HomeMy WebLinkAboutPermit Miscellaneous 1999-8-17
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP' I 7 IJ ~
I"
LOT:
OWNER:
ADDRESS: ~
CITY'
DESCRIBE WORK:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA' '
fJ/Vu~
PLUMBINt::'
MECHANICAL:
ELECTRICAL:
T./3./L
QUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER:
.
SPRINGFIELD
.11..." ,
. . '
JOB NUMBER -ZZ/// 7
225 Fifth Street
Springfield, Oregon 97477
~
BLOCK:
DEMOLISH
OTHER
TAX LOT:
SUBDIVISION'
D651".
ADDRESS
CONST,
CONTRACTOR'
EXPIRES ',Co PHONE
~J?Tlt~:
TL.I'SPER'1ITSHI\' ' ....vrln~I-~-=-<..__..
. / -1:.._,\ c.., 1,-Il:.VVvnr\
AUTHORI7Ffl IINn>:R TJ.lIC O!:ClMlT IS N8T
1""". ........J"..!::,... ""-1- Ie" ,- -
. - "._.:.7ct..'::'w,..J1-\ I"\lliUUI'ICUivn
ANY 180 DAY PERIOD, '
FLOOD PLAIN'
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
RANGF'
ZONING CODE:_
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspectlon, 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.
o Temporary Electric
D Slto Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Eleclrlcal/
Mechanical - Prior to cover. .
o Footing - After Irenches 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 Posl and Beam - Prior 10 IIoor
Insulation or de~klng,
I
o Floor Insulation - Prior 10
decking.
o Sanitary Sewer - Prior to filling
trench.
o Slonn Sewer - Prior to filling
trench.
o Waler Line - Prior to filling
Irench, ' . ,
o Rough Plumbing - Prior to
cover.
:,
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D RoughEleclrlcal - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Cell~ng Insulation - Prior to
cover.'
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected bllt prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and'sub-base material In placo.
o Fence - When completed.
D.s~reet Trees - When all required
trees are planted. '
o Final Plumbing - When all
plumbing work Is complet.e.
,
T~,,- ~,Inal Electrical - When all
~ectrlcal work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
~Inal Building - When all
equlred Inspections have been
pproved and building is
completed.
DOther
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.
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SYSTEMS DEVELOPMENT CHA'RGE (SDC)
Lot faces
L~t ~yp.
Interior
Lot SQ. fig.
Lot coverage
Corner
Topography
"
Panhandle
Total height
Cul-de~sac
BUILDING PERMIT'
ITEM sa, FT.
"
"t
X $/sa. FT. -
Main
Garage
Carport
C~~ /~dil"7 5l/WEi
LfA..9J/7JL~h/,T# 14.DM
Tolal Value
Building Permit Fee
State Surcharge
;.0.) 7-, <{-;
Tolal Fee
(A)
(B)
PLUMBING PERMIT
ITEM
.'
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT-
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace ~~It'
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge'
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding eleclrical)
(A. B, C. D. and E Combined)
,
.,
.... . , ",', " -~~
'~~ ~~ ~~ ,~;:!f'~.'.: ~"!':~!:r.~' .i \~p ~~~jd.:~.tF;: ~
',.:" ~.' Setba'ck's'. '"
h~L. HSE GAR ACC'!
I N 'I
I s I
~---I :
BUILDIN'G VALdE, PLAN CHECK
AND BUILDING PERMIT.
This permit is granted on the express condition that the said
constructlon 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.
VALUE
"
~b-. ~1)
FEE
/(~ >CJ
.
'.s THEP~OPOSED WORK tN THE., '
HISTOI;1ICAL DISTRICT, OR ON
, tHE HISTORICAL REGISTER?
If yes, this appliCation must be signed
and approved by the Historical
'Coordinator prior to permit Issuance.
APPROV"'"
;.. I.'.,.
Plan Check Fee:
Date Paid:
ReceIpt Number'
Received By:
Plans Reviewed By
Date
System~s Development Charge Is due on all undeveloped
properties withIn the City limits which are being Improved.
ADDITIONAL COMMENTS
"I II:.N II'JI'I:U'''YU11IOW IO'1~;;';;;; :tZll ~.,
L".... _..1M ""nntori hlltheOreaon Utility
N'oVtiii~~ii~~ C~nl~r. Those rules are set torth
. ~,\r"\""'r:""'nn"
inOAR95;<-UU1-UUIUl\IIUU\:Illt" ...:= 4".
;:;;:;0;:;. '::::. ~M~' nht"in r.noies of the rLJles by
, calling the centef. (Note: the tele~ho~e
flumberTOllne Ul"YUIl ui;I;~J r :,,:;f;:at!.c~
, "M'ndo 1_Rnn_~~2_2344). '
By sIgnature, I state ~nd 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 Ordinanc~s of the City of Springfield, and the Laws
of the Stale of Oregon pertaining to the work described
herein, and tha' NO OCCUPANCY will be made of any
structure without 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. a ~ the approved set of plans will remain
on the site a I t es,d~rlng c~truct~.
'ft,lgnatur ,~a<LJ
'-tPate' S-- /j- 77 (j
VALIDATION:
RECEIPT NUMBER
DATE PAID
~C' .;).,$""0
<(;-11-<;<=1
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~
AMOUNT RECEIVED
RECEIVED BY