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Home My WebLink AboutPermit Building 1993-02-08RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK ASSESSOFIS MAP: SPrlI^lGFIELE) o- JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 TAX LOT OrB* ?7#// h, *- LOT BLOCK: NEW - FIEMODEL ADDITION DEMOLISH OTHER PHONE: STATE:ztP .a CITY: DESCRIBE WOFIK: ADDRESS: OWNER: MECHANICAL: - CONST. ADDRESS EXPIRES PHONER#CONTRACTOB'S NAME PLUMBING: GENERAL: ELECTRICAL: _ OFFICE USE _ WATER HEATER: ZONING CODE: FLOOD PLAINQUAD AREA: r OF BI-DGS: SECONDARY HEAT: SQUARE FOOTAGE: CONSTR. TYPE: HEAT SOURCE: LAND USE: # OF UNITS OCCY GBOUP: * OF STORIES: To request an inspectlon, you must call 726-3769. Thls ls a 24 hour recording. All inspections requested before 7:O0 a.m. will be made the same worklng day, lnspectlons requested after 7:OO a.m. will be made the following work day. REOUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. Flnal Plumbing - When all plumbing work is complete. Site lnspeclion - To be made after excavation, but prior to setting forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. Final Mechanical - When all mechanical work is complete. Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing lnsp. Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, groutlng.Framing - Prior to cover. Foundation - After forms are erected but prior to concrete placement. Other Wall/Ceiling lnsulation - Prior to cover Underground Plumbing - Prior to filling trench.l--l DrVwall - Prior to taping. MOBILE HOME INSPE TIONS Underlloor Plumblng / Mechanical - Prior to insulatlon or decking.Wood Stove - After installation. Post and Beam - Prior to floor lnsulation or decking. B Blocking and Set.Up - When all blocklng ls complete.lnsert - After flreplace approvql and installatlon of unlt. Floor lnsulatlon - Prlor to decking.Curbcut & Approach - After forms are erected but prior to placement of concrete. 4 Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to filling trench.[-7I Eleclrical Connection - WhenIAJ blocking, set-up, and ptumbtng Storm S€wer - Prlor to filling trench. Sidewalk & Driveway - After excavation ls complete, forms and sub-base materlal in place.inspections have been approved and the home is connected to the servlce panel. Fence - When completed Rough Plumbing - Prior to Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed.cover. W SUBDIVISION: - ?/^ fi '; RANGE: # OF BDRMS: --=._- E E Waler Line - Prlor to fillirig trench. fl E tl E tl fl E E tl E tl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setbacks .-, THE PROPOSED WORK IN 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: P.L.HSE GAR ACC N S E 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 BUILDING PERMIT ITEM SQ. 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) ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fi replace Unit Dryer Vent t4t t), /500 /o.N ,7-r --< ?f,-zJ.(D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit M ECHANICAL PERMIT Fu rnace Exhaust Hood By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information hereon is true and correct, and I f urther certif y 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 f urther certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I f urther agree to ensure that all required rnspections 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 /-f-esDate K* on the site at all tim during construction. natu re MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E)7r DATE PAID AMOUNT RECEIVED RECEIVED BY VALI DATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) z-=s.4 ,4,{/, 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 S THE PROPOSED WOFIK IN 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: VALUE (A) X $/SO. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SO. FT. Main Garage Carport 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 anb use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plans Reviewed By Date Receipt Numbe Plan Checl< Fee: Date Paid Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home@fu,f_/fr FEE (c)/fr€l FT. FT. N0 FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/Fireplace Unit Dryer Vent (D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace 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 Springfietd, and the Laws of the State of Oregon pertainlng 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 ln compliance with OHS 701.055 will be used on this project. I further 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 on the sit Signature 7 eatal during construction. Date t3 MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Oemolition State Surcharge Total Miscellaneous Permits (E) Graf*o €-a t /-/>-rry/7 DATE PAID AMOUNT RECEIVED -RECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electricat) (A, B, C, Q and E Combined)/%-"! .T J -6lo.l aJ T b- +!)k \\p N VI t-{ * ..t \t -8.f( JS { j ""fj Lane Countg CERTIFICATE OF TAXES PAID ON MOBILE HOMES A11 taxes must be pald and thls certlflcate completed and slgned before Motor Vehicles Divlsion, Department of Transportatlon can transfer a tltle or lssue a trlp tlcket to move a mobile home. See informatlon below regardlng deferred taxes*. NOTICE: This Certiflcate is valld only for Movements/Ownership Changes occurring through June 30 , 1993. X TITLE TRAI{SFER Name of Buyer: LAY MARLIN S X LOCATION CHANGE New locatlon is within Lane County. CI^A,SS CHANGE New Classification: NEW LOCATION Park: MAR-SHELLCOIIRT Address:. 725 N 28TH STREET Clty: SPRINGFIELD State: OR Zip: Space: County: Map/Taxlot: 6 I^ANE 170231_00 01800 DESCRIPTION OF MOBILE HOME Assessment County: LANE Assessment Account : 4045L40 Lewy Code: 019 00 Make: Model: Serlal: X-Number: Model Yr: I.Ildrh: Length: SKYLINE HT L459 6L602 72 L2 l+O Legal Owner: Reg.Owner: GIDLEY JAMES W GIDLEY JAMES W ASSESSOR' S CERTIFICATION I CERTIFY THAT ALL TN(ES AND SPECIAL ASSESSMENTS FOR THE CURRENT AND fu\NT PAST TAX YEARS ON THIS I,IOBILE HOl,tE have been extended on tax ro11. TAX PAYMENTS Back Curr Warr .00 .00 .00 Assessed Va1ue:$5 ,080 MOBILE HOME: Was assessed ln thls county last year. *Deferred Taxes must be pald only if you requesC a tlcle transfer or a trip permit to move the mobile home out of Oregon. Then you must obcaln a slgned statement from the Oregon Department of Revenue showing payment of deferred taxes. Attach it to this cerEiflcate and send both to the Motor Vehicles Division. 00 X DEPUTY ASSESSOR L2/rL/92JIM GANGLE ,it'.a TA)( COLLECTOR'S CERTIFICATION I CERTIFY THAT ALL TAXES ON THIS MOBILE HOME TIAVE BEEN CERTIFIED TO ME FOR COLLECTION AND HAVE BEEN PAID. JIM GANGLE x DEPUTY TA)( COLLECTOR L2/LL/92 Form 113,., ..'' ASSESSOR 1 NEW LOCATION rl'.i