HomeMy WebLinkAboutPermit Demolition 1995-8-4
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
,
LOCATION OF PROPOSED WORK: ~9.~."5' ;t::?~//y ? .
ASSESSORS MAP' /?--<<!:} <,. -=5 c;-- '? 5>
LOT:
BLOCK:
OWNER'
ADDRESS:
CITY.
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JOB NUMBER q9-/2~/
225 Fifth Street
Springfield. Oregon 97477
. TAX LOT: ~/..PO::::::>
SUBDIVISION:
PHON'"
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STAT'"
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DESCRIBE WORK: ....-:t7~/S7~~ ~~~~.
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. ZIP: ~4"~
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl' a .-'l'~
PLUMBING:
MECHANICAl'
ELECTRICAL.
ADDITION
DEMOLISH
OTHER
__IA
.~
'!
EXPIRES PHONE
ADDRESS
CONST.
CONTRACTOR'
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 Wall/C.efllng Insulation - Prior to
cover.
o Drywafl - Prior to taping.
o Wood Stovo - Afte:r Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
O Sidewalk & Drlvewav - After
excavation Is compiete, forms
and sub-base material In place.
o Fence - When completed.
D Street Trees - When all required
trees are planted.
.1
- OFFICE USE -
QUAD AREA: LAND USF' FLOOD PLAIN'
. OF BLDGS' · OF UNITS' ZONING CODE:
OCCY GROUP: CONSTR. TYPE: . OF BDRMS:
· OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG'" SQUARE FOOTAG[:::
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.
D Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
seltlng forms.
o Underslab Plumbing/Electrical/
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.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
. cover.
o Final Plumbing - When all
plumbing w9rk Is complet,e.
D Final Electrical - When all
electrical work Is complete.
I,
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building is
completed.
[:KJ Other ~~c ~
- /)~/"'?/-s
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.
-
" , tit IS THE PROPOSED WORK IN THE. ..
Lot TY. ';.'1.
Lot faces Setbacks
I P.L HSE GAR ACC I ...HISTORICAL DISTRIGr, OR ON
Lot sq. ltg. Interior IN THE HISTORICAL REGISTER?
If yes, this appllcallon must be signed
Lot coverage Corner I
Is and approved by the Historical
Topography Panhandle Iw 1 Coordinator prior to permit Issuance.
Total height Cul-da.sac IE 1
APPROVED:
'.
BUILDING VALUE, 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. 01 Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any lime
upon violation of any provisions of said ordinances.
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. - VALUE
MaIn
Garage
Carport
Plan Check Fee'
Dale Paid:
Total Value
Recel pt Number'
Building Permit Fee
Received By:
Slale Surcharge
Total Fcc
(A)
Plans Reviewed By
Date
SY~TEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Resldenllal Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Vent Fan
N'
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances 01 the City 01 Springfield, and the Laws
of the State 01 Oregon pertaining 10 the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
J further certl fy that only contractors and employees who
are In compliance with OAS 701.055 will be used on this
project.
Exhaust Hood
Wood StovellnsertlFlreplace Unit
Dryer Vent
Me'chanlcal PermIt'
Issuance ..
State Surcharge
Total Permit
(D)
I further agree to ensuro that all required Inspections are
requested at the proper time, that each address 15 readable
from the street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
MISCELLAN/:OUS PERMITS
Mobile Home
State Issuance
State Surcharge
Slgnature~p~ - ~ d.,-~A ..A.-./t_
./
Datef6r /.~"
Sidewalk It
Curbcul ft
Demolition
/5
.,$, ---
.-k'y
VALIDATION:
RECEIPT NUMBER
State Surcharge
Total Miscellaneous Permits (E)
/~IT
DATE PAin,
/~>$?-
~- So/. ~.c-
/<::9.YV
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././,/ -
V
'-
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, D. and E Combined)
AMOUNT RECEIVEr>
RECEIVED BY