HomeMy WebLinkAboutPermit Demolition 1999-05-27RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
SPRINGFIELO
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
LOCATION OF PROPOSED WORK:
ASSESSOFIS MAP:TAX LOT:
BLOCK: SUBD|V|S|ONLOT:
PHONE:
ztPSTAIE: d(CITY:
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHER _-
DESCRIBE WORK:
0unna
ADDRESS PHONEflffir 's
ORIS
ENTION:Oreq
trE
THIS THIS
SAT
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
GENERAL:
PLUMBING
RANGF-:SOUARE. FOOTAGE
HEAT SOURCE:SECONDARY HEAT:
WATER HEATER:
QUAD AREA:
* OF BLDGST
OCCY GROUP:
* OF STORIES:
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:OO a.m. will be macle the followlng work ddy.
REOUIRED INSPECTIONS
Temporary Electric
Site Inspection - To be made
after excavatlon, but prior to
setting lorms.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Footlng - After trenchee are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
crcolccl but prlor to oonoroto
placement.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or clecklng.
Post and Beam - Prlor to floor
lnsulation or decklng.
Floor lnsulalion - Prior to
decking.
Sanitary Sewer - Prior to fllllng
trench.
Storm Sewer - Prior to filling
trench.
Water Llne - Prlor to filling
trench.
Rough Plumbing - Prlor to
cover.
Rough Mechanlcal - Prior to
cover.
Rough Electrical - Prior to
cover
Electrical Servlce - Must be
approved to obtaln permanent
glectrlcal power,
Flreplace - Prlor to faclng
materlals and framing lnsp.
Framlng - Prlor to cover.
WalllCelllng lnsulatlon - Prlor to
cover.
l--l Drywall - Prlor to taplng
Wood Stove - After lnstallatlon
lnsert - After flreplace approvql
and installatlon of unlt.
Curbcut & Approaclr - After
forms are erected but prior to
placement of concrete.
Sidewalk & Driveway - After
excavation is com,plete, forms
and sub-base material .ln place.
I--l Fence - When coiilpleted
Street Trees - When all required
trees are planted.
llfrtnrt Bultdlng - Wh€n elt
,}qrequired lnspectlons have been
approved and bulldlng ie
completed.
Eo,n"' Aetuq ?y.
Final Plumbing - When allplumblng worl< is complete.
Final Electrlcal - When all
electrlcal work is complete.
Final Mechanical - When all
mechanical work ls complete.
MOBILE HOME INSPE TIONS
Blocking and Set-Up - When all
blocklng ls complete.
tf
E
tf Plumbing Connectlons - When
home has been connected to
water and sewer.
Eleclrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home ls connected to
the servlce panel.
Flnal - After all required
lnspectlons are approved andporches, sklrting, decks, and
ventlng have been lnstalled.
a 7D7/z
C37AO
oAll obtain
-)!bUf\n
rulesotthe
FLOOD I)LAIN:
ZONING CODE: _
# OF BORMS:-
E
tl
tl
E
E
E
E
E
E
ACCPL.HSE GAR
N
S
E
Lot faces
Lot sg. ftg.
Lot coverage
Topography
Total helght
Lot Typev
-
lnterior
-
Corner
-- Panhandle
-
Cul-de-sac
backs IS THE PROPOSED WOBK TN THE .
HISTORICAL DISTRIC-T, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
arrd approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
VALUE
(A)
nirr
Total Value
Building Permit Fee
State Surcharge
Total Fee
'',. .h
X $/SO. FT.
BUILDING PER
ITEM SO.
Main
Garage
Carport
This permit is granted on the cxpress 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
oulldings, and may be suspended or revoked at any tlm6
upon violation of any provisions of said ordinances.
Fleceipt Number:_
Plans Reviewed By Date
Plan Check Fee:
Date Paid
BUILDING VALUE
AND BUTLDING P
, i5tRu cHEcK
ERMIT
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
5ndd4 ffi t5*
,75 f ,45 l,2o
FEE
---7----
/Q,rc(c)
N'
FT.
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
,
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformation hereon is true and correct, and I f urther cerilfy
that any and all work performed shall be done in accorrJance
with the Ordinanccs of the City of Springfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure wlthout perrnission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 wiil be used on this
proiect.
I further agree to ensure that all required inspections 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, and the approved set of plans will remain
on the site at all times during construction.
Date
Xnnr,,
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobite Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surcharge
Total Miscellaneous Permits (E)
(D)
44
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, Q and E Comblned)
VAI.IDATION
RECEIPT NUMBER 03rzr
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
z f f
Received By:
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