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Home My WebLink AboutPermit Building 1995-09-14SPRI]tGFIELD RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WOBK: ASSESSOBS MAP: LOT: t'lo ,// JOB NUMBER TAX LOT: BLOCK: PHONE: APSTATE:ZIP: /6 *8663 CITY: ADDRESS: OWNEB; ADDITION DEMOLISH OTHER DESCBIBE WOR NEW- REMODEL COcoADDRESS EXPI RES PHONE ouryl er Oun e{ o u)flsa c' T N NCONTBACTOR'S NAME GENERAL:Oatfl 97 PLUMBING: MECHANICAL; ELECTRICAL: T. FIACTOR # rp-- - OFFICE USE - E OF BDRMS: RANGE: OCCY GFIOUP: ZONING CODE: FLOOD PLAIN r OF UNITS: LAND USE: WATER HEATER: r OF STORIES:SECONDARY HEAT: SOUAFIE FOOTAGE: CONSTR. TYPE: HEAT SOURCE: QUAD AREA: I OF BLDGS: To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requested before 7:OO a.m. wilt bemade the same worklng day, lnspections requested after 7:00 a.m. will be made the following work day, REQUIRED INSPECTTONS Temporary Eleclrlc Rough Mechanlcal - Prlor to cover.-K Flnal Plumbing - When allplumblng worl( is complete. Slte lnspection - To tre made after excavation, but prior to setting forms. Rough Electrical - Prlor to cover.Flnal Electrical - When all electrlcal work ls complete. Underslab Plumblng / Electrical / Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be approved to obtaln perfllanent electrlcal power. Final Mechanical - When all mechanical work ls complete. Footlng - After trenches are excavated.ffflnat Building - When ail ,f-'\requlred I nspecilons have beenapproved and bullding is completed.Masonry - Steel locatlon, bond beams, groutlng, Flreplace - Prlor to facing materlals and framing lnsp. fr ttut"''g - Prlor to cover' Foundatlon - After forms are erected but prlor to concrete placement.Wall/Celling lnsulation - prior to cover. E l'Jffil:;'i;lJJ."tins - Prior [-l orywail - prror to tapins. l-_l Unaerlloor Plumblng/ Mechanicat Prior to lnsulatlon or decking. MOBILE HOME INSPECTIONS Wood Stovo - After lnstallatlon Post and Boam - Prlor to lloor lnsulatlon or decklng,lnserl - After flreplace approvqland lnstallatlon of unlt. Blocking and Set.Up - When allblocklng ls complete. Floor lnsulatlon - Prlor to decklng.Curbcut & Approach - After forms are erected bUt prior toplacoment of concrete. Plumbing Connections - Whenhome has been connected towater and sewer, l-l Sanltary Sewer - prior to filing - trench. I-_l Storm Sewer - prior to fiiling - trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Electrlcal Connectlon - Whenblocking, set-up, and plumbing /nspections have been approvedand the home ls connected tothe servlce panel.Water Llne - prtor L ,,,,,nn trench.Fence - When completed E Rough Plumblng - prior to cover,I-l Street Trees - When ail required - trees are planted, Final - After all requiredrnspections are approved andporc.hes, sklrilng, decks, andventing have been installed. 225 Fifth Street Spring(leld, Oregon 97477 7so , ^ /A SUBDIVISION: - lAausn fl u);tTS df,trul I tl E [_-l otnerll I lsT Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type -- lnterior _- Corner - Panhandle - Cul-de-sac PL.HSE GAR ACC N S E HE PFIOPOSED WORK IN THE.HISTORICAL DISTBIST, OR ON THE HISTORICAL REGISTER? - lf yes, thls applicailon must be slgnedand approved by the Hlstorlcal Coordinator prior to permit issuance. APPROVED: BUILDING PERMIT VALUE 4 tt-? /eE- z.*3 + /,7o (A) €o S3 SQ. FT, X S/SQ. FT.ITEM Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee Q33 qutLDtNG VALUE, PLAN CHECKAND BUILDING PERMIT This permit is granred on the express condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfield, lnctudlng theDevelopment Code, regulating the construction and use ofbulldings, and may be suspended or revoked at any tlmeupon violatlon of any provisions of sald ordinances. Pran check ree: .47t) P ,Z&lzza fr€ z v: ewed Received Plan Date Paidl Receipt Number SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within tlre City limlts which are being lmproved. Fesidential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT FEE .7f *,15 (\,) N0 // 2A/t?; LO 6roPlumbing Permit State Surcharge Total Charge ITEM Fixtures ADDITIONAL COMMENTS MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan No Wood Stove/ lnsert/ Fi replace Unit Dryer Vent aza>) ry*7x{ e*rytsc7 Mechanlcal Permit lssuance State Surcharge,Tf*r45 Total Permlt (D) 24),-P /e,.-_ zo 't/ b'l? t By slgnature, I slate and agree, that I have carefully examlned the compteted application and do hereby cerilfy that all lnformatlon hereon ls true and correct, and I f urther cerilfy that any and all work performed shall be done ln accordance wlth the Ordinances of the City of Sprlngfield, and the Laws of the State of Oregon pertalnlng to the work descrlbed hereln, and that NO OCCUPANCy wlll be made of any structure wlthout permission of the Bullding Safety Dlvislon. I further certify that only contractors and employees who are ln compllance with ORS 7Oj.OS5 wlll be used on thls project. I further agree lo ensure that all requlred lnspections are requested at the proper ilme, that each address ls readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans wlll remaln on the site all times s Date rdctlo >Z/ Slgnatu MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolitlon State Surcharge Total Miscellaneous Permits (E) 9G ,73 TOTAL AMOUNT DUE (excluding electricat) (A, B, C, D, and'E Combined) VALIDATION: FIECEIPT NUMBER DATE PAID AMOUNT FIECEIV FIECEIVED BY -ri;: r : - slsoa" FT- FT. FT. Permit #: Address Date: d t4qsIssued Statement: 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 following statement before a building permit can be issued. This statement is required for residential building, 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 3B: l. 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 (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. 38. I will be my own general contractor 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 CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above informationis correct and thatl have read and do understand the Information Construction Responsibilities on the reverse side of this form. 6 OR (Signature of permit (White copy to issuing agency perrnit file, pink copy to applicant) Notice to a (Date) q