HomeMy WebLinkAboutPermit Miscellaneous 1999-9-30
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT'
OWNER: 'Debb;,
ADDRESS:
CITY:
DESCRIBE WORI('
1) lA c.JlA \ Nz....t
NEW
REMODEL ......-
EXPII1ES
CONTRACTOR'S NAME
:.
:';PnJNCr-IE:LP /2Il';
BLOCK:
u.
STATE: _ OR
ADDITION
DEMOLISH
.
JOB NUMUER
.q4/"3'~
,
225 Fiflh Street
Sprlnglleld, Oregon 97477
TAX LOT:
SUBDIVISION:
PHONr-.
'7+I-4-/~
_ ZIP: _.3.14-77
A
~-
OTH~___
ADDRESS
CONST.
CONTRACTOR'
PHONE
GENERA' .
PLUMBING:
MECHANICAL: fumfm1....fJ.nw )qS;ll]D~0 ~,:b D
ELECTRICAl'
%0
Io::J7~O)
12{,-{)/ ac,
QUAD AREA:
. OF BLDGS:
OCCY GROUP:
. OF STORIES: ____
WATER HEATER:
- OFFICE USE _
LAND USE:_
n OF UNITS:
CON sm. TYPE:
HEAT SOURCE: _____
RANGE: __
FLOOD PLAIN:
ZONING CODE: ___
. OF BDRMS:
SECONDAFlY '-lEAl': ___..
SQUARE FOOTAGE: ...__._
To rOQuesl on Inspection, you mu::n call 726.3769. Till:; Is n 24 hour recordIng. Allln:;pcction:; rcqlJCSICc.l bcrorc 7:00 :J.rn. wlll be
made (ho same working dilY. In:;pccllon:; requesled otter 7:00 a.m. will be m<luc lhC fOlloWing Worl( day.
o Tcmpornry eleclric
D Silo InGpoction - To be made
aftor cxcLlvnllon, bul prior to
setting f~Hl1\::'.
o Undcrslnb Plumbing I Electric;!I'
Mcchnnlcal - Prior to Cover.
o Foollno - Atler Irenches arc
excavated.
o
Masonry - Sleel locntlon, bond
beams, grouting.
o
Foundnllon - After (arms me
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
10 rlIllng trench.
o
Underlleor PlumblnoJ Moch.micnl
- Prior 10 InsuJallon or decldng.
o
Po~t nod OOllm - Prior to floor
Insullltion or dccl<lng.
o Floor Insult'llion - Prior 10
dccl<lng.
o
SllnitMY Sewor - Prior to filling
Irench.
o
Storm Sewer - l'rier to fil/ing
trencll.
o
Waler Line - Prior to fillin,!)
tronch.
o Rough Plumbing - Prior 10
, cover.
REQUIRED INSPECTIONS
o Rough Mccll11nicnl - Prior 10
covor. .
D Rough Electric;,1 - Prior to
cover.
o Elcclricill Service - Mus! be
approvecl 10 obtnin permanent
elcclrlc~l power.
o
Fireplace - Prior to (;Icing
ma.terlals and (raming Insp.
o Frnmlno - Prior to cover.
o W.lIlJCclling In:;ulalion - Prior to
cover.
o
Drywnll - Prior to taping.
o
Wood Stovo - Aftor In:HalJ;l:ion.
o Inserl - Aftcr (Jrcplncc npprovcl
and Installation at unll.
o CUrbC\lt So AfJpro.llch - Aflcr
form::; are creeled but prIor 10
plncament of conCtch.l.
o Sidewnlk & OriVCW:I\, - Arter
excJ,villioll Is complete, form:>
ancl sul).base material in place.
o Fcncc - Wilen completed.
o ~;troot Tree:; - When nIl required
lrees nrc plan led.
_O.O.M____
o
Finnl Plllll1billlJ - When 0111
plumbIng W~HI< is complot.c.
o
Fin.1I EleCllicnl - When all
electrical worl( Is cOl1lplotc.
(
o Fillal Mcch.lIlical - Whon all
ITlccllimlcal worlel:> complCle.
o
Fin.1I Ouildino - Wllcn 0111
required In::ipccllons hJ,vc becn
approved and bulleJlng Is
compleled. .
o Ol.har
MOBILE HOME INSPECTIONS
o Olocl,ing flnd Set.Up - When all
bl()cl<ln~l I:; complete.
o PlllIllUil1H COl1l1eclion~ - When
home ha:.; been connected 10
w.llcr anc.l :.eW(lr.
o Electric,,1 COllnectlon - When
blocldnu. :;CI.up. and plumbing
In:.;pocllon:.; h;'lVC beon approved
anti Ihe 1101110 is connected 10
the .:.>ervlcc p.lI1cl..
o
Final - Alter all required
Inspecllons are oJpproved and
porches, "1IInlng, declls, and
venllng have been Inslalled.
LOI loceo
Lei Type .
Interior'
LOI sq. IIg.
Lot c,overage
Topography
Total helgl)!
Corner
P."nh:mc!lc
Cul.dc-sac
BUILDING PERMIT
ITEM
SO. FT.
X $/SO. FT.
Main
Garage
Carport
TOlal Value
Oulluino Permit Fcc
SI:JIC Surcharuc
TOI<11 Fcc
(A)
P.L.
Sctb.1cle. .
HSE I GAR ACC I
I
(.~HE PHOPOSED WORI< iN T1;E '
HISTOHICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
" yeo, Ihis appllcailon muol be signed
'and approved by Ihe Historical
Coo'rdinalor prior \0 permit issu<1ncc.
N
_s_~____
w
.----- -- ----
_L
APPROVED:
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
"
Tlli:; permitl::; gmnlcd on the express condition thol the ::;ald
con~truction shall, In all rC::;Pccls, conrorm \0 (he Ordinance
adopted by Ihe Cily 01 Springlield, including the
Development Code. rcgulilting the construction and use of
buildings, <3nd may be 5u~pcndcd or rcvoJ<cd tll <1ny time
upon violation or iJny provision::; 01 said ordinances.
Plan Chccl< Fcc:
Dille Paid:
Receipt NllIllbcr:__.._
Received By:
Plans Rcv"j.cwcd -.Oy-.----.--
Date
(D)
SYSTEMS DEVELOPMENT CHARGE (SDC)
Systems Development Chnrge is due on all undeveloped
properties within the Cily limits which arc being Improved.
PLUMBING PERMIT
ITEM
Fixtures
Reoldcn'i1al Dalll(s)
N'
SanHory S~wer
W<:iler
FT.
----.--
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permi!
Slate Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhau5t Hood
Vcn'l Fan
N'
Wood Stove/lnsert/Flrcplnce 'Unit
Dryer Vent
Mechanic..1 Permit
Issuance
Glalo Gurch~\lUc
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Homo
State Issuance
Slalc Surcharge
Sldewnll(
II
Curbcul
II
Demollilon
51 ole SurchiHge
TOlal Mlocellaneouz Perrnils (E)
TOTAL AMOUNT OUE (cxclutlin9 eleclrical)
(A, B, C, 0, and E Combined)
ADDITIONAL COMMENTS
FEE
\
(
By signature, I otale and agree, thai I h~ve carelully examined
1I1C completed npplication nnd do hereby certify th<lt .:Ill
Information hereon i:; lrue .1ml correct, and I furl her certHy
thaI any und ull worl~ pcrformccJ ~hall be done in accordance
wi 111 tlle Ordin,:mcu:.: o( IIw City o( Springfield, <Jnd the Law:.;
0' tile Slale of Oregon pertaining to the worl( described
heroin, .Jnd lhal NO OCCUPAbJCY will be rnadc of any
structure will10ut pcrmis::.ion of lhe Building Safety Division.
I further certify that only contmctors .:Ind employees who
arc in compliance'will1 ORS 701.055 will be used on this
project.
Slgn<lture
Date
VALIDATION:
RECEIPT NUM8Ef1 ?~?/e
DATE PAID ~~&> ~
AMOUNT RECEIVED~.z . ~
RECEIVED 8Y ~ d~~/""
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