HomeMy WebLinkAboutPermit Building 1994-06-07t
RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Offlce:72A8759
LOCATION OF PROPOSED WORK:
SP]lINGFIELE)
th
JOB NUMBER
225 Flfth Street
Sprlng fleld, Oregon 97 477
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ASSESSOBS MAP;/7 oA z/ / 3 TAX LOT 0
LOT ':.4--1*-,|?/ ----+/-trrE?;g5r-9-++BLOCK:SUBDIVISION:
PHONE:
ztP$7<STATE:I
j-h
CITY:1>frr ,-,L4{,'4[ d
ADDRESS:
OWNER:
OTHERAITIONoLrISH-
DESCRIBE WORK:
NEW- BEMOD
PLUMBING:
MECHANICAL:
R#EXPIBES PHONE
coNsr.
CONTRACTOR'S NAME
GENERAL:
RANGE:
r OF BDRMS:
- OFFICE USE -
LAND USE:
WATER HEATER:
FLOOD PLAINOUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUABE FOOTAGE:
OCCY GROUP:
* OF STORIES:
ZONING CODE:
CONSTB. TYPE:
HEAT SOURCE:
# OF UNITS: ---
To reguest ar, lnspectlcn, you must call 726-3763. Thls ls a ?4 l;our rcccrdlng, All lnspectlcns requested befcr.c 7:C0 a.rn. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTTONS
n Temporary Electrlc Rough Mechanlcat - Prlor to
cover.
Flnal Plumblng - When all
plumblng work ls complete.
Slte lnspectlon - To be made
afler excavatlon, but prlor to
settlng forms.
Rough Electrlcal - Prlor to
cover.Flna! Electrlcal - When all
electrlcal work is complete.
tl Underslab Plumblngl Electrlcal /
Mechanlcal - Prlor to cover.Eloctrlcal Servlce - Must be
approved to obtaln eermanent
electrlcal pow6r. ' ,v,6
Flnal Mechanlcal - When all
mechanlcal work ls complete,
J-l Footlng - After trenches arelJ excavated.tl
E
tl
Flreplace - Prlor to faclng
materlals and framlng lnsp
w Flnal Bulldlng - When all
requlred lnspectlons have been
approved and bulldlng ls
completed.n Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prlor to cover.a Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
WalltCblllng lnsulatlon - Prlor to
cover.
Underground Plumblng - Prlor
to lllllng trench.- Prlor to taplng.
MOBILE HOME !NSPE TIONStlUnderlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.n Wood Stov€ - After lnstallatlon.
Post and Boam - Prlor to floor
lnsulatlon or decklng.lnsert - After flreplace approval
and lnstallatlon of unlt.
Blocklng and Set.Up - When all
blocklng ls complete.
E Floor lnsulatlon - Prlor to
decklng.Curbcut & Approach - After
forms are erected but prlor to
plaoement of concrete.
Plumblng Connectlons - When
home has been connected to
water and sewer.
Sanltary Sewer - Prlor to fllllng
trench.Electrlcal Connectlon - When
blocklng, set-up, and plumblng
lnspectlons have been approved
and the home ls connected to
the servlce panel.
E
n
rl
Slorm Sewer - Prlor to fll'llng
trench.
Sldewalk & Drlveway - After
excavatlon ls completo, forms
and sub-base materlal ln place.
Water Llne - Prlor to filllng
trench.
Fence - When completed.
Bough Plumblng - Prlor to
cover.
Stroel Treee - When all requlred
trees are planted.
Flnal - After all required
lnspectlons are approved and
porchos, gklrtlng, decks, and
ventlng have been lnstalled.D
?,oaguz
I
-c/b{9-74
ELECTRICALi
E
E
tl
'a' ' ': .( ',i t ,. l:
Lot lacos
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
-
Corner
-
Panhandle
-
Cul.de'sac
( THE PROPOSED WORK tN THE -' HlsToRlcAL DlSTRlcT, oR oN
THE HISTOR]CAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved bY the Hlstorlcal
Coordinator prlor to permlt lssuance.
APPROVED:
ACCP.L.HSE GAR
N
S
IW
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express conditlon that the sald
consiructlon shall, ln all respects, con(orm to the Ordlnance
adopted by the Clty of Sprlngfleld, includlng the
Development Code, regulating the constructlon and use ol
bulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provisions of said ordlnances'
Plan Check Fee:
-
ewed ByPlan
/y=L
Recelpt Numb
Date Pald:
Recelved
BUILDTNG PERMIT
ITEM SO. FT. X $/SQ' FT.VALUE
2ffi
1fuf77
(A)
2#.?*
< f1/
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
Maln
Garage
Carport
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
No
FT.
(c)
Plumblng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
(D)
N0Vent Fan
Mechanlcal Permlt
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed appllcailon and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I lurther certlfy
that any and all work performed shall be done ln accordance
wlth the Ordlnances of the Clty of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Bulldlng Safety Dlvlslon.
I further certlfy that only contractors and employees who
are ln compllance wlth OBS 701.055 wlll be used on lhls
proJect.
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surcharge
Total Mlscellaneous Permlts (E)
TOTAL AMOUNT DUE (excludlng electrlcal)
(A, B, C, Q and E Comblned)
7{,r
/)z< r
z-2 -?qDATE PAID
AMOUNT RECEIVEO
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
Systems Development Charge ls due on all undeveloped
propertles withln the City llmlts which are being lmproved.
FT.
FT.
I further agree to ensure that all requlred lnspectlons are
requested at the proper tlme, that each address ls readable
from the streot, that the permlt card ls located at the front
of the property, and the approved set of plans wlll remaln
on the slte at all times durlng constructlon.
srsnatureS{ - (//,'ft '
Date