HomeMy WebLinkAboutPermit Building 1992-10-29BLOCK:
ELO
332 -l$LI-OCATION OF PROPOSED WORK:-- -
TAX LOT
SUBDIVISION
ASSESSORS MAP:
LOT:
JOB NUMBER
RESID ENTIAL
PERMIT APPLICATION
lnspections: 726'3765
Oflice: 726.3759
225 Flfth Street
Sprlngfleld, Oregon 97 477
qf PHONE:
O c,ZIP:STATE:I
3g a a+gr
CITY:
ADDRESS:
OWNER:
NEW .-_- REMODEL ADDITION DEMOLISH OTHER
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DESCRIBE WORK:
PHONEADDRESS]tao Krnc*J IB 1)J11 S alCONTRACTOR'S NAME EXPIFIES
PLUMBING; ..-. -
ELECTRICAL: -------
MECHANICAL
CONST.
CONTRACIOR #
3z.,to zGENERAL: G\ezqr Gy-{,*-
RANGE:
OUAD ARE.A:
P OF UNITS:ZONING CODE;
FLOOD PLAIN
WATER HEATER:
- OFFICE USE _
SECONDARY HEAT:
SQUARE FOOTAGE:
# OF BDRMS:-.-.---
* OF BLDGS: -
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
I-AND USE:
To request an lnspecilon, you must call 226-3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:0O a,m. wlll be
made the same worklng day, inspectlons requested aftor 7;00 a.m. wlll be made the followlng work day.
REQUTRED INSPECTIONS
[-_.l Temporary Electrlc Rough Mechanlcal - Prlor to
cover.
Flnal Plumbing - When all
plumblng work ls complete.
Sito lnspection - To be made
after excavation, but Prior to
sotting forms.
Rough Eleclrlcal - Prlor to Flnal Electrical - When all
electrlcal work ls comPlete.cover,
Underslab Plumblng/ Electrlcal /
Mechanical - Prior to cover.
Electrical Service - Must be
approved to obtain Permanent
electrlcal power.
Final Mechanlcal - When all
mechanical worl< ls complete.
Footlng - After trenches are
excavated.f-l Flreplace - Prlor to faclngLr materlals and framlng lnsP.
fi"'
lng - Prlor to cover'
N/Ftn.l Bulldlnq - When all
+ requlred lnsp-ectlons have been- approved and bulldlng ls
completed.tl Maaonry - Steel locatlon, liond
beams, groutlng.
Other
Foundatlon - After forms are
erected but Prlor to concrete
placement.Wall/Celllng lnsulatlon - Prlor to
cover,
Underground Plumblng - Prior
to fllling trench.f_l orywal! - Prlor to taplng
MOBILE HOME INSPECTIONS
Underlloor Plumblng/ Mechanical
- Prior to lnsulatlon or decklng.Wood Slove - After lnstallatlon
Posl and Beam - Prlor to floor
lnsulatlon or decklng.lnsert - After flreplace approval
and lnstallatlon of unlt.
Blocklng and Set-Up - When all
blocklng ls complete.
Floor lnsulatlon - Prlor lo
clecking.
Plumblng Conneclions - When
home has been connected to
water and sewer.
Sanilary Sewer - Prlor to filling
trench,Electrical Connection - When
blocklng, set-up, and plumbing
inspectlons have been approved
and the home is connected to
the servlce panel.
D4I"JI.sewer - Prior to fillins
Sidewalk & Drlveway - Alter
excavatlon ls complete, lorms
and sub-base materlal ln place.
Waler Llno - Prlor to fllllng
trench.
Fence - When completed.
Flnal -qulred
Street Troos - When all requliod
trees are planted.
ns and
d and
led,
Rough Plumblng - Prlor to
cover.ntlng n.
l.
S
tl
E tl
E
tl
tl
a
[--l Curbcul & Approach - AftertJ forms are erected but prlor to
placement of concrete,
i]
tl .tl
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total height
Lot Type --
.-- C6rner
-
Panhandle
-
Cul'de'sac
Set IS THE PROPOSED WORK IN THE
- IIISTORICAL DISTRICT, OR ON
I'I.IE HISTOFIICAL REGISTER?
-
l( yes, thls application must be slgned
and approvecJ bY the Fl istorlcal
Coordittator prior to permit issuance.
APPFIOVED:
GAR ACCP,L.HSE
l
S
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls pcrmit is granterJ r:rr tltc express conditiorr tlrat the said
constructlon shall, in all respects, conform to the Ordinance
adopted by the City of Sprlngfleld, including the
Development Code, regulating the construction and use of
bulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Flecelpt Number:-
dBvPlans Revl Date
Plan Check Fee
Date Paid:
Received By:
sQ. FT. X $/SO. FT. = VALUE
BUILDING PERMIT
(A)
<,23
ITEM
Main
Garage
Carport
Total Value
Building Permit Foe
State Surcharge
Total Fee
Systems Development Charge is due on all undeveloped
propertles within the City limits which are being improved.SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
NEA
ITEM
Fixtu res
Flesidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
N0
25*
ZS
FT.
FT.
zFT.
(c)
).sPlumblng Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
By slgnature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
lnformation hereon ls true and correct' and I f urther certify
that any ancl all work performed shall be done in accordance
wlth the Ordinances of tlre Clty of Springfleld, and the Laws
of the State of Oregon pertalnlng to the work described
hereln, arrct tlrat NO OCCUPANCY will bc' made o( any
structure without permission o{ the Building Safety Division'
I further certify that only contractors and ernployees who
aro ln compllarnce witlr ORS 701.055 will be used on tltis
prolecl.
I further agrce to erlsure that all required inspections are
requested at the proper tlme, that each address is readable
from the street, that the permlt card ls located at the (ront
/e -2f -7 >
gnatu re
Date
and the approved seof the prope
tirnes duringon the slte
t of plans wlll remain
,ructlon.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk -==-- tt
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)?eDATE PAID
AMOUNT RECEIVT:D ---
RECEIVED BY _-_
VALIDATION:
RECEIPT NUMBEH _--
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, O and E Combined)
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