HomeMy WebLinkAboutPermit Demolition 1995-12-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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SPRINGFIELD ,,',
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LOCATION OF PROPOSED WORK'
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DESCRIBE WORK' j./~~..<? ~,~ f~~ _~IdY~,
NEW REMODEL ADDITION
ASSESSORS MAP'
LOT
OWNER:
&;~~
ADDRESS'
CITY'
CONTRACTOR'S NAME
GENERAL:~D"'C,:,~ ,
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PLUMBING:
MECHANICAl'
ELECTRICA' '
.
QUAD AREA-
. OF BLDGS:
OCCY GROUP:
. OF STORIES:__
WATER HEATER'
BLOCK:
DEMOLISH
OTHER'
.
JOB NUMBER 95" /? 7/-4
225 Flflh Street
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION'
PHONF'
?Yo/-~29';>
.
ZIP'
""5' ) V? ?
".,..
ADDRESS
CONST,
CONTRACTOR'
PHONE
REQUIRED INSPECTIONS
D Rough Mechanical - PrIor t~
cover.
o 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.
D FramIng - Prior to cover.
D Wall/e"alllng Insulation - Prior to
cover.
D Drywall - Prior 10 taping,
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation of unit.
D
Curbcut & Approach - Arter
forms are erected but prior 10
placement of ooncrete.
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE: _
EXPIRES
"r\
7K
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 ]nspect1ons requested before 7:00 a.m. wll] be
made the same working day, InspectIons requested after 7:00 a.m. will be made the following work day.
D Temporary. Electric
D
SlIe Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbln9/Electrlcal/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
o 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.
D Sidewalk & Drlvewa\, - After
excavation Is complete, forms
and sub-base material In place.
D Fence - When completed.
D Street Troes - When all required
trees are planted.
o
Final Plumbing - When all
plumbing worl< Is complete.
o Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
. mechanical work Is complete.
~Inal Building - When all
~requlred Inspections have been
approved and buIlding is
completed.
~ Other 5Eu /<:?It.
,-->/fy?
, ,
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and p]umblng
Inspections have been approved
and the home ]s connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces Lol TYPO. Setbacks .IS THE PROPOSED WORK IN THE,
Lot sq, ltg, Interior I P,L, HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, Ihls application must be signed
Is I and a p proved by Ihe Historical
Topography Panhandle Iw I I I CoordInator prior to permit Issuance.
Total heigh I Cul-dc.sac ~--.LJ
APPROVE['\'
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
Main
Garage
Carport
Total Valuo
Building Permi t Fee
State Surcharge
Tota' Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
tTEM
Fixtures
Resldentla' Bath(s) N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
%........I,)?? ~
Plumbing Permit ,7) -f, <f' J
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unll
Dryer Vent
Mechanical Permll
Issuance
Stale Surcharge
.,';
Total Permll
(0)
MiSCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcul
It
Demolition
State Surcharge
Total Miscellaneous Permits
(E)
VALUE
'.
FEE
/5~
/ ~O
/020
. .
/~~
.'78
.L5Si,:?O
TOTAL AMOUNT DUE (oxcludlng O'ec,rlcal) '<;'c.::;"' /0
'(A, B, C, D, and E Combined) ,
"
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permills granted on the express condition Ihalthe said
construction shall, in all respects, conrorm to the Ordinance
adopted by thc City of Springfield, Including the
Development Code, regulating the c.onstructlon 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 8y
Date
Systems Development Charge Is duo on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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By signature, I state and agree, that I hc1ve 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 Sprlngfleid, and Ihe Laws
of the State of Oregon perlalnlng to the work described
herein, and Ihal NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certlty that only contractors and employees who
are in compliance with ORS 701.055 will be used on Ihls
project.
I Curther agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from Ihe street, Ihat the permit card Is located al the fronl
of the property, and the approved set of plans will remain
on the site at all times Ang construction.
Slgnalure -fft,./V<,. ~,,(~
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VAliDATION:
RECEiPT NUMBER
/9 f Y L
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/ ~/ /0
. 7)";
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DATE PAin
AMOUNT RECEIVED
RECEIVED BY
.
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DEVELOPMENT SERVICES
PUBLIC WORKS
METROPOLITAN WASTEWATER MANAGEMENT
.
~~
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726.3753
DEMDLITIDN PERMIT APPLICATIONS
Your demolition permit is currently being processed. There may be a slight
delay, of up to 2 working days for small structures, due to the time required
to review the history of the structure to determine if it needs to be documented
before demolition. This documentation is for archival purposes only and will
not affect the grant i ng of the demo 1 it i on permi t. If the structure is very 1 arge
or complicated the documentation process may take up to a maximum of 4 working
days. Documentation will consist of photographing the building, taking
measurements and making scaled drawings. The documentation will be undertaken
by the City at no cost to you. Documentation is being done on all structures
dated prior to 1940 that may have historic importance to the City's development,
THIS DOCUMENTATION WILL NOT IMPEDE THE DEMOLITION PROCESS.
An age cut-off of 1940 was chosen because this is the date that the National
Parks Service and the Springfield Development Code use to determine potential
historical significance.
I f you woul d prefer to complete th is documentat i on yourse 1f you must provi de the
City with the fo 11 owi ng i nformat ion: 1) bl ack and white photographs of each
elevation, a floor plan with measurements, and a set of elevation drawings with
measurements.
Thank you for your patience.
I grant the City of Springfield permission to enter my property to complete
documentation prior to the requested demol ition of the structure located at
Property owner signature: 1:1~,J~~~.I~
Date: If - 1. - <=7 S--