HomeMy WebLinkAboutPermit Building 1993-10-15
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: 7// 4 tl/ II I ~ -0 /-
XASSESSORS MAP: J "7 ~ I'J::; ~ ~ c. - ~ - I
()qy()~
LOT:
OWNER:J/!..eLr-S
ADDRESS: ...., / J t.J
.
JOB NUMBER
CJ-:<"/4" O_
r -........
225 Fifth Street
Springfield, Oregon 97477
SrF [D.
BLOCK'
..J- J".t: tJ /1./ M 11 err-If c ~.~
Y1 /4 J A.../ . ~ T.
CITY: S r",F L D
DESCRIBE WORK: E u j L
NEW ~ REMODEL
1')
CONTRACTOR'S NAME
A/cJ~C
r
)
/
GENERAl'
PLUMBING'
MECHANICA' .
ELECTRICAl'
STATE: -.Cir'r
CJ4UJOOI'?'T'
ADDITION
DEMOLISH
OTHER
TAX LOT:
SUBDIVIStON:
~ 7t7?Y,
PHONE: .li? - (. 7,/ ()
ZIP: '7 7'17 5Y"
."t~
)t~
EXPIRES ' PHONE
ADDRESS
CONST,
CONTRACTOR'
1-
- OFFICE USE -
QUAD AREA: 4R\\'l<( ./ LAND USE: ,\ \ \ FLOOD PLAIN'
. OF BLDGS' ~t . OF UNITS' ZONING CODE: Uj\z--
OCCY GROUP' CONSTR. TYPE:~) . OF BDRMS:
. OF STORIES: \ HEAT SOURCE: SECONDARY HEAT'
WATER HEATER: RANG'" SQUARE FOOTAGE: J..e.f1' )
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 'f.I!mporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~Footlng - After trenches are
r excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking,
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover. !
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After I~sta"atlon.
D Insert - After fireplace approval
and Installatl.on of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
o Final Plumbing....:.. When all
plumbing work is complete.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
15<::f' Final Building - When all
_......quired Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When ali
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Topography
Total height
Panhandle
Setbocks
I' 'I
P.L. HSE GAR ACC
IN
Is
Iw
IE
: tI THE PROPOSED WORK IN THE
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Lot faces
.
Lot Type
Lot sq. Itg.
Interior
Lot coverage
Corner
Cul-de-sac
APPROVED'
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT, ~ VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Carport
/~
Jt)."'D
~o
This permit is granted on the express condition that the said
construction shalh 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.
4t:J,~ 3
~~
Recei pt Number: / t9 J 0
Received By: . . .
~~~-
pran~CVlewed By ~ .
Plan Check Fee:
Main
Garage
Date Paid:
Total Value
Building Permit Fee
c,2. ~a
2, .r~
05. Cd
SYSTEMS DEVELOPMENT CHARG~~~
(B)~~'
(A)
JO~fZ/5j
'Date ( -
State Surcharge
Total Fee
Systems Development Charge Is due'on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Storm Sewer
FT,
FT.
FT.
~ J,(J.S''l;!1T/.A77/Ji)(
" ., .-
~//L.L ~EfJI'<4'~ --+ JOPA"HJ:F
'J)L5tf{J~/-r.
,
. .
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
Water
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
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 Ordinanc(:js of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work descrlbed
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 OAS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
. m t street, that the permit card Is located at the front
If the pr perty. and the approved set of plans will remain
~ sit at all times during construction.
1 ~gnature /) -;l71u;"~~' ~~~-
Datp
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
-::2.&('..... ~ J
VALIDATION: (Oc::::Q3
RECEIPT NUMBER 'I ~
DATE PAID If ) .I~>--'I_~
AMOUNT REC~ /) ( .(rJ:5/
RECEIVED B'C7J(J''("~.__-,")
State Surcharge
Total Miscellaneous Permits (E)