HomeMy WebLinkAboutPermit Miscellaneous 1996-7-24
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT'
J 71'J 2.
OWNER: t?e./lf1 fYJ c:J<:;-fJ4J
ADDRESS' fa C; / 7 /'111,'VI
CITY: 41<1I1J Ell,,)
DESCRIBE WORK: I< ep 1);<::("
NEW
REMODEL
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SPRINGFIELD
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JOB NUMBER 9(" ~/)rJ~_
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT:
97if?K"
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BLOCK'
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SUBDIVISION:
PHONF'
?trl- 2 t: P19
STATE: _0/2 e
Bt3d w~ilel2 I'}Jp
ADDITION
DEMOLISH
OTHER
ZIP:
971LZ~
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CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES PHONE
GENERAL: fJe-4J'? Moo C'/FJ.) t"t: / 7 !I1/J, 'rJ )f
i ..F
PLUMBING' ~W..o~
MECHANIC" .
ELECTRICA' .
- 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' RANGF' 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 working day, Inspectlons requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be mado
after excavation, but prior to
setting forms.
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 - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. .
~ater Line - Prior to filling
~ ;;~nch.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - 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 Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stov. - Alter Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is compictc, forms
and sub.base material In place.
o Fence - When completed.
o Slroet Trous - When all required
trees are planted.
o Final Plumbing - When all
plumbing W9rl< Is complet,e.
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 - Alter all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces Lol Type. Se I bac ks -as THE PROPOSED WORK IN THE.
P.L. HSE GAR Accl HISTORICAL DISTRICT, OR ON
Lot sq. Itg. Interlor I THE HISTORICAL REGISTER?
lot coverage Corner N II yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle \W I Coordinator prior to permIt Issuance.
Total height Cul.de.sac
IE I APPROVEI""
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT.
VALUE
BUILDING VALVE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
This permit Is granted on the express condition that the said
construction shall, In all respects, conlorm 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 tlme
upon violation of any provisions of said ordinances.
Main
Carport
Plan Check Fee'
Dale Paid:
Total Value
ReceIpt Number'
Building Permit Fee
Stale Surcharge
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
FEE
ADDITIONAL COMMENTS
,,{Jf#~ L-AJC!. (Z73 ~)
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT. '2.73
Storm Sewer FT.
Mobile Home
~/"'}170
I
Plumbing Permit
State Surcharge
3,'>,c> -r Z(O
(C)
5.~C
75, {, Cl
Total Charge
MECHANICAL PERMIT
Furnaco
Vent Fan
N'
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 certify
that any and all work performed shall be done In accordance
with the Ordinances of the City of Springfield, and the Laws
of the State 01 Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of Ihe Building Safety Division.
I lurlher certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stovellnserl/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agreo 10 ensuro thai 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 slt~ all times during construction.
X A.-7 '"
Signature . ~'/q~/Jh~{..
Date 7-24--~~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surchargll
VALIDATION:
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) . 1 s-:~ t)
(A, B, C, D, and E Combined)
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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0-~AL:
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