HomeMy WebLinkAboutPermit Miscellaneous 1993-6-17
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RESIDENTIAL
PERMIT APPLICATION.
Inspe~iions: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WOR!" .
ASSESSORS MAP'
LOT:
/~C7~
BLOCK'
OWNER:.
ADDRESS:
CITY:
DESCRfBE WORK'
NEW
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REMODEL
ADDITION
SPRINGFIELD
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STATE:
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JOB NUMBER
'7~~~55
225 Fifth Street
Springfield. Oregon 97477
TAX LOT'
SUBDIVISION'
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PHONE:.-!L'l. f, 11",--1]..1,..3
ZIP: ~~1"
DEMOLISH
OTHER~f
'-,..'
CONST,
CONTRACTOR N
EXPIRES
PHONE
CONTRACTOR'S NAME. ADDRESS
~ GENERAL ~}L~.-IlAJll*"~ L ,
1 ' PLUMBING: _\LJA.ffi~I-1,1,A ,^. ,,~ ~ j
MECHANICAL:
ELECTRICAl'
~
~\\
~
- OFFICE USE '-
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS: N OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR, TYPE: N OF BDRMS'
N OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG'" SQUARE FOOTAGE:
To request an inspect,1on. you. must call 726-3769." This is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same w,?rking day. Inspections requested after 7:00 a.m. "will b~ made the fOllow,lng work day.
o Temporary Ele~tric .
.0 Site Inspection - .To be made
. alter excavation, but prior 10
setting forms.
0' Underslab Plumbing/Electrical I
Me.chanical - Prior. to cover..
,,0
Footing - After trenches are
excavated. .
o
Masonry - Steel location, bond
beams, grouting.
,0
Foundation - After forms arc
erected but prior to concrete
placement. .
o Underground Plumbing - Prior
to filling trench. .
o Undcrtloor Plumbing/Mechanical
_ Prior 10 insulation or decking.
--,
O Post and'Se'am ....:... 'Prior to' floor
insulation or decking.. .,
. . ,\
o Floo~ Insulation.- Prior to _'.
deckIng. ::.
o
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewef'- Prior to filling
trench. ~, .
o
Water Line - 'Prior 10' filling
trench. .'
o Rough Plumbi!l.9 - Prior to
cover. ..... .........
REQUIRED INSPECTIONS
o Rough Mechanical '- Prior to
cove~ ~,
D Rou'gh Elcct;ical -' Prior to
cover.
o Electrical Service - Must be .
approved to obtain permanent
electrical power.
o Fireplace -' Prior to facing
materials and framing Im~p.
~t".ramin~ - ~rior t,o cover.
o Wall/Ceiling Insulation - Prior to
cover. ,
o Drywall - Prior to taping.
o Wood St~ve - After installation.
.[3] Insert ...:...- Aiter fireplace approval
and installatlon of unit.
- '
" . O"'Curbcu~ & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-bnsc material in place.
o Fence - When ~ompl~t€t1.
o Street Trees - When <Il1';cqulred
trees arc planted. .
,.-
l'><1 r-inal Plumbing - When all
.~Iumblng work Is complet.e.
D Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work is complete.
Final Building - When all
required inspections have been
proved and building Is
pleted,
OOthcr
MOBILE HOME INSPECTIONS
",
o Blocking and Set-Up - When all
blocking is complete.
o
Plumbin'g 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 pB,net.
o
Final - After all required
inspections are approved and
porches, skirting, decks, and
ventlng have been installed.
J
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Lot faces Lot Type
Lot sq, ftg, Interior I :L.
Lot coverage Corner Is
Topography Panhandle Iw
Total height Cul-de-sac IE
..
i, . IS 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.
Setbacks
I I I I
HSE GAR ACC
I
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
VALUE
Main
Garage
Carport
'.
Total Value
~ . . i
'2CJ1)~
/5. cro
.7S"
/c:; ?J-
Building Permit Fee
Slate Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM FEE
Fixtures ~d) /"It:m
Residential Bath(s) N'
Sanitary Sewer FT,
Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge .?S
Total Charge (C) /5:7,)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan N'
Wood Stove/lnserllFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
/? /.(J fJ'y:?
,
JC:<:JU
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
4/... .5" tJ
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1':--
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is grant~d'on tt1...c express conditiof1lhat the said
construction shall~in all respects, conform to the Ordinance
adopted by the 'City' of Springfield', fncluding the
Dcvclbpmcnl C'ode. rovulating the construction and use of
buildings, and :n~y be' susPEmd~d or\.e~oked at any time'
upon violation of any proxision's.of sai~ or~inances.
Plan Check Fee:
". ":,
Date Paid:
Receipt Number'
RCC?Civcd By:
Plans Reviewed By
Dale
. . ' .
Systems Development 'Cnarge i~ due' on aJl undeveloped
properties wilhln the City limits which are being improved,
ADDITIONAL COMMENTS
By signature, I state and agree, that' I have carefully examined
the completed application and do hereby certify that all
~nformation 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 cornrac,tors land employees who
are in compliance with OAS 791.055 will be used on this
project.
I further agree, to ensure that all reQuire~ inspectio.ns are
reQuested at the proper time, that each address is readable
from the street, that tile permit card is located at the front
of t~e property, and th~ap oved set of plans ,will remain
on the Sitelj::S du irr:~
Xgnature ! /I ,
Date ----L-/ J - i 3
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
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RECEIVED BY