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HomeMy WebLinkAboutPermit Demolition 1995-05-01]{GFIELt)RESIDENTIAL PERMIT APPLICATION lnspections: 726-3765 Office: 726-3759 \_/ ?fr, JoBNUMBE" ?*<73 225 Fi(th Street Sprlngfleld, Qregon 97 477 LOCATION OF PROPOSED WORK: ASSESSORS MAP:/242-3r-22 TAX LOT: LOT:BLOCK;SUBDIVISION:- STATE:ztP PHoNE: 6A ?-B€? CITY: ADDRESS: OWNER: NEW - BEMODEL ADDITION DEMOLISH OTHER DESCRIBE WORK: EXPIRES PHONEZCONTRACTOR'S NAME ELECTBICAL: NST. PLUMBING: GENERAL: TFIACTOB # I OF BDRMS: - OFFICE USE - FLOOD PLAIN RANGE: SECONDARY HEAT: SOUABE FOOTAGE: LAND USE: OCCY GROUP: I OF STORIES: ZONING CODE: CONSTR. TYPEr HEAT SOURCE: # OF UNITS: _-- To request an lnspectlon, you must call 726-3769. Thls ls a24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll bemade the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day. REOUIRED TNSPECTIONS Temporary Electrlc Rough Mechanlcal - Prlor to cover. Flnal Plumbing - When altplumblng work ls complete. Slte lnspectlon - To be madc after excavatlon, but prlor to settlng forms. Rough Electrlcal - Prior to tl Flnal Electrical - When ail electrical work is complete,cover. Underslab Plumblng/ Electrical / Mechanlcal - Prlor to cover.Electrlcal Ser,vlce - Must be approved to obtaln permanent olectrlcal powor. Flnal Mechanlcal - When allmechanlcal work is complete. Footlng - After trenches are excavated.[-l Flreplace - Prlor to factng - materlals and framlng lnsp. Final Buildlng - When allrequlred lnspectlons have been approved and buildlng is completed.Masonry - Steel locatlon, bond beams, groutlng.Framlng - Prlor to cover.tl Foundatlon - After forms are erected but prlor to concrete placemont. w Othe Wall/Celllng lnsulatlon - Prlor to cover.fc-Wq q?- Underground Plumbing - Prlor to fllllng trench.l--l Orywall - Prtor to raping Underlloor Plumblng / Mechanlcal - Prlor to, lnsulatlon or decklng. Post bnd Boam - Prlor to floor lnsulatlon or decklng. MOBILE HOME INSPECTIONS Wood Stovo - After lnstallatlon lnsert - After flreplace approval and lnstallatlon of unlt. Blocking and Set.Up - When ailblocklng ls complete. Floor lnsulatlon 4 Prior to decklng.Curbcut & Approaclr - After forms are erected bUt prlor to placomont of concrete. Plumblng Connectlons - When home has been connected to water and sewer. Sanltary Sewer - Prlor to fllllng trench.Electrical Connection - Whenblocking, set.up, and plumblng inspections have been approved and the home ls connected lothe servlce panel. l-l Storm Sewer - Pilor to ftlling* trench. Sldewalk & Drlveway - After oxcavatlon ls completc, forms and sub.base materlal ln place. [--l Water Llne - Prlor to fiillng 'J trench. Fence - When completed Stre€t Trees - When all requlred trees are planted. Rough Plumblng - Prior to cover. a-C/ur+, MECHANICAL, QUAD AREA: I OF BLDGS: WATER HEATEB: E tl E l--l Final - After ail requiredu lnspections are approved andporches, sklrtlng, decks, andventlng have been lnstalled.tl i :. ii r,,t .!.r.'i'f o,l' Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot I - lnterior -- Corner - Panhandle .-- Cul-de.sac P.L.HSE GAR ACC N S E 1 lS THE PROPOSED WORK tN THE -HISTORICAL DISTFIICT, OR ON THE HISTOFIICAL REGISTER? - lf yes, thls applicailon must be slgnedand approved by the Historlcal Coordinator prlor to permit issuance. APPROVED: VALUE (A) BUILDING PERMIT Total Value Building Permit Fee State Surcharge Total Fee so. FT. X . $/sQ. FT.ITEM Main Garage Carport Pp.t_LD_tNG VALUE, PLAN CHECKAND BUILDING PCNruIir Thls permit rs granted on the exprgss conditron that the saidconstruction shail, rn arl respecis, conform io tne ordinanceadopted by the City of Sp;in;fi;l;: inctudins the Pu.ygloOrunt Code, regutating in" ","on.trlciion and use ofbulldlngs, and may be suspended or revoked at any ilmeupon violation of any provisions of sald oiJrn"n""". Plan Check Fee: Beceipt Number: _ Date Plan s Revi ewed By Date Pald: Beceived By: DEVELOPMENT CHARGE (SDC) (B) SYSTEMS Systems Development Charge is due on all undevelopedproperties within il.re City limits which are being improved. ITEM Fixtures Besidentiat Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT FEE N0 FT. FT. (c) -#ruPlumblng permlt State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert / Fl replace Unit Dryer Vent - - - - MECHANICAL PERMIT (D) No Mechanlcal permlt lssuance State Surcharge Total Permlt Fu rnace Exhaust Hood Vent Fan By slgnature, I state and agree, that I have caref ully examlnedth6 comploted applicailon and do hereby cerilfy that alllnformatlon hereon is true and co!.rect, and I f urther cerUfythat any and ail work performed shail be done rn accordancewlth tho Ordinanccs of the City of Sprlngfleld, and the Lawsof the stato of oregon pertarnrng to the work descrrbedhereln, and that NO OCCUPANCy wlil be made of anystructure wlthout permission of the Bulldlng Safety Dlvlslon,I further cerilfy that only contractors and employees whoare ln compliance wlth ORS 7Ol,O55 wlll be used on thlsproject. I further agree to ensure that all required lnspections arerequested at the proper ilme, that each address rs readabrefrom the street, that the pormrt oard rs rocated at the frontof the property, and the approved set of prans wirr remarn Date -r /'/z-- ESlgnatu on the slte at all times durlng c on. MISCELLANEOUS PERMITS Mobile,Home State lssuance State Surcharge Sidewalk _- ft Curbcut _-_* ft Demorron //b /ce@ State Surcharge Total Miscellaneous Permlts 4\/a7)_ (E) TOTAL AMOUNT DUE (excluding etectricat) (A, B, q D, and E Combtned) ,9-/^ -aAMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER DATE PAID FT- CITY OF SPRINGFIELD, OREGON DEPARTMENT OF F'RE & L'FE SAFETY OPEBATIONS The property owner(s) shal includes: regu'l at j ons apply. have the structure inspected for asbestos. Th'is SPrlINGFIELE, 225 FIFTH STREE SPRINGFIELD, OR 9747 (50s) 726.373 FAX (sos) 726 229 i rm. S'Codt IrUa lo Oox__3_d_? €ttdE/,/t_ lz ?7/fra IDDRffi- (97-86 // ?HOI{E-N[r'IB-r]- h, TRAiNING BURN AUTHORIZATiON y'/tr/fr , te T0: City of Springfield, a Municipal Corporat'ion, acting by and through its Department of F'ire and Life Safety You are hereby authorized and permitted to burn under supervision and for education and instruction purposes that certain house or building located on Tax Lot # t7 aLJl_ ll -_/e ot _, in -_ _ Add'ition to springf ield, 0regon wh i ch 'i s des ignated as _11 6.1 ,{ q',? d Street , Spr i ngf i e'ld , 0regon . I/He, express'ly warrant and represent to you that I/We, the undersigned, pre-. the owner(s) of said property, and that the same is free and clear of any and all 1iens, encumbrances, judgments, and any'interest, r'ight, title or cla'im in any other person other than the undersigned, and that this consent is free'ly and voluntarily given, and that we will save the City of Springfield harmless from any liability to any person whomsoever by reason of any statement or warranty contajned'in this letter. I/l,le, the undersigned, also agree to the follow'ing requirements imposed by the Oepartrnent of Fire and Life Safety to assure completion of al1 regulations. he property owner(s) shall remove alI debris on the lot(s) 'involved jn this urn within sixty (60) days after completion date of the burn by the Departmenlf Fire and L'ife Safety. he property owner(s) is to secure the requ'ired demolition and plumbing cap ermits from the Bujlding Department when inside the City Lim'its. i .T b o.T p .0 2 3 4 utside City L'imits, Count v I a. An internal and external'inspection of the structure by an asbestos or environmental consulting firm.b. Removal of asbestos containing materials, as ind'icated by the inspecting firm. -Non-friable (bound) asbestos may be removed by non-certified people. -Friable (unbound) asbestos must be removed by people certified to dci"so c.Thepropertyowner(s)shallsubmitacopyoftheoriginalasbestos inspection as written by the insOectin2f