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HomeMy WebLinkAboutPermit Demolition 1997-09-16SPRINGFIELEl RESIDENTIAL PERMIT APPLICATION lnspec' Of f ice: tions: 726-3769 726.3759 JoB NUMBE a a2l >>4 225 Fifth Street Sprlngfleld, Oregon 97477 LOCATION OF PROPOSED WOBK: ASSESSORS MAP:TAX LOr.l @a a\ LOT:BLOCK:SUBDIVISION D,n.zte: 4)71-STATE: E: CITY: ADDRESS: OWNER: ELECTRICAL: ADDRESS T EXPIRES .1 PHONE GENERAL: MECHANICAL: PLUMBING: CONST. CONTRACTOR # RANGE: _ OFFICE USE - LAND USE: WATER HEATER ZONING CODE:g OF UNITS: QUAD AREA: I OF BLDGS: SECONDARY HEAT: SQUARE FOOTAGE: , OF BDRMS: - OCCY GROUP: r OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspectlons requested belore 7:00 a.m. wlll be made the same worklng day, lnspections reguested after 7:00 a.m. wlll be made the followlng work day. REOUIRED INSPECTIONS Temporary Electrlc Rough Mechanlcal - Prlor to cover. Flnal Plumblng - When all plumbing worl( ls complete. Slte lnspectlon - To be mado after excavation, but prior to setting forms. Rough Electrlcal - Prlor to Flnal Eleclrlcal - When all electrical work is complete.cover. Underslab Plumblng/ Electrlcal/ Mechanlcal - Prlor to cover.Electrlcal Service - Must be approved to obtaln permanent electrlcal power. Final Mechanlcal - When all mechanical work ls complete. E Footlng - After trenches are excavated.Flnal Building - When all required lnspectlons have been approved and bullding ls completed. Flreplace - Prlor to faclng materlals and framlng lnsp. Masonry - Steel locatlon, bond beams, groutlng.fl E Framlng - Prlor to cover. Foundatlon - After forms are erected but prlor to concrete lplacornont. w Othor WalllCelllng tnsutatlon - Prlor to cover, Underground Plumbing - Prior to fllllng trench.l--l Drywatl - Prlor to taplng. Underlloor Plumblng/ Mechanlcal - Prior to lnsulatlon or decklng. MOBILE HOME INSPECTIONS Wood Stovo - After lnstallatlon Post and Beam - Prlor to floor lnsulatlon or decklng.lnsert - After flreplace approval and lnstallatlon of unlt. n Blocking and Set.Up - When ailu blocklng ls complete. Floor lnsulatlon - Prlor to decklng.[_l Curbcut & Approaclr - After 'J forms are erected but prlor to placoment of concrete. Plumbing Connectlons - When home has been connected to water and sewer. W?fr:Wewer - Prior to,rrrns [-l Storm Sewer - Prior to fllllng - trench. Sldewalk & Drlveway - After excavation ls complote, forms and sub-base materlal in place. Electrical Connection - When blocking, set-up, and plumbing lnspections have been approved and the home is connected tothe servlce panel, Water Llne - Prlor to filllng l-l Fence - When coinpleted trench.Flnal - After all required lnspectlons are approved and porches, sklrtlng, decks, and ventlng have been lnstalled. Rough Plumblng - Prlor to Strcet Trees - When all requlred trees are planted.cover. 24,/^77?./ DESCRIBE WORK: NEW - REMODEL ADDITION DEMOLISH OTHER CONTRACTOR'S NAME FLOOD PLAIN: E E E tl tl E tl E . rt:; :: Lot faces Lot sq. ftg. Lot coverage Topography Total helght t-ot Type - lnterlor - Corner - Panhandle - Cul-de.sac 'S THE PROPOSED WORK TN THE " HISTORICAL DISTFIICI, OR ON THE HISTORICAL REGISTER? - It yes, thls appllcailon must be slgnedand approved by the Historlcal Coordlnator prlor to permit issuance. APPROVED: PL.HSE GAR ACC N S W E VALUE (A) BUILDING PERMIT Total Value Bullding Permit Fee State Surcharge Total Fee :h, ,l i X $/SQ. FT.SQ. FT.ITEM Maln Garage Carport BUILDING VALUe, ptRtt CHECK AND BUILDTNG PERMIT This permit is granted on the express condition that the saldconstruction shall, ln all respects, conform to the Ordinanceadopted by the City of Springfleld, includlng theDevelopment Code, regulating thE construcilon and use ofbulldings, and may be suspended or revoked at any tlmeupon violation of any provisions of sald ordinances. Beceipt Number:_ Plans Revlewed By t Date Plan Check Fee: Date Paid Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge ls due on all undeveloped properties withln tlre City limlts which are belng lmproved. ITEM Flxtures Resldentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home N' ./6, > FEE rr. z? FT. FT. 4' (c) PLUMBING PERMIT Plumblng Permlt Stale Surcharge Tolal Charge ADDITIONAL COMMENTS By slgnature, I state and agree, that I have carefully examlned the completed appllcatlon and do hereby certlfy that all lnformatlon hereon ls true and correct, and I lurther certlfy that any and all work performed shall be done in accorrJance wlth the Ordinances of the City of Sprlngfietd, and the Laws of the State of Oregon pertalnlng to the work descrlbed hereln, and that NO OCCUPANCy will be made of any structure wlthout permission of the Bulldlng Safety Dlvislon. I further certify that only contractors and employees who are ln compliance with ORS 701.055 wlll be used on thls proiect. I further agree to ensuro that all requlred lnspectlons are requ€sted at the proper tlme, that each address ls readable from tho street, that the pormlt card ls located at the lront of the property, and the approved set of ptans will remaln on the slte at all times durlng construcilon. Date 1'ta -za Slgnature Wood Stove/ lnsert/Flreplace Unlt Dryer Vent MISCELLANEOUS PERMITS Total Mlscellaneous Permits (E) d - ,u/ Demolltlon State Surcharge _G.-/5--;37 (o) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan No Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcut - ft Mechanlcal Permlt lssuance State Surcharge Total Permlt TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined)RECEIVED BY QoAMOUNT HECEIVED DATE PAII) VALIDATION: RECEIPT NUMBER a Z,-Z*.r* DEPARTMENT OF FIRE & LIFE SAFETY OPERATIONS SPFIINGFIELc, d FD- I 58 225 FIFTH STREET SPRINGFIELD, OR 97477 (503) 726 37s7 FAX (503) 726 2297 Area Code changes to (541) November 1995 .t. h, TRAINING BURN AUTBORIZATION Date:.-1 L) TO:City of Springfield, a Municipal Corporation, acting by and tfuough its Department of Firc and Life Safety You are hereby authorized and pcrmitted to burn under supervision and for education and instruaion purposes Orat certain house or building located on: Tax lot # BW , in -Addition to Springfield, -J s/1!Oregon which is desigruted as Springfiel( Oregon L/We, cxpressly warrant and represent to you that I/We, the undersigne( are the owner(s) of said propcrty, and tlut the same is free and clear of any and all liens, encumbrances, judgments, and any interesl, nght, title or claim in any other person other than the undersigne4 and that this mnsent is freely and voluntarily given, and tlut we will save the City of Springfield harmless from any liabiliry to any pcrson whomsoever by reason of any statement or warranty contained in this letter. I/We, the undersignd also agree to the following requirements imposed by the Department of Fire and Life Safety to assure completion of all regulations. l. The property owner(s) shall remove all debris on the lot(s) involved in this burn within sixty (60) days after completion date of the burn by the Department of Fire and Life Safety. 2. The property owner(s) is to sectue the required demolition and plumbing cap permits from the Building Department when inside the City Limits. 3. Ouside City Limits, Coung regulations apply. 4. The property owner(s) shall have the structure inspected for asbestos. This includes: a. An internal and external inspection of the strucnre by an asbestos or environmental consulting firm. b. Removal of asbestos 6pnteining materials, as indicated by the inspecting firm. l. An Owner-occupant may perform asbestos removal. a. The Waste Shipment Record (ASN4) musr be filled outb. Setup an appointment with Short Mountain kndfill - 6874120 - for disposal. 2. [f not an owner-occupan! a removal company must perform ashstos removal and disposal. c. The property owner(s) shall submit a copy of the original asktos inspection as written by the inspecting firm and a signed note stating that the asbestos has been removed. rf ADDRESS a,+:..-\v1 '-J') 1/_t n ir I\\i ,"0:i,t r'. , hcirr{ t',\1.' PHONE Qzr;rV /zafu*;czalo pra/u/u4, fk cr*rrr*rrfq r