HomeMy WebLinkAboutPermit Building 1995-09-13SPFlII\lGFIELD RESIDENTIAL PERMIT APPLICATION lnspectlons: 726.3769 Ofllce: 726.3759 LOCATION OF PROPOSED WORK:o ASSESSORS MAP: LOT: PHONE: ot2-ZIP: -r+t\ ar*te-- STATE:\ 4ss -tz-l CITY:E.rc, OWNER; ADDRESS: q3o2-I DEMOLISH OTHER DESCBIBE WORK: NEW-- FIEMODEL X ADDITION ADDFIESS E,j.c q z.so6 CONST. CONTRAoToR #EXPIRES PHONE -G-) CONTRACTOR'S NAME ELECTRICAL: GENEBAL: MECHANICAL: PLUMBING; FIANGE: r OF BDRMS: WATER HEATEB: - OFFICE USE - LAND USE: I OF UNITS: OUAD AREA: * OF BLDGS:FLOOD PLAIN:, ZONING CODE: SECONDARy HEAT: SQUARE FOOTAGE; OCCY GROUP: r OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an lnspectlon made the same worklng n femporary Electrlc Slto lnspecilon - To be madeafter excavatlon, but prlor tosettlng forms. fl:*:,lr"i!,t?i 3i i5, :c r r, c a, / I--l Footlng - After rrenches are - excavated. [-f y-asonu - steet tocaflon, bond - beams, grouilng. f] s[i::#"it,, ;, #tr J:ili,T" fl lrng:tnround ptumbtng _ prlo, - to fllllng trench. fl 3 E:,l,"iJ,?,:ffL,:i' y,T::[,,ff : f-ost a.r.rd Beam _ prlor to floorInsulailon or decklng. Floor lnsutatlon _ prlor tooecKtng. Sanltary Sewer - prlor to fllllngtrench. 31"-rl Sewer - prtor to filtngrrench. Y:l:r.Ltne - prtor to fliltnsrrench. , you fiust call 726-3769. Thls ls a 24 hourday, lnspecilons requested after Z:OO a.m REQUIRED INS [-l nough Mechanlcat - prtor toH cover. ' recordlng. All. lnspecilons . wlll be made, the foilowln PECTIONS requested before 7:00 a.m. wlll beg work day. E 5ll;l'?[T"'j:*' ;"y,1 ;i" il: E 5,',::1,,:fi*::1,, l"H;i",xl. ffi Flnal Mechanlcal _ When all---: mechanlcal work r" "orp"rei"l E F:{ii."'Jif:?g";, # i3,,x,,0 " " "approved and bulldlng l;- --"'. completed. lIl I;#, Electrlcat - Prror to -Electrlca.l .servtce _ Must be 3iJ#ti i'"fl:::'' Permane n t fl rtrentace - prto'r to faclngH matertals and rramrnglispl ffi Framlng - Prlor. to cover. f] y:ttt"blilns tnsutailon - prr.jr.to - cover. ffi orvwalt - Prror to taprng. I Wood Stovo - Aft6r lnstallailon. ln"glt - After ftreplace approvaland lnstallailon of 'unlt. Curbcut & Approach _ Afterrorms are erected but prlor toptacement of concrete. Sldewalk & Drlveway - After i excavailon ls compieto, forms ..and sub.base malerlal in ptace. Fence - When completed. MOBILE HOME INSPE TIONS [-l etocklng and Set.Up _ When ail - blocklng ls complete. Other ffi nouet plumblng - prtor to - cover.fl i*:t"["n;flen arr requrred , IllToinn Connecilons _ whenh.ome has been connectec, towater and sew?r. fl$i#f""'#:#*:#ir,:.an_d the.home ls connected tothe servlce panel. ,li!"t - After alt requiredrn_specilons are appioved and 9"',li,i?: ; iH'.?h., :"T: i, # i .. JoB NUMBE* QS- on.ro 225 Flfth Street Sprlngfleld, Oregon 97477 . (al2 (- \<l t q \ r r E tl nl "iJ l' Lot faces Lot sq. ftg. Lot coverage TopographY Total [elght Lot Typ - - lnterlor - Corner - . Panhandle - Cul-de'sac PL.HSE GAFI ACC N S E S THE PROPOSED WORK IN'THE - HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, thls applicatlon must be slgned and apProved bY the H lstorlcal Coordinator prlor to permit isSuance' APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permit is granted on the express condition that the said consiruction shall, ln all respects, conform to the Ordlnance adopted by the City of Sprlngfleld, lncluding the Development Code, regulating the constructlon and use of bulldings, and may be suspended or revoked at any tlme upon virclation of any provisions of sald ordinances' Plan Check Fee: DatePlans Reviewed BY Receipt Numbe Date Paid: Beceived BY: so. FT. x $/so. FT. - VALUE (A) 5@?'I?g-a+a -ty "2-o l?€ BUILDING PERMIT Total Value Building Permit Foo State Surcharge Total Fee ITEM lv!ain Gaqage Carport Systems Development Charge ls duo on all undeveloped properties wlthln the City limits which are being lmproved'SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Flxtu res,. Residential Bath(s) SanitarY Sewer Water Storm SevYer Mobile Home PLUMBING PERMIT FEE %a ,aLO Zog3 N0 FT. FT. FT, (c)3 ao ltl Plumbirrg Permlt Stato_ Surcharge Total Charge Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent MECHANICAL PERMIT loe t20 ?nZb(D) N0 Mechanical Permit lssuahce State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan By slgnature, I state and agree, that I have caretully examlned the completed appllcatlon and do hereby certlfy that all lnformatlon hereon lS true and correct, and l f urther certlty that any and all work performed shall be done in accordance wlththeordinancesoftheCityofspr|ngfie|d,andtheLaws of the State of Oregon pertalnlng to the work descrlbed hereln, and that NO OCCUPANCY wlll be made o( any structure wlthout permission of the Bulldlng Safety Dlvislon' I further certlry that only contractors and employees who are ln compllance with OBS 701'055 wlll be used on thls proiect. I further agree to ensure that all requlred lnspections are requested at the proper tlme, that each address ls readable from tho strest, that tho psrmlt card ls located at the lront of the property, and the approved set of plans wlll remaln on the slte at all times durlng constructlon' Slgnature Date MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sldewalk -- lt Curbcut -- ft Demolitlon State Surcharge Total Miscellaneous Permits (E) q5t AMOUNT RECEIVED RECEIVED BY DATE PAID C>\boooVALIDATION: BECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Comblned)