HomeMy WebLinkAboutPermit Building 1998-3-16
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.,?" RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Orflce: 726.3759
ASSESSORS MAP'
LOT'
OWNER'
CITY:
.
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SPRINGFIELD
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BLOCK:
STATF'
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JOB 'NUMB'~R ~;/
'f' .,
22S"Fi'fth Street. '. ,.,' ." .'
Sprln~leIQ" Oregon' 9747:1.
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TAX LOT'
SUBDIVISION'
4-9~j
.~.. .
PHONF'
ZIP:
97~-:::>
DESCRIBE WORK: ~/~ /?r~Y ~,____~7, ~ ---;.f'/L""......;,....:- A~:r" ~
NEW REMODEL ADDITION DEMOLISH OTHER
CONST.
CONTRACTOR'S NAM~ ' ...,~~S;_ 'f?~~ CONTRACTOR # EXPIRES
GENERAL'~ .o#'''.' ,..Ab~~~.~...,",_">, ~~_ ~/q6
7~ I, . ... -;-,. t /' "",- - ,.. r
PLUMBING'
MECHANICA' '
ELECTRICAl'
,'"' PHONE
7.afi(. ":--_ ~
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
# OF BLDGS: # OF UNITS' ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SQUARE FOOTAGE:
To request an Inspection. you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day. Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal1
Mechanical - Prior to cover.
ri7I Footing - After trenches are
LA.J excavated.
o Masonry - Steel location, bond
beams, grouting.
ri7I Foundation - Atter forms are
~ erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
O Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to fUllng
trench. "
o Rough Plumbing - Prior to
cover.
......
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrlcaf power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
O Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & DrIveway - After
excavation Is complete. forms
and sub-base material In place.
o Fence - Whon cOinpleted.
o Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing w9rk Is complet,e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
~ Final Building - When all
V4--J required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
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SYSTEMS DEVELOPMENT CHARGE (SDC)
Lot faces
L~l ~y.
Lot sq)tg.
Interior
Lot cov~rage
Topography
Total height
Corner
Panhandle t"
Cui.de'sac
BUILDING PERMIT "/ ;i .~
ITEM sa. FT. x $/SO. FT.
Main
Garage
Carport
._~~/Cil';'~~~~
Total Value
Building Permit Fee
State Surcharge
Total Fcc
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
MechanIcal Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
Curbcut
II
Demolillon
State Surcharge
Tolal Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C. D, and E Combined)
'-...
I PL.
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VALUE
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--,
-., ''/vr./'
FEE
HSE GAR
~'.:..'. '. .' : 'j :;~ ,; ~~,:i~:~:;{ \~ ~ .
:'.:IS TH'~:PFlOPOSED WORK tN TH~~..,
"'):lISTOI:UCAL DISTRICT, OR ON
'THE HISTORICAL REGISTER?
, .
',. "".
If yes, this application must be signed
and" approved by the Historical
Coordinator prior to permit Issuance.
Setbacks' .
;.
Acc'l
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APPROVED'
,
v ~'_. .1
BUILDING VALUE, PLAN 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 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.
Plan Check Fee:
2~. CJ ...,
Date Paid:
ReceIpt Number'
Received By:
Plans Rev/ewed By
Date
. J
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
II
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinanc~s of the City of Springfield. and the Laws
of the State of Oregon pertaIning to tho work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
J further certIfy that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required 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 ail times during construction.
Slgnature~ \;""~
Date ~I~/qp'
VALIDATION:
RECEIPT NUMBER :2"9H:3
-3 A:.!9.t::
DATE PAIr>
AMOUNT RECEIVED -L.?'
~ ~-
RECEIVED BY - .,
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