HomeMy WebLinkAboutPermit Miscellaneous 1996-12-18
RESIDENTIAL
PERMIT APPLICATION
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SPRINCFIELD
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LOCATION OF PROPOSED WORK' ,t::""O /~~u..~,,(>'z::>
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Inspections: 726.3769
Office: 726.3759
LOT-
OWNER:
BLOCK'
STATE: _b?=?
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JOB NUMBER
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225 Fifth Street
Springlleld. Oregon 97477
PHON'"
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TAX LOT: /V~&:>t>
SUBDIVISION:
DESCRIBE WORK' .~b-~q
ZIP: ~?~?
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ADDITION DEMOLISH OTHER
CITY'
NEW
REMODEL
CONST.
CONTRACTOR'S NAM. E . ~ADD E C' CONTRACTOR' EXPIRES-. PHONE
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GENERAL: ~hffq~~;.c:.~~ ~~_ y::z.?,/ //. '7 ~7- 6~~'>
PLUMBING'
MECHANICAl'
ELECTRICAL'
- OFFICE USE -
QUAD AREA' LAND USE:_ FLOOD I'LAIN'
. OF BLDGS: . OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTA. TYPE: 'OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: _ SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. AlIlnspecllons requested before 7;00 a.m. will be
made the same working day. Inspections requested atlcr 7:00 a.m. will be made the following work day.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prlor to
seltlng forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D Footing - After trenches are
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 Underfloor Plumbing/Mechanical
- Prior to Insulatlon or decking.
D Post and Beam - Prior to floor
. Insulation or decking.
D Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to fflllng
trench.
o Storm Sewer - Prior to fillIng
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior \0
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/e"elllng Insulation - Prior to
cover.
eEl Drywall - Prior to taping.
D Wood Stovo - After Installallon.
o Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior 10
placement of concrete.
o Sidewalk & Drivewav - After
excavntlon Is complete, forms
and sub.base material In place.
D Fence - Wilen completed.
D Streot Troos - Whon all required
Irees are planted.
D Final Plumbing - When all
plumbing worl< Is complete.
. .
D Final Electrical - When all
electrical worl< is complete.
o Final Mechanical - When all
mechanical work Is complete.
r17I Final BUilding - When all
J+-1 required Inspections have been
approved and building Is
completed.
DOlhcr
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking is complete.
D
Plumbing Connections - When
tlOme has been connected to
waler and sewer.
o
Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home is connected to
tile service panel.
D Final - After all required
Inspections are approved and
porches, sl<irting, decks, and
venlJng have been installed.
Setb leks
HSE GAR' ACC I
I
I
Iw I
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Lot faces
Lot Type .
Lot sq. Itg.
Interior
I P.L.
IN
Is
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT.
VALUE
.:Q7#7 ~
Main
,
"
Garage
.'1,'
.,
Carport
Total Value
9~
7?7'" -:::(, "7':?
/.77c- /. ~
(A) .~ 97""-
Building Permi t Fee
State Surcharge
Total Fcc
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S!'Jwcr
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
\":ood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Curbcut
ft
Demolition
~tate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
.~ 55"
i/ ~ :..,: ;~-:
'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.
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 Ihe 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'
Date Paid:
Receipt Number-
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undevcloped
propertics within lhe City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I stale 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 of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safely Division.
I further certify that only contractors and employees who
arc 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, find the approved set of plans will remain
on the site at all times du~n~yr~t10n.
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VALIDATION: .
RECEIPT NUMBER -:;z.,. ij~~
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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