HomeMy WebLinkAboutPermit Demolition 1995-05-01]{GFIELt)RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3765
Office: 726-3759
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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