HomeMy WebLinkAboutPermit Building 1998-05-29SP ELE,
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BLOCK:SUBDIVISION
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LOT
JOB NUMBER
LOCATION OF PROPOSED WOFIK:
ASSESSORS MAP:
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
225 Fifth Street
Springfleld, Oregon 97477
PHONE:
STATE:Oagod F/ZIP:q"7? 7 7
7tllf- Slco fl tt Taeatryijr--*OWNER:
ADDRESS:
CITY:
NEW
-
REMODEL ADDITION DEMOLISH OTHER {I
DESCRIBE WORK:
PLUMBING:
/lrle,
NOTICE:
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CONTRACTOR'S NAME
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MECHANICAL:
ELECTRICAL:
GENERAL:
ADDRESS
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CONST.
CONTRACTOR #EXPIRES ,$ PHONE
r OF BDRMS:
WATER HEATEB:RANGE:
ZONING CODE:
FLOOD PLAINQUAD AREA:
g OF BLDGS:
SECONDARY HEAT:
SOUARE- FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recording. All inspections requested before 7:00 a.m. will be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the following work day.
REOUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prlor to
cover.
Flnal Plumbing - When att
plumbing work is complete.
/\l-l Footlng - After trenches are
luy'cavated.-"-<:.
Slte lnspection - To be made
after excavation, but prior to
setting forms.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Masonry - Steel locatlon, boncl
beams, groutlng.
Foundatlon - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to fllllng trench.
Underlloor Plumbing/ Mechanlcal
- Prior to lnsulatlon or decking.
Post and Beam - Prlor to floor
insulation or decking.
Floor lnsulation - Prior to
decking.
Sanllary Sewer - Prior to filling
trench.
Storrn Sewer - Prior to filling
trench.
Water Llne - Prlor to filling
trench.
[-l Rough Electrical - Prior tot--J cover.
Electrlcal Service - Must be
approved to obtain permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and framing lnsp.
ng - Prior to cover.
Waltf Ceiling lnsulatlon - Prlor to
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work ls complete.
Flnal Buildlng - When all
required lnspections have been
approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When atl
blocklng ls complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Eleclrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
lnspections are approved andporches, sklrtlng, decks, and
ventlng have been lnstalled.
E
cover.
Drywall - Prior to taping
Wood Stove - After lnstallation.
lnsert - After fireplace approvql
and installation of unit.
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Sidewall< & Driveway - After
excavation ls complete, forms
and sub-base malerial in place.
l-l Fence - When conpleted
$treet Trees - When all required
trees are planted.
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[--l Rough Plumbing - Prior toU cover.
+ - l :;
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle l'
-
Cul-de-sac
IS THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
PL.HSE GAR ACC
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BUILDTNG PERMIT
VALUE
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ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT. X $/SQ. FT.
' 't.BUILDING VALUE, PINru
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
CH ECK
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Plan Check Fee:
Date Paid:
Recei pt Number:
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N0
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carefully examlned
the completed apptication and do hereby certlfy that all
lnformation hereon is true ancl correct, and I f urther certify
that any and all work performed shall be done in accorrJance
wlth the Ordinanccs of the City of Springfield, and the Laws
of the State of Oregon pertainlng to the work described
herein, and that NO OCCUPANCy will be made of any
structure without perrnission of the Building Safety Division.
I further certify that only contractors and enrployees who
are in compliance with ORS 701.055 will be used on this
proiect.
I further agree to ensure that all requlred inspections are
requested at the proper tlme, that each address is readable
from the street, that the permit card is located at the front
of the property, and the approved set of plans will remain
on the site at all times during con ructlon
sis
Date
Wood Stove/ lnsert/ Fl replace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Perrnils (E)
N0Vent Fan
(D)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Mechanical Permit
lssuance
State Surcharge
Total Permit
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Combined)
3oo7b
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VALIDATION:
BECEIPT NUMBER
DATE PAII)
AMOUNT HECEIVED
RECEIVED BY
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