HomeMy WebLinkAboutPermit Building 1993-03-11SPRI1\lGF!ELc,
RESID ENT!AL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726-3759
LOCATION OF PRO ED WOR
ASSESSOBS MAP:
LOT:
h,
"t41_Bb
JOB NUMBER -
225 Filth Street rv
Springf ield, Oregon 97 477
TAX LOT:
SUBDIVISION:
-
Lq
BLOCK:
PHONE
zlPSTATE:
OWNE
ADDR
CITY:
A ITION
-
DEMOLISH OTHER
ESCD
LDEEN
PHONEEXPIBESADDRESSAME
GENERA
CONT
CONST.
CONTRACTOR #
i rl
SE_
LAND USE:
'T'[
I OF BDRMS:
OUAD A
A OF UNITS:ZONING CODE:
FLOOD PLAIN
OCCY GROUP:
g OF BLDGS:
WATER HEATER:
, OF STORIES
RANGE:
SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspections requested before
made the same working day, inspections requested after 7:00 a.m. will be made the following work day'
7:00 a.m. will be
REOU IRED INSPECTIONS
[-l TemporarY Electric
ll
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 Eteclrical - 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.
x'Footing - After trenches are
excavated.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.
F-'"-'ng - Prior to cover'
Other
N7'Foundation - After forms arelA ut""t"d but prior to concrete
placement.
Wall/Ceiling lnsulation - Prior to
cover
Underground Plumbing - Prior
to filling trench.l-l orywall - Prior to taoing.
MOBILE HOME INSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After installation
Post and Beam - Prior to floor
insulation or decking.lnserl - After iirePlace 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
trenc h.
'nr.
Rough Plumbing*l- Prior to
cover.
[_l fence - When comPleted
Final - After all required
inspections are aPProved and
porches, skirting, decks, and
venting have been installed'Street Trees - When all required
lrees are Pianted.
43c\DD--
E
r
E
E
tl
tl
tl
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type \E/
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L.HSE GAR ACC
N
S
E
n
r.y HE PROPOSED WORK lN THE
HISTORICAL DISTRICT, OR ON
THE HISTOFIICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING PERMIT
ITEM SQ. FT. X $/SO, FT.
4os
a7=;
VALUE
tJloO
fo
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, rn all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, requlating the construction and use of
buildings, and mai, be suspended or revoked at any time
Date Paid
, -//-?)
Date
C (
upon violation of any p rovt st ons
r:_
Plan Check Fee
%auBy
said ordinances.
Receipt Numbe":W
SYSTEMS DEVELoP*.*r,rl' o [r;W #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/ Fi replace Unit
Dryer Vent
(D)
N0Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hobd 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 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 70'1.055 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, thal the permit card is located at the front
of the property, and the approved set of plans will remain
K
ctioncons
Date
gnatu re
on the site at all times durin
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)fr4/,ro 2q.7e
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
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