HomeMy WebLinkAboutPermit Miscellaneous 1997-6-25
RESIDENTIAL
PERMIT APPLICATION
-~
Inspections: 726.3769
Office: 726.3759
SPRINGFIELD
LOCATION OF PROPOSED WORK: _..:I Cf.2.,Q
ASSESSORS MAP: /7/] 3> 2.. '7
'1-\1' DCWVl Jrl CO nu v-t
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LOT'
BLOCK'
OWNER' J~~-t 1:\h"-l. 0 rV
ADDRESS: Iq~q HI' t1I'TYV. lr~ ern 1 v{-
CITY: .s~lVIV"lr,.fI/>.tr\ STAT'" .
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()R.,
DESCRIBE WORK:
NEW REMODEL
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hI!n
:-~~-.uV\ / P_l P,l Vlj
OTHER L-
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CONTRACTOR'S NAME
GENERA' .
PLUMBING: J:"'. ::L
MECHANICAl'
ELECTRICA' .
ADDITION
DEMOLISH
.
JOB NUMBER 9' 70 f,/ /
225 Fifth Street
Springfield, Oregon 97477
~?'(l hJ-I='lPld
TAX LOT: ;<') 7'9&,~F"l
SUBDIVISION'
PHONE: 7 L\(,.,- '6'-91
ZIP: CJ 7l.J 7-~
ADDRESS
CON ST.
CONTRACTOR'
.,,,, PHONE
'112.\ ~t\'-'lI/r..J.<..,tQI}1.1\.'.i\(i(.
EXPIRES
II!}:?:''? S
(2.jq -: S(!:hS7 ~?I/
- 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'" 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 wO'kln~ day, Inspections requested after 7:00 a.m. will bc made the following work" day~ . .
'.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
seltlng forms.
I
o Underslab Plumblng/Electrlcall
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.
o Underground Plumbing - Prior
to filling trench.
o Underlloor PlumbIng/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - PrIor to
decking.
o Sanitary Sewer - Prlo' to filling
trench.
o Storm Sewer - Prior to filling
trench. .
O Water Line - Prior to filling
trench.
D Rough Plum.blng 7 Prior to
cove~ ~
REQUIRED INSPECTIONS
D Rough Mechanical - Prior .to
cove~ .
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrlcal'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 Stove - After Installation.
o Insert - After fireplace approve.1
and Installation of unit.
o Curbcut & Approach - Alter
forms are erected but prior to
placement of concrete.
o Sidewalk & Drlvewav - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
D Street Trees - When all required
trees are planted.
~rial P.lumblng - When all
TPlum:,ng worl, Is completo.
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.
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.
. .'
Lot faces Lot Type
Lot sq. Itg. . , Interior I PL.
, IN
Lot coverage Corner Is
Topography Panhandle
Iw
Total height Cul.de.sac
IE
'I',. . I .' , ~;' ,: ~ji: ~~"~: \~)
1;1" "
.
IS THE PROPOSED WORK IN THE.
'''HISTOI;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
Setbacks.
HSE GAR Acc'l
I
APPROVED:
X $ISO. FT.
VALUE
BUILDING VALVE, 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.
." "1
BUILDING PERMIT
ITEM SO. FT.
,'1 !
Main
Garage
"
Carport
Plan Check Fee'
Date Paid:
Total Value
Receipt Number"
Building Parmi t 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 the 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
/P~~ ~tlPL-"
I,., ~,q'.
Plumbing Permit
State Surcharge , 7J" ..,..,.-15'"
Total Charge
(C)
~:
/, :4.-0
;6~
MECHANICAL PERMIT
Furnaco
Vent Fan
N'
By signature, I state and agree, that I have carelully examined
the completed application and do he,eby 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 O,dinances of the City of Springfield, and the Laws
of Ihe State 01 Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of th~ BuIlding Safety DivisIon.
I further certify that only contractors and employees who
are In compliance with ORS 701.0S5 will be used on this
project.
Exhaust Hood
Wood StoveJlnsertlFlreplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
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 the site at all times during construction.
Signature ~ h_ , ". J tL-Uc%..
c--
0/:'J'1/97
Date
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcha,ge
Sidewalk
It
Curbcut
It
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
Jl41l
f - .
VALIDATION:
RECEIPT NUMBER
DATE PAIr>
AMOUNT RECEIVED
RECEIVED BY
2.&>,212
&;p~r?
/~~.
,1t:?7~~
State Surcharge
Total Miscellaneous Permits (E)