HomeMy WebLinkAboutPermit Building 1998-1-15
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK: \ )~ 5\
ASSESSORS MAP: V\t\~44- .
LOT:
BLOCK:
.
JOB NUMBER C\ mill
225 Fifth Street
Springfield, Oregon 97477
__ TAX LOT'
SUBDIVISION'
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1
OWNER: ~l\!\\L rVl ""d\elJ,t{, \~PHONE:_~410'N.qp,
ADDRESS: -4\4 0\.\ Q \ 'r O-~~l/ 0 . \.... '~,d))( _ - -=
CITY: ~~oO S~ATE: _ ~ ZIP: ~'112B
DESCRIBE WORK: ~ \ tAolQ& C\~D\b'! ~~
NEW REMODEL - . . :bD~N \' ;kLlSH OTHER ~~
;1
CONTRA~'S NAME
GENERA' . ~ \\ \\\0 '\2-- ~
PLUMBING.\\)\\(\ti)~ A Y
MECHANICAL'\)\~
ELECTRICAl'
QUAD AREA'
I OF BLDGS:
OCCY GROUP'
I OF STORIES'
WATER HEATER'
CON ST. /h
ADDRESS CONTRACTOR ~ V);EXPIRES ,'"' PHONE
-1,." ~ '^ ;e.-,^
C!/~ <-~ ".;,
.A q,.. V^ ~,.
"'~7;''{<-Ito~ ~'/~
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\: "A~ ' ! ~ '''Y ,1,...0
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- OFFICE U.~""'?~q, '~Q ~-1& '>%> ~~
.~ O"'~~~1;<9...o.", V '1~ ~ ~ .
LAND USE: O,,%,ol'.o_ ,,-'to?,,';- FLOOD PLA~ ~. ~.
'<'+J'4< Y, Q '~ "/)' 'U
I OF UNITS: ..~t"6'7/'a.~<'6' ZONING CODE:(). {\'l V,of
?'t, <"'0:,,, <", ' Q 'Yo .
CONSTR. TYPE: 7~p ~7 I OF BDRMS: ~ :.>-
HEAT SOURCE:
RANGF'
SECONDARY HEAT:
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, Inspections requested after 7:00 a.m. will be made the following work day.
REQUiRED INSPECTIONS
o Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Eleclrlcall
Mechanical - Prior to cover.
o Fooling - 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 mllng
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical ServIce - Must be
approved to obtai n 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 Stovo - After Instal/atlon.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms afe crected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complote. forms
and sub.base material In place.
o Fence - When corilpleted.
D Street Trees - When all required
trees are planted. '
~Inal Plumbing - When all
plumbing w9rk Is complete.
~al Electrical - When all
electrical work Is complete.
~ &inal Mechanical - When all
L...lJ"'"'" m~chanlCaJ work Is complete.
~BUlldlng - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking end 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..
':' ' ..'
~t~P. ..- .
Lot faces
Lot sq. Itg. Interior I P.L.
IN
Lot coverage Corner
Topography I' Is
Panhandle .. Iw
Total height Cul-de.sac IE
BUILDING PERJtlJIT ',j ~ .,
ITEM sa. FT. x s/sa. FT. =
VALUE
Main
Garage
"
Carport
.' ,; ::, \~ ~~.~~~ht.?~ I.
_S THE PROPOSED WORK IN THE. '
--'HtSTOI'iICAL DISTRICT, OR ON '
'THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks,
HSEIGAR
I
I
I
I
I
Acc'l
I
I
BUILDING VA uk PLAN CHECK
AND BUILDING PERMIT
APPROVED'
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
buildings, and may be suspended or revoked at any time
upon violation of any provisions of saId ordinances.
Plan Check Fee:
ftll{JJ!- Date Paid:
Total Value
, \~CU Receipt Numbe"
Building Permll Fee
1- -~PIO \',1D Received By:
State Surcharge \. \ 0Ji)
Total Fee (A) Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
;
'.
.. . ;,FEE'
Fixtures
Residential, Ba)h(s)
Sanitary S~wer
Water
N'
Storm Sewer
FT.
FT,
FT
Mobile Home
Plumbing Permit'
State Surcharge + 30lu
\ Y\ pO
- 1.0
\ .
\ lo /LU
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
\D,OO
\.n.(jJ
. \ .2.0
J-Lo .2[)
Issuance
State Surcharge
-\~
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ft
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
:S<6lo0
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
, ~ ~Q ~ .mi, ~J\~ \C\OjJY\rt
\AQ~~ "
By signature, I state and agree. that I have carefully examined
Ihe 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 of Oregon pertaining to the work described
herein, and that 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, and the approved set 01 plans will remain
on the site at all times during construction.
c---.
Slgnaturp ~~. _ " ^
" C:2. "'-
Datf' / - / t~ - 7/
VALIDATION:
RECEIPT NUMBER ~q I
DATE PAID 1- }.r;--'<ft'
AMOUNT RECEIVED 5h.l ell
~ -
RECEIVED BY