HomeMy WebLinkAboutPermit Building 1994-8-24
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK' S R., S- /'Y) fl.,' ll.J
ASSESSORS MAP' /.,'V'?:z_~V ~?,
LOT'
OWNER'
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ADDRESS'
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STl2.~C -,
BLOCK'
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"99" .....:?9:?
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:~C - .....
SUBDIVISION:
PHONE: ~ " - '3 4.~
oR ,,?y/-3YS-S--
ZIP' 97 Y' "'7 ;]
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DESCRIBE WORK: ;'?'-!J!/l' . ,- ~ ii: ~ _. -~ ~.d-~~ ,
NEW-!?- RE:O'~ .~'P~DDITON~ ' DEMOL! H ~~~~- - -'.. . :
CITY:
CONTRACTOR:S NAME
GENERAI,'PR~VL/~ h
PLUMBING: :jt--AYC: p~ ~
MECHANICAl'
ELEcTRICAL: ~ ~.;d' -=~ ~
QUAD AREA'
. OF SLOGS:
OCCY GROUP'
. OF STORIES'
WATER HEATER'
STATE: ~r2.. L. ~ -0"
.
ADDRESS.
.'T R-o 1TPtC'
CONST,
CONTRACTOR'
(DWrr ele )
'-
EXPIRES PHONE
- OFFICE USE -
LAND US'"
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
~
~b
IZAT
v '"
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS:
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 8.m. ~III be made the following work day.
REQUIRED IN~PECTI,ONS
o R~ugh Mechanical :....:. Prior to
cover.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Fooling - Alter trenches are
excavated~
D Masonry - Steel 'location, bond
.beams. grouting,
D Foundation ~ After forms are
erected. but prior to'concrete
placeme~t.
D Underground Plumbing - Prior
to filling trench,
D Underlloor Plumbing/Mechanical
-.Prlor to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation.~ Prior to
decking,
. iJ\..
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
. ..-,',.
D Water LIne -'.Prlorto filling
trench. _' ',:
rVl Rough Plumblng'''7 Prior to
~ cover. .
rA71 Rough" Electrical - Prior' to
~ cover.
o Electrical Service - Must ba
approved to obtain permanent
electrical power,
D Flrapl~ce - Prior to lacing
materials and lramlng Ins!,
JEJ Framing - Prlor:to cover.
I:xJ Wail/Ceiling Insulallon - Prior to
cover.'
1)3 Drywall - Prior ~.. taping,
D Wood Stovo - After I~stallatlon.
D Insert - Arter fireplace approv41
and Installallon 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 Fen~e - When completed.
o Street Trees,:","" When all required
trees are plante,d.., . ~ ,,-......
fI7l Final Plumbing - When all
IAJ plumbing w9rk Is complet.e.
l29 Final Electrical - When all
electrical work Is complete. C
r./f Final MechanIcal - When all
~ mechanical work Is complete.
~ Final Building - When all
required Inspections have been
approvad and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set,Up - Whep all
blocking Is complete. '
D Plumbing Connections - When
home has been connected to '
water and sewer. "
D Electrical Connection - 'When
blocking, set.up, and plu"lblng
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.
',>., :~~"~~.\(:~l
Setbacks.
HSE GAR' ACe' I
I
I
I
I
Lot Type,~ "~
Lot faces
I'P.L,
Lot sq, ftg, Interior IN
Lot coverage Corner
Is
Topography Panhandle
Iw
Total t\elght Cul-de-sac
IE
BUILDING PERMIT
ITEM SO, FT, X $/SO, FT, - VALUE
Main
Gao:age
"
Carport
~ .1..-.?FC,
(
1!!fit'17 - :.
r
Total Value
Building Permit Fee
~ '5'"c
,...~ y.~
r-n,... "'7"~
77-~
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Z~
Flxl,ures
7
Residential Bath(s) N'
Sanitary Sewer FT,
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
~.,cse
; .l__1
, tG:::>
'2/.t:C...o
~
Stat! Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
~
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit ~~. /'""7. c::e:>
Issuahce ~ /0.. -
State 'Surcharge :- ?5-
Total Permit (0) ~:2.0
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding elactrlcal)
(A, B, C, 0, and E Combined)
/.::?/./?
.
\ IS THE PROPOSED WORK tN 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 thai the said
construction shall, In all respects, conform to the Ordinance
adopted by the Clty.ol 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 undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
By slgnature,l 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 perlormed shall be done In accordance
with the Ordinances of the City of Sprlnglleld, and the Laws
01 the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made 01 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
'rom 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.
Slgnature~~,' ~_
Date ~ - ,'2J.(. _C; eLl
, , (
VALIDATION:
/VV"9"cr-
, - -
~~'9Y'
AMOUNT RECEIVED /~/.?"5J
q~-
RECEIPT NUMBER
DATE PAID
RECEIVED BY