HomeMy WebLinkAboutPermit Building 1998-6-25
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
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LOCATION OF PROPOSED WORK: _/'9~c> , ft'/AI"f-"?~ 7?<,
ASSESSORS MAP: /? -41:;>' ::?5";:> '2
LOT'
BLOCK'
OWNER'
ADDRESS'
CITY:
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DESCRIBE WORK:
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NEW REMODEL
STATE:
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JOB NUMBER
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225 Fifth Street
Sprlnglleld, Oregon 97477
TAX LOT'
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SUBDIVISION'
PHONE:
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ZIP:
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ADDITION
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REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvlll
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Drlvewav - Aller
excavation Is compiete, forms
and sub.base material In place.
D Fence - \1\then completed.
D Street Trees - When all required
tree.s are planted.
_ CONST.
CONTRACTOR'S NAME A~!" Lh =-- ' CONTRACTOR N EXPIRES,~ PHONE
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GENERAL:;'_i- //N~ C-~~ _4.'?.....~"1../-_ //V~;;:-."../~_ 41~3"~;>?
PLUMBING-
DEMOLISH
OTHER
MECHANICA' .
ELECTRICAl'
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
N OF BLDGS' N OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: N OF BDRMS:
N OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE:_ 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.
D Temporary Electric
D Sito Inspection - To be mado
after excavation, but prior to
settIng forms.
D Underslab PlumbIng/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulatlon or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench. .
D Rough Plumbing - Prior to
cover.
D FInal Plumbing - When all
plumbing w9rk Is camplet.e.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
r.7l Final Building - When all
~ required Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D BlockIng end Set-Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home 15 connected to
the service panel.
D 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~t ~vp.
Lot sq. ltg.
Interior
Lot coverage
Corner
Panhandle 'p.
Topography
Total height
Cul-de.sac
BUILDING PERMIT "1 .~ 't
ITEM sa. FT. x $/sa. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
N'
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
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
ft
ft
Curbcut
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
Setbacks .
I P.L. HSE GAR ACC'
IN
Is
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VALUE
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FEE
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. IS THE PROPOSED WORK IN THE.
'''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
.
,
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
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APPROVED:
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BUILDING VALOE, 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
adopled bV the City of Springfield, including the
Development Code, regulating the construction and use of
oulldlngs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed BV
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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 Ordinances of Ihe City 01 Springfield, and Ihe Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure wllhout permission of the Building Safety Division.
I 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 time, 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 th site a all times dUringnn~.;:tlon.
Slgnatur ~~ _..~
Datp ~~d~
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VALIDATION:
DATE PAID
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RECEIPT NUMBER
AMOUNT RECEIVEr>
RECEIVED BY r/;.."~ -~
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r 2"x 6" MUD SILL PLAIT
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2" x 8" FLOOR JOISTS
- STD/BTR
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6"x 8" BEAMS STD/srn
REPLACE AS NEEDED
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PLANTER BOX
MARKET STREET
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GARAGE
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