HomeMy WebLinkAboutPermit Building 1996-10-7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olllce: 726.3759
.
LOCATION OF PROP'?1l\D WORK: \pP\~
ASSESSORS MAP: \ I 1~~
LOT'
BLOCK:
~OB NUMBER C\ \ 0 \ ~~~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
1l\\T11)
OWNER: \''\\\:}().\(. ,\f)X\J\ () 1 PHONE:1J~~. Cv.'2sLP
ADDRESS': ~~~l) (""1'f..o,o 1'\\\\ \ \ \\(Y r
CITY' hJn(~()./ ~ STATE: \)\O~. ZIP: l\-'40?-
DESCRIBE WORK' \X o. tOO., l f 0_ I\1r1 0 f'lnL- . ~I
NEW ~_ REMODEL AD[ IT)ON DEMOLISH OTHER ~
U \VI
CONTRACT~R'S NAM~\ "- \ L-.
GENERAL:~ .o_~ ':"'UD..r.
PLUMBING'
MECHANICAl'
ELECTRICAl'
"
CONST.
CONTRACTOR #
"T3\d,o-\
ADDRESS
\0.0..\ OW 21-\11\. V~
- [I )~. Y14ri~
S.\~q1S ~4 .q~l~
- OFFICE USE -
QUAD AREA- LAND USE: FLOOD PLAIN:
# OF BLDGS: # OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYPE: # OF BDRMS'
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: _ SQUARE FOOTAGE:
To request an Inspectlon, 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 after 7:00 8.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
D Site Inspection - To be made
. after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical!
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o
Underfloor 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.
D Rough Plumbing - Prior to
cover.
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 Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approv~1
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement ot concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When completed.
D Slreet Troos - When all requIred
trees are planted.
o Final Plumbing - When all
plumbing worl< Is complet.e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building is
~~:;ro.ft
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, sklrllng, decks. and
venting have been Installed.
Setbacks
I P,L. HSE GAR ACC I
IN
Is
Iw
IE
Lot faces
Lot Type-
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM
SQ. FT.
X $/SQ. FT.
VALUE
Main
Garage
"
Carport
Building armit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unll
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
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
~B+
.,i-;1.\} .~.; >
'.: .
.
t, IS THE PROPOSED WORK iN THE.
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
It 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 the City 01 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 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 of the City of Springfield, and the Laws
of the State of Oreg,on pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure wi thout 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.
(
Qulred Inspections are
requested at the proper time 4hat ch address is readable
from the street, that the pcrr "It ca d Is located at the front
of the property, and the app ove set plans will remain
on the site at all times duril str: cUon.
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VALIDATION: 1)"1\/1
RECEIPT NUM~ ~\. ~
DATE PAID \IJ.1-GtlQ
AMOUNT RE'fliE~ ~ ~.J~
RECEiVED BY ~A_