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HomeMy WebLinkAboutPermit Miscellaneous 1997-9-12 . . RESIDENTIAL PERMIT APPLICATION !nspectlons: 726.3769 Office: 726.3759 97/S(4 ( JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 '77{", S-7r7ckl}",,~if .? c:-, .~ n dW<4 J LOCATION OF PROPOSED WORK: ASSESSORS MAP' ) 70 2.- LOT' O/'2..~ TAX LOT: SUBDIVISION' BLOCI<" OWNER: .:-,() r. '" j [,. e Id ADDREe",. ,1)<:"0 /IJ. (,-J rl -j- U./..';. t-y B c''''lrzD A ~ PHONE: /}:J(,., ::J. ':i9e-- crJ 1/ '7'7 Or CITY: STATF' ZIP: ,-/)S7;?C:;//<;d /PC:l/~{l~ DEMOLISH L DESCRIBE WORK' NEW REMODEL ADDITION OTHER CONST. ADDRESS' <Ii- CONTRACTOR · ~-< RiVO,,-L~ J f(/rlJ,. ":nU-3 CONTRACTOR'S NAMh GENERAL: fr;cT' QI YA,/..:J $'. I ' EXPIRES S.~ ..... PHONE .. ?,K!- 7c><:~ PLUMBING' MECHANICAl' ELECTRICAl' - OFFICE USE - i"'~ \NO~" LAND US'"^.,.\c~: . 'l,.'- ~'I."\~~\~ow.\'tl~~~\LAIN' ~. w.\ibl'\I" ",\S""-" p- · OF UNIJ:Sn"- \lE.~ . \\\r!:'p. i O~~~ING CODE: ID'- "'ll~Uv B",~t) CONSTR. T~O ':P IS '" . OF BDRMS: I" ~~C\:.U \) HEAT SOU_"^ " ?I"-'P,IO . eO\)t'\ RANGE: -':"IloN~ , QUAD AREA' . OF BLDGS: OCCY GROUP: . OF STORIES: WATER HEATER: SECONDARY HEAT: SQUARE FOOTAGE: To request an Inspection, you must call 726-3769..Thls Is a 24 hour recording. All Inspections requesled 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. REQUIRED INSPECTIONS D Temporary Electric D Rough Mechanical -.: Prior to cover. D Final Plumbing - When all plumbing w9rk Is complele. D Site Inspection - To be made after excavation, but prior to setting forms. D Rough Electrlcsl - Prior to cover. D Final Electrical - When all electrical work Is complete. D Underslab Plumblng/Electrlcal/ Mechanical - Prior to cover. D Final Mechanical - When all mechanical work Is complete. D Electrical Service - Must be approved to obtain permanent electrical power. D FooUng - After trenches are excavated. w('Flnal Building - When all ~equlred Inspections have been approved and building Is completed. D Flreplece - Prior to facing materials and framing lnsp.. D Masonry - Steel location, bond beams, grouting. D Framing - Prior to cover. DOther D Foundation - After forms are erected but prior to concrete placement. D Wail/Ceiling Insuletlon - Prior to cover. D Underground Plumbing - Prior to filling trench. D Drywall - Prior to taping. MOBILE HOME INSPECTIONS D Underlloor Plumbing/Mechanical - Prior to Insulation or decking. D Wood Stova - After Installation. D Blocking snd Sat.Up - When all blocking Is complete. D Post and 8eam - Prior to floor Insulation or decking. D Insert - After fireplace approvel and Installation of unit. D Floor Insulation - Prior to decking. D Plumbing Connections - When home has been connected to water and sewer. D Curbcut & Approach - After forms are erected but prior to placement of concreto. D Sanitary Sewar - Prior to filling trench. D Electrical Connection - When' blocking, set.up, and plumbing. Inspections have been approved and the home Is connected to the service panel. D Sidewalk & Driveway - After excavation Is complete, forms and sub.base material In place. D Storm Sewer - Prior to filling trench. D Water Line - Prior to filling trench. , D Fence - When completed. D Final - After ell required Inspections are approved and porches, skirting, decks, and venting have been Installed, D Rough Plumbing - Prior to cover. D Street Trees - When all required trees are planted. . , L~I ~ype. ',.? ',\ Lot faces Lot sq. ftg. . Interior Lot coverage Corner Panhandle " Topography Total height Cul.de.sac .' :i BUILDING PERMIT ITEM SQ. FT. if "1: X $/SQ. FT. D Main Garage Carport Total Value Building Permit Fee Slate Surcharge TOlal Fee (A) '{ ..f :' . ~~',;,,:.:ti;! '1 :~: .v' ~'~.~Nr.~ \' .... I P.L. IN Is Iw IE VALUE " (B) SYSTEMS DEVELOflMENT CHARGE (SDC) PLUMBING PERMIT.", , ITEM ..~ ,j .,' Hr, ',. I,. "1, 1l ...,', ',. ;j Fixtures ',' . N' , Residential Balh(s) Sanitary S~wer FT. Water FT. Storm Sewer FT. Mobile Home -lI' Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnaco Exhaust Hood Vent Fan N' Wood Stovellnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition 1'10 r- I)f State Surcharge Tolal Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) FEE . Ii / f/-, '?tJ l/t-1- Ji. f4- n.#!- Setbacks, HSE GAR ACC' '. ( IS THE PROPOSED WORK IN THE. --'HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? II yes, lhls application must be signed' and approved by the Historical Coordinator prior to permit Issuance. I I I I APPROVEn. BUILDIt.J!G V~L1jE. 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 bulldl ngs, 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 By Date Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS '~A~7b3 ~.r.~~rJ 'j ~~~1'3j _~. 7)/~n/~7fl) 7T) , /17/.);~ t0fYr i . ;lA-Ie- 5lf1t(1r- ~.e ~~) .j ~~) : CI!ttl(7P1~~ ~/7c.. ~C6- Vb1t:.. ~p i'i'kJ.c f-,BtL k}/ . - 5Ifwl" AY.2' ~' , f':: -0..// ~ By slgnature,l state and agree, that I have carefully examined the completed application and do hereby certify that all Informatlon hereon Is true and correct, and I further certify that any and all work performed shall be done In accordance with. the Ordlnencus of the City of Springfield, and the Laws of the State of Oregon perlalnlng to tho work described herein, and that NO OCCUPANCY will be made of any structure without permission of lhe 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, lhat each address Is readable from the street, that the pormlt card Is located at the front of the property, an e approved set of plans II remain / on the site at al mes during construct on. ~atu r7 .~- 0 Dat". . ")'-/2 -1; v VALIDATION: RECEIPT NUMBER DATE PAir" AMOUNT RECEIVED RECEIVED BY 2715'7 q//l./, ') F /1',..# Af/~.