HomeMy WebLinkAboutPermit Building 1993-6-3
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olfice: 726':3759
'LOCATlOr~ OF PROPOHA ~R..!S!. . cJ4,9 ~
ASSESSORS MAP: \' 1lJ...J d ~ \ \"
BLOCK: SUBDIVISION'
OWNER\J~O \\1 ~ ~\Q(\0n~Q \~\ J) P~.~E E '-1~.\.9-qy(b
ADDRE~;~:~ C\ ~ l roU)\. ("f) \ () .1, Jrn~l fl" I ~
Cln Jr(jJ \ STATE:_(910CYW') ZIP:~
(rl~( ~(\D- . I ~r-D,Nl)
OTHER 4
CONST.
\ 1 ADDRESS (\ I ~"," C~TRACTOR'..,O EXPIRES -, . ~HONEC:r:d:
.\\\)~ ~~(1)'\\I)\Qf-' '/2S,('\ ~<;;5~QJr::1
LOT:
DESCRIBE WORK:,=~',
NEW __'
REMODEL
ADDITION
CONTRACT~S NAME r\.,.".l
GENERAL: __, r- \.:.U\\.
.... . ~
PLUMBING: _
MECHANICA"
ELECTRICA"
OUAD AREI~ QJl tu
. OF BLDGS: \
OCCY GROUP: __\:\?=>
. OF STORIES:
WATER HEATER:__
- OFFICE USE -
LAND USE: --1L11 .
:~:S~:IT;~PE: ~ 0
HEAT SOURCE:
RANGE:
JOB NUMBER qQ.{'()~ f
)
r-.
no~
TAX LOT'
FLOOD PLAIN'
\ [)R-
ZONING CODE:
. OF BDRMS'
SECONDARY HEAr
SOUARE 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, Inspectlons requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be made
aHer ~xcavation, but prior to
scttir,Q forms.
o
Underslab PlumbinnJ Electrical/
Mechanical - Prior to cover.
o
Footing - Arter trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o
Foundation - After forms are
crectr::d bul prior to concrete
placement. .
o
Underground Plumbing - Prior
10 IlI1in~1 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 - Prior to filling
trencll.
o
Storm Sewer - I"rior to filling
Irencil.
[]
Water line - Prior to filling
trench.
\KJ
Rough Plumbing - Prior to
covel.
REQUIRED INSPECTIONS
~ Rough Mechanica(- Prior to
~ cover.
f""Vl.Rough Electrical - Prior to
W cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prior to facing
materials and framing Insp.
[Z]
Framing - Prior to cover.
o Wall/Ceiling Insulation'- Prior to
cover. \
~ Drywall - Prior... to taping.
o Wood Stove - After installation.
o Insert - After fireplace approval
and installation of unit.
D
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base materiai in place.
o Fence - When completed.
D Street Trees =--,~When a!! required
trees are planted. -
o Final Plumbing - When all
plumbing work is, complete._
"-1..1 .
[Z] Final Electrical - When all
electrical work is complete.
r--;r Final Mechanical - When all
LL\l mechanical work Is complete.
rl/f Final Building - When all
~ required inspections have been
approved and building is
completed.
DOther
,
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - Wilen 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. fig.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fec
State Surcllargc
Total Fee
(A)
Setbacks
, , , I
HSE GAR ACC
I
I
I
I
.
I PL
IN
Is
W
E
VALUE
.31ArtJ
'22'9. .-
/"'.~
2JO. '-6
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
(B) -er
PLUMBING PERMIT
ITEM
Fixtures -?
Residential Bath(s) N'
Sani tary Sewer FT,
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
, Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
N' --------
Vent Fan
Wood StoveJlnsert/Fircplace Unit
Dryer Vent
Mechanical Permit
IYJ#.
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
It
Demolition
Slate Surcharge
~- ..- ~
('1".-- "
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
~.-
:de?
~
/,~
?/-.~
/5. <oe>
/&;7,-
- 75""
~5: /{)
/f/B- ~
~.5,?
.
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTEFI?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condilion that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulcting the construction and use of
buildings, and may be suspended or revoked al any time
upon violation of any:'provisions of said ordinance::;.
Plan Ci'eck Fee: ~tl$ S-
Date Paid:
Receipt Number:
R/Zceive By: - .
-,,'/-lA..-~~~/
pi~~~/
& t]/- /--=t
Date -
Systems Development Charge is due On all undeveloped
properties within the Cily limits which are being improved.
ADDITIONAL COMMENTS
~~t\ %~Ob\l ~~ ~ ,-\'lW
D ~\)))\\\~(). ,ckroVTOOJl
. ,~~ -3ri ~A
.
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 cerlify
that any and all work performed shall be done in accordance
with the Ordinances of the City ot Springfield, and lhe Laws
of the State of Oregon pertaining to the work described
herein, and, that NO 'OCCUPANCY will be mode of any
structure without permission of the Building Safely Division.
,
I further certify that qnly contractors and employees who
arc In compliance wl1h ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspcction~ are
requested at the prop~r time, that each address is readable
from the street, that the permit card is located at the fronl
of the property, and the approved set of plans will remain
on the site at all times during construction. .
Signifj Yhni O/V~ c~~.
Date 0/-1 :;;;
VALIDATION: R7rJ!c::..
RECEIPT NUMBo/' _". ":'/ - )
DATE PAID (Q '3... .~
AMOUNT R~EIV 1,.__ ~~
RECEIVED BY ;/\n. ~~ .
~. -