HomeMy WebLinkAboutPermit Building 1997-10-07RESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
SPRINGFIELC'(!'
JOB NUMBER Q1 14 G*7
225 Fifth Street
Sprlngfleld, Oregon g7 477
LOCATION OF PBOPOSED WORK:O i/ r*
ASSESSORS MAP:11o. v3 3a b c-t.o-b
LOT
-
BLOCK:
TAX LOI
SUBDIVISION: -
PHONE:
sC
ZIP:STATE:Ore-CITY:
ADDRESS:
OWNER:
NEW- REMoDEL ADDrroN DEMoLTsH orHER
-L
DESCRIBE WORK:
MECHANICAL:
-
ELECTRICAL:
AME ADDRESS
{(,
PLUMBING:
coNsT.
CONTRACTOR 'EXPIRES ,.1l PHONE
t Of 3W-
,T OF BDRMS:
- oFFrcE usE -
WATER HEATER:
ZONING CODE:
FLOOD PLAIN
* OF UNITS:
RANGE:
OUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE. FOOTAGE:
LAND USE:
OCCY GROUP:
I OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
[l Rough Mechanlcal - Prior to fl Finat plumbing - When ail
-
cover. lJ plumblng work ls complete.
E
Temporary Electrlc
Slte !nspectlon - To be made
after excavation, but prior to
settlng forms.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng,
Foundatlon - After forms are
erected but prlor to concrete
placemont.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Boam - Prlor to floor
lnsulatlon or decklng.
Floor lnsulalion - Prior to
decking.
Sanltary Sewer - Prior to fllling
trench.
Storm Sewer - Prior to fllling
trench.
Water Llne - Prlor to filling
trench,
Rough Plumbing - Prlor to
cover.
Rough Electrical - Prior to
cover.
Electrlcal Servlce - Must be
approved to obtaln permanent
olectrlcal power.
Flreplace - Prlor to faclng
materlals and framing lnsp.
Final Electrlcal - When all
electrical work is complete.
Final Mechanical - When all
mechanical work ls complete.
flFlnd Buitdlng - When ail
'a regulred lnspectlons have been
approved and building is
completed.
l_111'Framlng - Prlor to cover.
WalllCelting lnsulatlon - Prlor to
cover.
l--l Drywall - Prlor to taplng.
Wood Stovo - After lnstallation.
lnserl - After flreplace approval
and lnstallatlon ot unlt.
Curbcut & Agrproach - After
forms are erected but prior to
placement of concrete.
Sidewalk & Drlveway - After
excavation ls complete, forms
and sub-base material ln place.
n Fence - When coiilpleted.
Street Trees - When all requlred
trees are planted.
Other
MOBILE HOME INSPE TIONS
Blocking and Set.Up - When all
blocklng ls complete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the servlce panel.
Flnal - After all required
lnspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstallect.
CONTRACTOR'S
GENERAL:
tl E
tf
tl
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tl
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fl
E
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tl
lir
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot '. ..
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
IS THE PFIOPOSED WORK iN THE .
HISTORICAL DISTBICT, OR ON
THE HISTORICAL REGISTER?
-
ll yes, thls appllcatlon must be slgned
and approved by the Htstorlcal
Coordinator prlor to permit lssuance.
APPFIOVED:
P.L.HSE GAR ACC
N
S
E
.t
BUILDING PERMTT ' i
State Surcharge + OA Af111;
VALUE
l,bg+-.4$
3q.llTotal Fee
+
(A)
Total Value
Building Permit Fee
!,o oo
v7,50
ITEM
Main
Garage
Carport
SO. FT. X $/SQ. FT.
BUTLDING VhItle, Fmru cHEcK
AND BUILDING PERMIT
Thls permit is granted on the express conditlon that the said
construction shall, in all respects, conform to the Ordlnance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
bulldings, and may be suspended or revoked at any tlme
upon violation of any provisions of sald ordinances.
Plans Reviewed By Date
Receipt Numbe
Plan Check Fee
Date Paid:
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties withln tlre City limits whlch are being improved.
ITEM
Flxtures
Residentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N0
FT.
FT.
PLUMBING PERMIT
Plumbing Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done in accorrJance
wlth the Ordinances of the City of Sprtngfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCy will be made of any
structure wlthout permission of the Bullding Safety Divislon.
I further certify that only contractors and employees who
are In compllance with ORS 70j.0S5 wlll be used on thls
proiect.
I further agree to ensure that all requlred lnspections are
requested at the proper tlme, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
"-q'7
on the site at I times du ring constructlon.
-gtlr----Signatu re
Date
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMIT
Furnace
Exhaust Hood
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, q and E Comblned)
VALIDATION:
RECEIPT NUMBER
ro )-7
/dcr^^^-
0tA
/o-
DATE PAID o
L/AMOUNT RECEIVED
',],
k4eL ittpa-i r GA..Af
FT.
./cBECEIVED BY r)fYA r