HomeMy WebLinkAboutPermit Building 1991-11-25RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
INGFtELfI \
JOB NUMBER o.i9
h,225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK:q2 3 tUo /t!/- .t
ASSESSORS MAP / 7o a_3 72q J oTAX LOT:
LO-n BLOCK:SUBDIVISION:
-OWNER:D PHONE:?//' 5z s-/
ADDRESS:a 2
CITY:STATE:./rztP
DESCRIBE WORK .S-e c-tJ\)>t- Y-
NEW- REMODEL ADDITION DEMOLISH OTHER-
CONTRACTOR'S NAME ADDRESS
CONST.
CONTBACTOFI #EXPIBES PHONE
GENERAL:
PLUMBING
,r) /l D <-.tr-.
MECHANICAL:
ELECTRICAL
_ OFF]CE USE _
QUAD AREA:
II OF BLDGS:
LAND USE:
I OF UNITS:ZONING CODE:
OCCY GROUP:
I OF STORIES:
CONSTR. TYPE
HEAT SOURCE:
I OF BDRMS:
WATER HEATER:RANGE:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m, will bemade the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
Rough Mechanical - Prior to
cover.
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.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When alt
mechanical work is complete.
inal Building - When alt
Fireplace - Prior to faclng
materials and framing lnsp.
required inspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, grouting.Framing - Prlor to cover.
Foundation - After forms are
erected but prior to concrete
placement.
Other , (z ,-.t q..- Co- V
Wall/Ceiling lnsulation - Prior to .<"*t,. ;;/r"J
cover.,r 7
Underground Plumbing - Prior
to filling trench.l--l Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
Wood Stove - After installatlon
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.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.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Slorm Sewer - Prior to Iilling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Line - Prior to filling
trench.
Fence - When completed.
Streel 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.
o
.f.ar tn *(dtz/)6,/-(T)
FLOOD PLAIN:
fl Temporary Electric l-_l Final Plumbing - When ail
'J plumbing work is complete.
E
f_l Underslab Plumbing/ Electrical/
" Mechanical - Prior to cover.
fl Footing - After trenches areu excavated.
tf
E
tl
E
E
E
tl
E
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.
E
E
fl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L.HSE GAR ACC
N
J
E
S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
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.
Receipt Number:-
DatePlans Fleviewed By
Plan Check Fee:
Date Paid:
Received By:
BUILDING PERMIT
ITEM SQ. FT. X $/SO. FT.VALUE
hrno-
(A)/U e-
-&,**'= -1/e
Total Value
Building Permit Fee
State Surcharge
Total Fee
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)
ADDTTIONAL COMMENTS
Y\A
ITEM
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
S.yto fu','nA * F't
FEE
7J
/ ,f- 75(c)
No
FT.
FT.
Gt. /s1 o o
PLUMBING PERMIT
Plumbing Permit
Statc Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
(D)
N0Vent Fan
Mechanical Permlt
lssuance
State Surcharge
Total Permit
M ECHANICAL PERMIT
Furnace
Exhaust Hood By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
lnformation 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 Springf ield, 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 OBS 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
{rom the street, that the permit card is located at the front
of the property, and the approved set of plans will remaln
on the site at all times during construction.
Date lL:?'Ql
Signature
MTSCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk ---- ft
Curbcut
-
{t
Demolition
State Surcharge
Total Miscellaneous Permits (E)
VALIDATION:
RECEIPTNUMBER 3/43
///z{,/eDATE PAID
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
AMOUNT RECEIVED
BECEIVED BY
v 7 ?'-
FT.