HomeMy WebLinkAboutPermit Building 1990-03-16.. RESID.- lTlAL..
22s North sth streeaPPLrcATrw/PERM*Springfield" Oregon gZ4Z?
Building Diuision
7 26-37 53
SPFTINGFIFLTT
Date:
to aee
Loeated
on the
Iour Citg Desigr,ated Job llwnbez, fs
ll
*ubR-
!
1
Plumbi ng
Str
It ie tlu
fnon the*BuiHing
forme.
FITIAL PLUMBIIIG
FINAL I,IECHANTCAL
FINAL ELECTRICAL
Elec tr 1an
?o be afterp*iot tc set uP of
'-reeponaibililU of the pernit holder"'fr?,3!*?,IirYi..?3HY*r#*that-all inopectiona ate nad,e
fri,o'rTo,,{Zi"'L'?rroiffiZi?'
at the prope? tine, that each address is rea4qh
of inspec;icn
befcre- ?:00 ot
'f*i]:i;:""r*:;'""i'"x:""1,"tr*?:,*zor#':! ,"u ntnbe,', iob accress. type.after ?:00 an "r11-;; ,*d" ll;;";;:f;"iT "refl;e
nunbcp. Reque,ts reeeii;Zd.
w
x
rrude OR
Sctti tazA sa)e? eapped at ptope?eg- Line,
_Dotk ie cotsered.
P)_O?ING & FgUNpA?ICN: ?o be tmCea-1'yer tz.enches a?e e.ccatsated and.forms ane eteeted, but prior lJpounng ccne"eta.
n
4j'Prl,00=fi_rtr13.IJ' +irs+t#++...?o be made prior io-iliii|Tffifr orfloor ineutation or decking.
fr] epsT 4yo s,Eau: ?o be nad,e pr.tot to'4-J instalZation of floor insulation otdecking.
ROUGH PEUI#*I](h ELECYRTCAL H#fl-;i;itii: ;;o uoii ii-7o876.*&ii-ut:til these inspectiors ltaue been
nwd,e and. appnoued..
FfPEPLACE: prior to placira facinomatertals arzd before franitfi Zn"pnZ_
tLOn.
ffi pnuract_ Itust be req-uested afterIt/ I approoal of rough plwnbing, electni_eal & neelanieal. - AL! ?obling
bractrq & chinmeys, ete. rrust" be
. eompleted. lto ucrk is to be eon-. eecled unti,L this inspeetton lws
'been nad,e anC approued.
w D4YT.ALL_INSiECyIOil: Ic be nadealxez, aLL dtguall is in plaee,but p?io" to any ta?ing.
UAS1NRI: SteeZ Loeation, bond.beams,_ grouling or oerticals inaccopdozce uLth U.B.C. Section2415.
VO2DSTO,IE: Aftez, itatallation ieuntpleted.
CURB & APpRg4CIt AppON: Aftet fornsee erecteC but prior to pourttqeoncrete.
SIDEIIALK & DRf,,E\4AI: Fot, all eott_erete paoing ttthin et?eet r.ight_of-Ya, to be nade after aLL Lrca-oating conplete & fotn wtk & sub_base tnaterial in place.
Septic totk Va;.,rped and. filled tith gra;sel
Final-- t{hen abase itens are canpleted,and uhen C_q.tolition is canplete Z"-;;;"_ture notsed attd. prerrises "tZ"ii;;.-'*-
!E!!!: hthen eotnplete -- prouiCe
gates or notsable sectiane throzgh
P.A.E.
ALL project conditions, sucV. as the i.nstallation of stteet trees, eonpletion of tie
required Landsccpi,r.g, ete,, rmtst be satisfied before the BUILDIN? FillAL can be requested.
fiNAL BUILDING: The tinal Bui.Lding Inepection mtst be requested after the Final Pllotbing
Anoi"i;"i,--and t"teelnrieal Inspecti,ons haoe been made and approoed.
Job Locaticn:
Aesessors Map #?as Ipt # Cg
Asner:
Phone:
Address:
Qa 6*<a'D?r<Z Z*-z .bVz>r,Va.zryb'
Descz.Lbe Hoyk:
Additicn
VaLue ?'a*=>-Date of Applicatian 2
General
ect
Mobi Hcmes
BZoeking od. Set-up
Plunbing connectione -- saie? ad. aatet,
Ele-ctr.tcaZ Ccmneetion - Bloeking, sei_uDand- p Lunb ing c onne c t i on e,ros t b"e' apii clln abefore requeeting eleelrical l,""eiZ'tl.o7*
Aceeesory* Buiaing
Pinal - Aften-pcte-kes, ski.rting, d,ecks,etc. @e cotnpleted.
n
*ALL IIANHCLES AND CLEANOUTS MUST BE ACCESSIBLE, ADJI]STIIEIIT TO BE I'L4DE TT NO CCST TO CITY Page 1 of 2
_^---
? z=-
r
T
/CL
-- Fees --
L-co #
OLAR ACCESS REQ.-JOB NO.
EuildLng Petmlt
State
Total Chargea
TotaL
Lot Faces -
zls--
IHAWIAREEULL|EXAMINEDtheeompletedappl-icationforpertnit,'ald'do
hereby certify tn {"i"l."iJr "iizn tnn"oi is trae a,.d cbrrect, ard. I
i)"ti"", eertiiy that'Lny- oii all uork per.for"zed slnll be dota in acco?-
dance vLth th" 0"d;;;:;2""';f ;h; ilv Zf 'springfield'
.artd th.e .Las of the
* State of aregcn p"":,;;;;1;g-'to- iin *il, Ces'cribbd herein, cnd ttnt N0 ocCU-
Pl.Ncv tvitl be nace ;7"';;;;" t;;;i*' *ttno't pernission of the gui'tdins N-
rlLsion. r fut'thet'7""1:;?|l"i;;--i'1v oo't'o;to?s eid anplcyees ako are tn
Lor,pllance uith cRS-iol.b"ss uiLL be used on this proiect
)t^t (, ),ilu z-0
BeCtoons
AccessHouse
l-ot Sq. ?tg.
% cf Lct Cotserage
# of Stoties
Total Eeight
lropogrcPhY
Grc
LOT TWE
_ Intericr
Cormer
Panhartdle
Cul-de-sac
ValueFTGITEM
TOTAL VALUE
S.D.C. 7.5 t
5>Date Paid
ReceiPt #:
7
CHARGEcr'r'No.
Ei,ztutes
Residztttial (1 bath)
Seue?Sani
2 e.*
e
4?
2/-P
cant.
Plunbing PenrLt
State
22Nea/tutetd Circuits
Sensice
-6=
Wlpre State Las tequiree tllat the ele^etri,caL uotk be ilone by
contractor', the eleeti'c"i';;"i;';;"- of t'his 'pennit sho'Ll rot
the Label lns been u'g""Z fu the EleetrLcal conttactot'
Total
a tImreoPcrtceIE ELectricalan
Lunt'LoaLi.Cbe
it, A Dal
NC.IT9M
,
bhanst HooC
Vent P@l
llcodstote
*
Mechonicol Permit
Permit Issusrce
Mee?wnicel Perrtt
- gpgp1\gsMEXT -'
Secari
Petwit
Attbcut
Sideualk
L
Mobile Hone
OTAL AT\OI/ilT DUE: *ft6-ae Date
Qo
North
Fnsf.
5outh
llest
Main
(21Tace
&>7*=>Lt>-zt:.;,1-q<a*
4-?7
Permit No:
Address:
lssued Date
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTTON RESPONSIBILITIES
Fill in the applicable blanks, and initial box 1 and either box 2A or 2Pi:
I own, reside in, or will reside in the completed structure.
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.d
Note: Oregon Law, ORS.701-055(4), requires residential building permit applicantsyl.o a.re not registered with the Construction ContractorsEoard to'sign thefollowing statement before the building permit can be issued-. f--icenseJ iiinitectand Engineel.aRolicants, exempt from iegistration under oRS 7o1.0io1i;, neeonot submit this statement. This statement will be filed with tne perm'it.
1A
1
2. A.
I will be my own general contractor.
lf I hire subco4tractors, I will hire only subcontractors reoistered with theConstruction Contractors Board. lf I chanoe my mind and Eo hire a oeneratcontractor, I will contract with a contrattor -who is reoistered wlth theConstruction Contractors Board and I will immediatelv-notifv the officeissuing this building permit of the name of the contraitor. '
03-tb-q0
Signature of Permit Applicant
GONSTRUCTION @NTRA TORS BOARD
0244J10i24t@
Date
h
[? Lfuk*PY ro rssurNc AGEN.YI ,r )i-,Ptga COPY TO APPLICANT
L,*-'f LLtA_,
PERMIT FILE
I hereby certify that the above inlormation is correct and that I have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side ol this form.