HomeMy WebLinkAboutPermit Miscellaneous 1996-4-5
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK.
ASSESSORS MAp.
/783.
LOT.
OWNER:
ADDRESS:
IJAJuA-
/474-
Euc;.
~A-A5.1
4~:)"I)I'_.nj'" ~
CITY:
DESCRIBE WORK:
~~2n.
NEW
REMODEL
PHONE
.
$A>€~t:!?-
2-
BLOCK.
STATE: .
~
J5<::781.)(/~J ~
/
ADDITION DEMOLISH
r-~
OTHER
e.
JOB NUMBER
~ ~ C9~ 7;'::
225 Flf1h Street
Springfield, Oregon 97477
t
. TAX LOT.
SUBDIVISION.
) < Scro
PHONE:_~(.;. r-//,e-
ZIP:
)'740/
4( A--7 ":i
~~
'II
ADDRESS
CONST.
CONTRACTOR .
-,
CONTRACTOR'S NAME
GENERA' .
PLUMBING: 7'f1}k::rX) 'I P~.!'1.
MECHANICA' .
ELECTRICAL.
EXPIRES
9/ rgr %. r ",..".....". ~. ~ /t': .
- 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: RANG~. SOUARE FOOTAGE:
To request an Inspecllon, 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. Inspectlons requested after 7:00 a.m. will be made the (ollowlng work day.
o Temporary Electric
o
Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to Cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, groutIng.
o Foundation - After forms are
erected but prior to concrete
placement.
D
Underground ~Iumblng - Prior
to f11l1ng trench.
o
Underlloor Plumbing/Mechanical
- Prior to Insulation or. decking.
o
Post and 8eam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decKing.
~anltary Sewer - PrIor to filling
~ench.
D Storm Sewer - Prior to filling
trench.
o Water Line - PrIor to fIIl1'1g
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
electrical power.
o FIreplace - Prior to facing
materials and framing Insp.
o 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
placemont of concrete.
D SidewalK & Drlvewav - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all required
trees Bre planted.
o
Final Plumbing - When all
plumbing w~)(I{ Is complet.c.
D Final Electrical - When all
electrical work Is complete.,
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
DOthor
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 arc approved and
porches, sklrllng, decks, and
venting have been Installed.
Lot faces
L01 Type
" -:::. -' ';'1 \..;: :0~..
l,l "
'...IS TH.E PROPOSED WORK iN THE.
HISTORICAL DISTRICT, OR ON-.,. ..
THE HISTORICAL REGISTER?'. .
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Topography
Total height.
Panhandle
I PL
IN
Is
Iw
IE
Setbacks
HSE . GAR. ACC I
I
I
I
APPROVED:
LOI sq. fig.
Interior
Lot coverage
Corner
Cu1.de.sac
Garage
"
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition thai 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.
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. = VALUE
Main
Carport
Plan Check Fee:
Date Paid:
Tolal Value
Receipt Number.
Building Permit Fee
Received By:
Slate Surcharge
Total Fee
(A)
Plans Reviewed By
Date
. .
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
,properties within tho City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s) N'
Sanitary S~wer FT. ~
Water FT.
Storm Sewer FT.
Mobile Home
2 .<": l>>O
Plumbing Permit
State Surcharge l 2..) --r- , 7 r
2~
?-7,MJ
Tola1 Charge (C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, I state and agree, that I have carofuliy examined
the completed application and do hereby certl fy 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 Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance w11h ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stovellnsert/F1replace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the front
of the property, anq the approved set of plans will remain
"-Zhe site at~ times during construction.
Signature 2 \ ;t;- /7 -
Date ~- <'- 9C
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
Slate Surcha~e
VALIDATION:
RECEIPT NUMBER
DATE PAID
RECEIVED BY
71) 7~.J
4/0~
?7tTC
,~~~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
zztn
AMOUNT RECElv"n,