HomeMy WebLinkAboutPermit Building 1997-11-19SPF:II\lGFIELE)RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office:726-3759
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(bcerroN oF PRoPosED woRK:
JoB NUMBEa-2-V6-Sz-
225 Fifth Street
Sprlngfleld, Oregon 97477
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ASSESSORS MAP:TAX LOT:o/'2.4
LOT
-
BLOCK:SUBDIVISION:
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.fowr.ren'PHONE:
2ro2
STATE:
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ZIP:q1q1aCITY:-< PzclO
ADDRESS:,"P.{
NEW r./ BEMoDEL ADDIIoN DEMoLtsH orHER _
\J ,Lip t)@escnrae woRK:
PLUMBING:
MECHANICAL:
ELECTRICAL:
AODFIESS EXPIRES ,f PHONEporurnacroR's NAME
S e/,EGENERAL:
CONST.
CONTBACTOR #
RANGE:
- OFFICE USE _
LAND USE:
WATER HEATER:
ZONING CODE:
FLOOD I]LAIN
* OF UNITS:
QUAD AREA:
I OF BLDGS:
, OF BDRMS:
-
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons 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.
REQUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prlor to
cover.[-l Flnal Plumbing - When aillJ plumblng work ls complete.
n Underslab Plumblng/Electrlcal/u Mechanlcal - Prlor to cover,
l-l Footlng - After trenches areu excavated.
Slt€ !nspectlon - To be made
after excavatlon, but prior to
settlng forms.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulation or decklng.
Floor lnsulalion - Prlor to
decking.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to filling
trench.
Rough Plumbing - Prlor to
cover.
E Electrlcal Servlce - Must be
approved to obtain permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and framing lnsp.
n Framlng - Prlor to cover.
l-l Wdl/Celllng lnsulatlon - Prlor toIJ cover.
n Wood Stovo - After lnstallation.
tl
Rough Electrlcal - Prior to
cover,
lnsert - After flreplace approval
and lnstallatlon ot unlt.
Curbcut & Agrproaclr - After
forms are erecled but prior to
placement of concrete.
Sidewalk & Drlveway - After
excavation is complete, forms
and sub-base materlal in place.
Fence - When cciilpleted.
Streel Trees - When all requlred
trees are planted.
Flnal Electrlcal - When all
electrical work ls complete.
Final Mechanlcal - When all
mechanical work ls complete.
Flnal Bulldlng - When alt
required lnspectlons have been
approved and bullding is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When all
blocklng ls complete.
Plumbing Connections - When
home lras been connected to
water and sewer.
Electrlcal Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Flnal - After all required
lnspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
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W
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SECONDARY HEAT
SOUARE. FOOTAGE:
E
E
E
l--l Drywall - Prlor to taping.
E
E
E
,lt. .. i;i
Lot faces
Lot sg. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
-
Corner
-
Panhandle !
-
Cul-de-sac
Setbac
P.L.HSE GAR ACC
N
S
E
IS THE PROPOSED WORK }N THE "HISTORICAL DISTRICI, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
VALUE
(A)
'\ '1r
iohr
Total Value
Building Permit Fee
State Surcharge
Total Fee
FT. X $/SQ. FT.
BUILDING PER
ITEM SO.
Main
Garage
Carport
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, ln all respects, conform to the Ordlnance
adopted by the City of Springfleld, includtng the
Development Code, regulating the construcflon and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
BUILDING LIJE,LAN CHECK
Plan Check Fee
Date Paid:
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties wlthin the City limits which are belng improved.
ITEM
Fixtures
Residentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
N'
)-?FT. 8O
FT.
,:Z1a(c)
.*
.2e
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fl replace Unlt
Dryer Vent
MECHANICAL PERMIT
(o)
N0
Mechanical Permit
lssuance
State Surcharge
Total Permit
Furnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have caref ully examlned
the completed apptication and do hereby cerilfy that all
lnformation hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
hereln, and that NO OCCUPANCy wlll be made of any
structure wlthout perrnission of the Bulldlr.lg Safety Divislon.
I further certily that only contractors and employees who
are In compliance with ORS 701.055 will be used on thls
prolect.
I further agree to ensure that all required lnspections are
requested at the proper time, that each address ls readable
from the street, that the permlt card ls located at the ,ront
of the property, and the approved set of plans will remaln
on the site at all times durlng constructlon.
Date
Signature
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sldewalk
-
lt
Curbcut
-
ft
Demolltlon
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Combined)
,76
DATE PAII)
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
(
Receipt Number:_
FT,
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