- Prlor to lnsulatlon or ctecklng.
MOBILE HOME INSPE TIONS
Wood Stovo - Alter lnstallatlon.
Post and Beam - Prlor to floorlnsulatlon or decklng.l-_| tnsert - After flreplace approval
-
and lnstallatlon of unlt.
l-_l Blocking and Set.Up - When ail.J blocklng ls complete.
Floor lnsulallon - prlor to
decklng.Curbcut & A1:proaclr - After
forms are eru:cted but prlor toplacoment of concrete.
Plumbing Connectlons - Whenhome has been connected towater an<J sewer.l-l Sanltary Sewer - Prtor to fliltng
-
trench.
l-l Storrn Sewer - Prlor to fllllng
-
trench.
Sidewalk & Driveway - After
excavatlon ls complete, for.msand sub-base materlal ln place.
Electrical Connection - When
blocklng, set.up, and plumblng
rnspecuons have been approvedand the home is connected tothe servlce panel.
[-l Warer Llne - prtor to fiillng
-
trench.l-_l Fence - lvhen coinpleted.
Rough Plumblng - Prlor to
cover.
Flnal - After all requiredlnspectlons are approved andporchos, sklrtlng, decks, andventlng have been lnstalled.
[-_l Street Trees - When ail roqutred
-
troes are planted.
SUBDIVISION: -
.- .1,
!ou
.t\
EE
P.L.GAR ACC'HSE
N
S
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type *
-
lnterlor
-
Corner
-
Panhandle !
-
Cul-de-sac
(- IS THE PROPOSED WORK TN THE .- HrsroBrcAL DtgTRtcT, oR oN
THE HISTORICAL REGISTER?
lf yes, thls appllcatlon must be slgned
and approved by the Hlstorlcal
Coordlnator prlor to permlt lsguance,
APPROVED:
BUILDING LAN CHECK
AND BUILDING P
,
E RMIT
Thls permlt is granted on the express conditlon that the said
construction shall, ln all respects, conform to the Ordlnance
adopted by the City of Sprlngfleld, includlng the
Development Code, regulating the constructlon and use of
oulldings, and may be suspended or revoked at any tlme
upon violation o
Plan Check Fee:
Date Paid
Receipt Numb
f any provifz slons of sald ordlnances.
3
Recelved fll:ATO
Plans Reviewed By Date
Systems Development Charge ls due on all undeveloped
properties wlthln the City limlts which are belng lmproved.
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done ln accordance
wlth the Ordinances of the Clty of Sprlngfield, and the Laws
of the State of Oregon perlalnlng to the work descrlbed
hereln, and that NO OCCUPANCY will be made of any
structure wlthout perrnission of the Bullcllng Safety Dlvlslon'
I further certify that only contractors and employees who
aro In compllance with ORS 701.055 wlll be used on thls
prolect.
I further agree to ensure that all requlred lnspections are
requested at the proper tlme, that each address ls readable
from the street, that the permlt card ls located at the front
of the property,the set of plans will remaln
on the slte at imes rl constructlon
Slgnature
Date
a,L*
VAI.IDATION
BECEIPT NUMBER 0
DATE PAID 11
AMOUNT RECEIVED
SQ. FT. X $/SO. FT. = VALUE
BUTLDING PERMTT
( t.gf(A)
o(^
fi rou
,.
..1
@.rl
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ITEM
Fixtures
Residentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N'
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
. FT.
Wood Stove/ lnsert/Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
(D)
N0
Mechanical Permlt
lssuance
State Surcharge
Total Permlt
Furnace
Exhaust Hood
Vent Fan
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
--
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Miscellaneous Perrnits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Comblned)RECEIVED BY
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