HomeMy WebLinkAboutPermit Building 1999-12-15u a
SPRIr\lGFIELD
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office:726-3759
LOCATION OF PROPOSED WOFIK:
ASSESSORS MAP:Z@OZ
LOT:
-
BLOCK:
?7 /67?
efr,
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
TAX LOT:oo*o o
,
SUBDIVISION
.A^AfrOv^-OWNER:PHONE:
CITY:STATE:ZIP:G\-O{<-
ADDRESS:
7 ru7?
()' /os{ 1 3y F/a,*z
DESCRIBE WORK:
ADDITION DEMOLISH OTHERNEW- BEMODEL A
MECHANICAL:
-
ELECTRICAL;
ADDRESS
)t"*l ,fr6
??
CONTBACTOR'S NAME
GENERAL:
PLUMBING:
CONST.
CONTRACTOR #EXPIRES '1 PHONE
RANGE:
# OF BDRMS
_ OFFICE USE _
LAND USE:
WATEB HEATER:
FLOOD })LAINOUAD AREA:
* OF BLDGS:
SECONDARY HEAT
SQUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requested before 7:00 a.m. will be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REOUIRED INSPECTIONS
Temporary Electrlc Rough Mechanical - Prior to
cover.|14fl Flnal Plumbins - When ailTAplumbing worl( is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prlor to Final Electrical - When all
electrical work is complete.cover-
Underslab Plumblng/ Electrical /
Mechanlca! - Prlor to cover.Electrical Service - Must be
approved to obtain permanent
electrlcal power.
Final Mechanical - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Fireplace - Prlor to faclng
materlals and framing lnsp.
Flnal Building - When all
required lnspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prior to cover,tl Foundallon - After forms are
erected but prlor to concrete
placemont.
Other
WalllCelllng lnsutallon - Prlor to
cover.
tl Underground Plumblng - Prior
to fllllng trench.[--.l Drywall - Prlor to taplng
E MOBILE HOME INSPE TIONSUnderlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng.Wood Stovo - After lnstallation.
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnserl - After flreplace approvql
and lnstallatlon of unlt.
Floor lnsulatlon - Prlor to
decklng.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumblng Connoctlona - When
home lras been connected to
water and sewer;
Sanltary Sewer - Prior to fllllng
trench.Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
tl Storm Sewer - Prlor to fl'lllng
trench.
Sidewall< & Driveway - After
excavation ls complote, forms
and sub-base materlal ln place.
Water Llne - Prlor to filling
trench.
Fence - When coirrpleted
Rough Plumbing - Prlor to
cover.
(itreet Trees - When all requlred
trees are planted.
Flnal - After all required
inspectlons are approved andporches, sklrtlng, decks, and
ventlng have been lnstalled,
tf
I
# OF UNITS:
--__
ZONING CODE:_
tl
tl
E
fl
il
[-_l Blocking and Set.Up - When ailu btocklng is complete.
E
D
tl
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
-- Corner
'- Panhandle !
-
Cul-de-sac
IS THE PROPOSEO WOFIK IN THE "HISTORICAL DISTRICT, OB ON
THE HISTORICAL REGISTER?
-
lf yes, thls applloatlon mu6t be slgned
and approved by the Historlcal
Coordinator prlor to permit lssuance.
APPROVED:
P.L.HSE GAR ACC
N
I
I
S
E
VALUE
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
FT. X $/SQ. FT.
BUILDING PER
ITEM SQ.
Main
Garage
Carport
BUILDING TAIOE, FMN CHECK
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 ol Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
Plan Check Fee:
Date Paid:
Receipt Num
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
Mobile Home
22oo
//o/-,bo ZLP
M
(c)
Nc
FT.
FT.
FT.
2 Ot)
FEE
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Building Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 7O1.O5S wlll be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
from the street, that the permlt card ls localed at the front
of the property, and the approved set of plans will remain
on the site at all ti s during constructlon.
gnature
Date
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
NoVent Fan
(D)
MECHANICAL PERMIT
Fu rnace
Exhaust lJood
Mechanical Permit
lssuance
State Surcharge
Total Permit
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
.2 1Aoz-?-
t
Z
2/DATE PAID
o431
AMOUNT RECEIVED
RECEIVED BY
VAI-IDATION:
RECEIPT NUMBER
;Ji
2,
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