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Home My WebLink AboutPermit Building 1999-01-05RESID ENTIAL PERMTT APPLTCATTON I ns pectiortsr 726-3769 Office: 726-3759 - LOCATION OF PROPOSED WORK:26/2 A/ Z .JOB NUMBER 225 Fifth Street Springfleld, Oregon 97477 111zsiASSESSORS MAP: LOT - BLOCK:SUBDIVISION TAX LOT:D/1oo NEW- REMODEL ADDITION DEMOLISH OTHER- S7e PHONE: nr<ZIP: d+t .7 .>) STATE: 71{/-/f2ffu^ 7 CITY: DESCRIBE WORK: ADDRESS: OWNER: 2uru.orz ADDRESS EXPIRES .A PHONECONTRACTOR'S NAME GENERAL: PLUMBING: MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # OUAD the@regurnlJtil PE: - oFFlcEAfftNrroN:oregon law requires you to LAND USE: - follow rules adopted by Notification Center.# OF BLDGS: - 'r OF UNTTS:ffi10 occy cd5{,ff0Rizrp UNpEF ri_tls pERMiE&l*gh. rv # OF STORIES: -- HEAT SOURCE: NAY PFH,INN WATER HEATER:RANGE:__ Centeris 1-800-gsaag*f)roorece: To request an lnspectlon, you must call 726-3769. Thls ls a24hour recording. All lnspections requested before 7:00 a.m. wlll be made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day. UIRED INSPECTIONS ugh Mechanical - Prior to Plumbing - When alt bing worl< ls complete. l-l Site tnspectlon - To lre made|J after excavatlon, but prlor to settlng forms. l-l Rough Electrical - Prior tol---J cover.Final Eleclrlcal - When alt electrical work is complete. tl Underslab Plumblngl Electrlcal / Mechanlcal - Prlor to cover.Electrical Servlce - Must be approved to obtaln permanent electrlcal power. Final Mechanlcal - When all mechanical work ls complete. Footlng - After trenches are excavated.Flreplaco - Prlor to faclng materlals and framlng lrrsp. Flnal Building - When all reguired lnspectlons have been approved and building is completed.Masonry - Steel locatlon, bond beams, groutlng,Framlng - Prior to cover.€^5 Foundatlon - After forms are erected but prlor to concrete placoment. E Other Wall/Celllng lnsulatlon - Prlor to cover. Undorground Plumblng - Prlor to flltlng trench.Drywall - Prlor to taplng MOBILE HOME INSPE TIONSUnderlloor Plumblng/ Mechanlcal - Prlor to lnsulatlon or decklng.Wood Stovo - After lnstallation Post and Beam - Prlor to ,loor lnsulatlon or decklng.- After flreplace approval Blocking and Set-Up - When ail blocklng ls complete. lnstallatlon ol unlt. Floor lnsulatlon - Prior to decklng.Curbcut & A]rproaclr - After forms are erected but prior to placement of concrete. Plumbing Connectlons - When home has been connected to water and sewer. Sanitary Sewer - Prior to fllllng trench.Electrical Conneclion - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the servlce panel. Slorm Sewer - Prlor to fllllng trench. Sidewalk & Driveway - After excavation ls complete, folms and sub-base material in place. Water Llne - Prlor to filllng Fence - When ccilpleted. Streel Trees - When all requlred trees are planted. Final - After all required lnspections are approved and porches, sklrtlng, decks, and ventlng have been lnstalled. h. Plumblng - Prlor to €q+z 7 n temporary Electrlc E tl tl tf tl E E E fl tl ,l Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type - - lnterior -_ Corner .- Panhandle i - Cul-de-sac Setbacks P.L.HSE GAR ACC N I I S E (-rS THE PROPOSEO WORK tN THE . HtsToEtcAL DtsTRlcr, oR oN THE HISTORICAL REGISTER? - lf yes, thls appllcatlon must be slgned arrd approved by the Historlcal Coordinator prlor to permlt issuance. APPROVED: BUILDING PERMIT VALUE (A) i ITEM Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee SQ. FT. X $/SQ. FT. BUILDING TAIIIE, FMru 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 Springlield, includlng the Development Code, regulating the construction and use of ouildings, and may be suspended or revoked at any tlme upon violation of any provisions of sald ordinances. Receipt Number:- Plans Fleviewed By Date Plan Check Fee: Date Paid Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge ls due on all undeveloped properties wlthin the City limits whioh are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT FEE /{ /f. o, /o Nc FT. FT. (c) ?s 7r 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 certlfy that any and all work performed shall be done in accordance with the Ordinances of the City of Spdngfield, and the Laws of the State of Oregon pertalnlng to the work descrlbed herein, and that NO OCCUPANCY wlll be made of any structure wlthout permission of the Bullding Safety Division. I further certify that only contractors and employees who are in compliance with ORS 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 the street, that the permlt card ls located at the front of the property, and the approved set of plans will remaln on the site at all times durlng construcilon. t- 5-q?Date Signature MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolitlon State Surcharge replace Unit /f ac: /o. do 'K lr Total Miscellaneous Permits (E) stor"r6il)t =-/ Wood (D) Dyer Yent (>r/< P4,fl)T- Mechanical Permit lssuance State Surcharge Total Permlt TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 3z /f 2.oAMOUNT RECEIVF.D RECEIVED BY DATE PAID VAI-IDATION: BECEIPT NUMA FT. MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan No 2e ?2 Permit # Address 0[, L k/ a/ //r",1 )5 Date:Issued by t Statement: lnformation Notice to Property Owners About Construction Responsibilities Note; Oregon Law, ORS 701.055(4), requires restdential construction permit appli- cants who ore 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, mechonical, 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 3,A' or 38 l. I own, reside in, or will reside in the completed structure. V2. I rndnstand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A.. 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. OR '{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 information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. t-5 of permit applicant) (White copy to issuing agency permit file, pink copy to applicant) eb" (Date) - qcl ,/