HomeMy WebLinkAboutPermit Building 1990-09-28lGlIrEfrL- -" -
Si.t]>ditt:.sion:
C\ner
Adilrcs:
ll..RESIDE ;IAL..
APPLrCATro,"/PDillrr
225 llov,th Sth Street
Springfteld, Oregon 97477
Building Diuision
ooa ?nc2/ LU-O / OO
.tob Loeaticn
SPRINGFIELD
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Describe lJorl<:
Val-ue
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stdte yout, Citlt Cesignated iob
'tors oi asners rnne end Phone
be nade the ncrt -aotki-ttg daY.
ptope? tine, that ecch cdibess is readabl'e
, ntsrber, iob aCi.ress, type of inspeclicn
nmber. Requests receit;ed befcte 7:00 an
Date
IlaLe of Applicaticn.
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(lc tt e r;t
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Ilt,ciritrr Lclt I
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Srtllt livr:f?.,jr.1 lilercrt-it irttr
It is the resp.onsibility of the permit ho-Ldet to see that aL! inspec-tions ate nade at !'he
jlrnn- ti,i "tne'et, a*l tnlat tne po**it eard is Located at the ft'ont of the propenty'
'i:,1,,,tt,tiiTti it,tut,iio-. "pf iii."l;r1ri it',itt remain on tlo Buildtng Stt;c at aLL tines'
lp i'2!ii!--i1-l lt!!9!: 0 :!-!!9!E!!: C A LL 7 26- 37 6 e ( ? ecorder )
i,1""t; m-i,iJ-"iii-axliu-be ready fo-r inspoction, cont"ae
:'ili l,r narlc the xonc Cc1r, requests mcde aftet'7:00 on uiLL q
Your City DestgrutLed Job Nunber fs
:'t _,.r; !il.,ii i,'.'.'-i.)!!: !',t i,i: ntule aJ'tet'
,.i.:;,,i-,ii-- l,rrl ;,r'i,,r' !t set ttp of
i I ttlt\Eti::t,AB !'LUl.nI"lC. liLECTRICAL CrlI I .t'!';t;!!i:; l';Al': 'lo bc nurle Lte! ot'e .:'nyl- t i;.;r-,L-;;;r"*nu.
i l !';|o'!MC I FOU:IDA?TCN: ?o be nsde
I | :i;,:;-r";,*t,"" ,rr* "rcauated anl
-l'rrr,rilri rr.I'c erecti'd, ltut priot' to
:,, 'lrrir;9 ccneret:.
:i(;l')ut't3 t Nc I't.1
D|YUAI,L INSPECTI)N: Tc be nade
*n: aTT-Zrwitfts .in plaee,
bub prion bo cnY taPtng.
bIASONRI: Steel Location, bond
iifrElgrouting or verticals in
aeeordance utith U.B.C, Section
UOO|)STOVE: Aftt* installation is
cc,nrl;;;J.
CURB & APPRCACII APP,QN: After forns
ai,e;r'"ct*l b"t Prior to Pouring
conirf,ol;e.
SIDIIUA|,X ,t DRII'til't.t,Y: For aLL con-
.r,er; parrr"o uYttlrtn st?eet right-
of-xru', to be naCe after aLL erea-
oatin-o can?Lel;e & forn lurt'k & cub-
bace "rnaterial in Place.
IENCE: h4ten conPl';tc -- ProuiCe
gaLo.6 or nooablc secttans tht'ough
P,U.E.
ALL [;roiecb contlitions, suah as tlte installation of street t:?r-,- "o'pxctton of the
reqtirerl Landscaping,'Lti'-'',rr.u"t be satisfiZl- a'iil"n- ti" BUrLDrttc FriAt can be nequested'
prNAL Burr,r)r*c: ?tre Finol Btdlding rnspection mtet be requected alter the Final Plwnbing
ii"l"lii', 'irC un.tori...ii liopn"tlorn irqvo been nade atd approoed-
i;r o| to
r,tt.r il,1;;,tl(
I i,,':!'!:!i.,t,,J pr,u:st:uc .q, !.tEc ' ^| .'' 1.' ntulu t,t'ior Do ittsl:aLLatlon oJ
.i'.',',,,' ixt;trl,: t i.on or deckinq.
l:;f) fiEti!: To be nade P?io? to
| ,..,,., :,Ttc" ol fioor insulat'ion ot'
:, ! : ! ::t!Jjl_Q,_:!i.:!', t' [:!"1 !.,') ttq c t t a'.i.' : :to 'D!): i:i lo i'c aocered
:)'tt,:e inspecl:ior:s haoe becr
, Jkl dT'pyolca.
/..jli.'Jt.' ?r,i.ot, to plccir4 fccing
i.r.t.i ,r,:d bcforc franing insPee-
|.htxL le requestetl af ter
,t1' t'ough plwtbing, electt'i-
')t,ttt"i.ca'1, ALL r'ooling
,.:.'.,rrt 'i ohirmcys, etc. rrust be
,rr11,.',1,,,!. llo r,rork it; to be con-
"; !, , i trrri. )' L tlis i.nspection has
, ' ., t,i, :'u! appnot;cd.
t
Phrmc\,rv
ess
DEI,IOLITIOII OR BUILDI;1CS
Sanitary serser eapped 7.t Propert! Li'''e
Septic tank p;,nped attd filled uith gratel
Final - l{hen abctte 'Ltens are canpleted
and uhen Cenolition is cotnplete oP at/'uc-
ture noued and prenises cleaneC up.
Ilcnes
Bloeking otd Set-:tP
Pttnbing eonnections -- lefure? atC uater
Eleetrical Ccnneetion - Blocking' set-ui -ind olwnbinq eonneetions nttst be appra;eC
befonc reqieoting eleclrteal inspeeliot'
Acceecor"g Building
pcrches, ekitting, decks,
leted.
Final - After
etc. ate conq'
i__l
,t.t.;:t ANt) ct,ti,1,\tou,r:: tltlr ltt.; /lcctiiirnt,t, AI)Jtr;1':fiirr ro nE IilnE 1T tt) ccsr T0 eTly Pqt? 1 of 2
/I
_/
,|''..i
JOB NO
Buildinq Penrit
State Surcharge
Total Clwrgea
Plwnbing Pernit
State
Total
?otal
SOLAR I ',ESS REQ'-
11,.1,:roar:!';
Ra
ri
Sottt',:r::
t
Lacc
toDe
Building Volue & Permit
ThispermiLt)sgtantedontheeoples$cond.iLionLlttt.Ltlu:.1;'1;'/'''ri.r"'
sLnLL', in otL r"cspccts, confgtm'Lo tlt-c. Ordirt'ti;ca-ilo1;t'"! l.'1 t;;' :'
ip.liifl"ti, including' the Toning cxlinalc.e , re';lulcLi.tt'1 .Lli '',':":" '
;ie ":;" of ituildinlTs, and fiay ba, cuspendeJ ot reuckcrl uL (:titi t:t't' :
tatton of ,trty pt'ctsisions of said 0rdinattces'
{tL -
*
Date Paid
ReaeiytL ll
Signed
Plumbing Permit
No percon:;lnll aonstt.uct, i.ns,;aLL,- aLter or clu,tt11t: dllll l.],ers..},i]..1-i;.1 I]/i.,'p1iifi o, ,lr'oirage syq|,n in i,thole or. in pan't, urtles:; such persort i's t t:''
iLjof p"orno""o, o7" o ,LlLi ptrrt,nr's Lic-ens'e, eicepb Llnt a pet:;on rt'i'l t!"
p;roA;rg aork to propor;ty ,hi"h i" or,mecl, Leaaec ol'oitct'ateti oy th': ':;:;'i i-
cant.
Plant Etantner Date
r HAVE CAREFULLy EXAl'ffll\D the conpleted applt,caLion for pennit, cnl do
i"'iity iirll.fV ttot otl infox,nati'on hereoi-is ttue anC eorrect, cr"l I
futth"et cettiiy that any ard aLL aonkperfotned sfuzLL be dote in accot'-
'danee witlt th-e- ordinenc'es of tlrc city of -springfield" and th-e Lc;s of tiic
Siate if Oregon pertahting to tlrc uoik Ceebyibcd heretn, cnd tlwt NO OCCU-
iiiCy ,itt b"e nnTe of any" structure uithout permisai-on of the Suitding D.L-
uision. I further iertihl thet o:tly contracl;ot's and enplcyees til':o ore Ln
eonpliance uith 1RS 701.0-5s aiLL be used on this project
L
[,ot Faees -
Setbacks
C(tPaqe AccesrtP.1,.ilouse
Not th
East
Soul;h
t
Int So. Fts.
% of Lot Cooerage_
! of Stortes
ValuexFTGITEI'l
Total Height
Topography
INT TYPE
Interior
CoPner
Panhandle
CuL-de-sac
I'laitt
Gcraoe
Carport
IAccessoru
TOTAL VALUE
S.D.C. 1.5 s
1s
\'5.-1s
CHARCDFEENO,ITEM
Fistwes
Residential (1 bath)
Sanitary Seuten
Hc!;en
Electricol Permit
where sLate Lau nequires tlat; tha clectt:.i.aal uork be dotc bll art ElecLrtatl
Contio"tor, the aictricoi portion of lhts lsennit, siull roL l:t: ualiJ uttil'
the Label luts been signed by the EleaLrical CottLl'dctot'
CIIARCENCrT!M
I Mechqnicol Permit
Nau/Eotetd Circuits
Seruice
State
Total
Eolmnst Hoo,7
I'lcodstoue
vent P@t
PemLt fssuanee
Mechanicel Pet'mit
-. ENCROACIIMENT --
SecarLtu Deposit
Storage
I,laintenance
Permit
Clttbcu!
Sidewalk
fence
Electrical tabel
Mobile llone
TO'IAL AMOUN? DUE: *lsts *
|lllll
.ar ) 9c
charaas
Permit No
Address:*tn
lssued by Date:
q
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 2B:-
1 I own, reside in, or will reside in the completed structure.
2. A. l---l My general contractor is
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 onlv subcontractors reoistered with the
Construction Contractors Board. lf I chanoe mv mind and do hire a general
contractor. lwill contract with a contrabtor-who is reoistered w-ith the
Constructibn Contractors Board and I will immediately-notify the office
issuing this building permit of the name of the contractor.
I hereby certify that the above information is correct and that I have read and understand
the lnlormation Notice to Property Owners about Construction Responsibilities on the
reverse side of this
can
CONSTRUCTION @NTRACTORS BOARD
v44J 10t24t89
Date
WHITE COPY TO ]SSUING AGENCY PERMIT FILE
PINK COP{ TO APPLICANT
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