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Home My WebLink AboutPermit Building 1991-05-21-SPRINGFIELE, RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF D WORK: ASSESSORS LOT: Qr05p r BLOCK: JOB NUMBER 225 Fifth Street Spri ngfield, Oregon 97 477 TAX LOT: SUBDIVISION STATE: PHONE: ZIP: OWNER: CITY: ADD NEW - REMODEL ADDITION DEMOLISH OT DESCRIBE WORK: ADDR PHONERNZ--EXP RR' ELECTRICAL CONST. MECHANICAL: RAL: BING CONCONT GENE PLUMI RANGE: - OFFICE USE _ WATER HEATER: FLOOD PLAIN ZONING CODE: # OF BDRMS QUAD AREA: * OF BLDGS: CONSTR. TYPEr HEAT SOUFICE: LAND USE: # OF UNITS OCCY GROUP: * OF STORIES:SECONDARY HEAT: SQUARE FOOTAGE: To request an inspection, you must call 726-3769. This is a24hour 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. REQUIRED INSPECTIONS f.l Temporary Electric t-___l Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. 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, 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.p Fireplace - Prior to facing materials and f raming lnsp. Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover, OtherFoundation - After forms are erected but prior to concrete placement.Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.l--l 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 trench. 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. lRN\Dh\ r E E E r E E E E E E r E E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type.- . - lnterior - Corner - Panhandle - Cul-de-sac S 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: PL.HSE GAR ACC N S E VALUE (A) X $/SO. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT, Mai n 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 and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. ByEV eived Plan Check Fee: Date Paid Receipt Number: 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 FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) N0Vent 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 further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springf ield, 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 project. I f urther agree to ensure that all required inspections are requested at the proper time, that each address is readable hat the permit card is located at the front the approved set of plans will remain te at all u ng nstruction. Signat Date f rom the st mes of the on the MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 4d.o,-]3 BY ECEI VALIDATION: RECEIPT NUMBE DATE PAID AMOUNT R RECEIVED s&Lqt Permit No:/ Address: lssued Date OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. 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 applicable blanks, and initial box 1 and either box 2A or 28: 1 I own, reside in, or will res My general contractor is ide the com ure. 2. A.ttr Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B.I will be my own general contractor. lf I hire subcontractors. I will hire only subcontractors reoistered with the Construction Contractors Board. lf I chanoe my mind and -do hire a general contractor. lwill contract with a contrattor-who is reoistered w-lth the Constructibn Contractors Board and I will immediately-notify the office issuing this building permit of the name of the contractor. I hereby certily that the above information is correct and that I have read and understand the lntormation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. cant CONSTRUCTION CONTRACTORS BOARD 0244J 1190 Date COPY TO ISSUING AGENCY PERMIT FILE w COPY TO APPLICANT @s c \\ I 1 't l)