HomeMy WebLinkAboutPermit Demolition 1991-07-19SP]lINGFIELE,
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LOT:
TAX LOT:
JOB NUMBER
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:o>
RESIDENTIAL
PERMIT APPLICATION
lnspections:726-3769
Office: 726-3759
BLOCR: SUBDIVISION
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225 Fifth Street
Springfield, Oregon 97 477
5er*rvaln}OWNER:PHONE:
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C STATE:
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NEW
-
REMODEL ADDITION DEMOLISH F OTHER
DESCRIBE WORK:
ADDRESS EXPIRES PHONE
'II
MECHANICAL:
ELECTRICAL:
PLUMBING:
G EN ERAL:
CONST.
CONTRACTOR #CONTFIACTOB'S NAME
RANGE:
* OF BDRMS:
_ OFFICE USE _
LAND USE:
WATER HEATER:
ZONING CODE:
FLOOD PLAIN:
* OF UNITS:
QUAD AREA:
* OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
# OF STORIES
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. This is a24 hout recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQU!RED INSPECTIONS
Temporary Electric 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 all
mechanical work is complete.
Fireplace - Prior to facing
materials and framing lnsp.
Final Building - When all
required inspections have been
approved and building is
Masonry - Steel location, bond
beams, grouting.
complete
v Other
Wall/Ceiling lnsulalion - Prior to
cover.
Underground Plumbing - Prior
to filling trench.Drywall - Prior to taping
MOBILE HOME INSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After installation.
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.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Line - Prior to filling
tren c h.I-l Fence - When completed
Slreet 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.
I
f--l Underslab Plumbing/Electrical/
'J Mechanical - Prior to cover.
l--l Footing - After trenches areU excavated.
Foundation - After forms are
erected but prior to concrete
placement.
E
l-l Framing - Prior to cover.
f-l Final Plumbing - When alltJ plumbing work is complete.
tl
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
S
E
_, THE PROPOSED WORK rN 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:-
Plans Reviewed By Date
Plan Check Fee:
Date Paid
Received By
VALUE
(A)
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BU!LDING PERMIT
ITEM SO. FT.
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)
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
l4-c:,)
(c)
N0
FT.
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
information 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 Springfield, 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 ORS 701.055 will be used on this
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
of the property, and the approved set of plans will remain
re
site at all times d ngt ction.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition B,a)
(E)
U
Total Miscellaneous Permits
State Surcha
ct()
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3b 1b
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
52,b5
4-A
DATE PAID
AMOUNT REC
RECEIVED
VALIDATION:
RECEIPT NUMBER
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