HomeMy WebLinkAboutPermit Building 1997-2-24
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP; ~'7 CJ 2-
LOT'
.
SPRINGFIELD
.
JOB NUMBER
?~/~/ ,gA
,r>~
- -
BLOCK;
225 Fifth Street
Sprlnglleld, Oregon 97477
7I-/? 2
~_'f~
TAX LOT'
SUBDIVISION;
OWNER'
ADDRESS'
CITY:
(:/:t-.p /) /
,?7 :> :J ,C;-
53 J1d1
t! .
~Plk'
DESCRIBE WORK'
NEW
REMODEL
CONTRACTOR'S NAME L7(
GENERAL: H:1'e/'J,
PLUMBING:
MECHANICAL'
ELECTRICA' '
" PHON'"
-~ / /7 '2- "1\1f
STATE:~~
~ n7?j~' 4.a./7U//LA::::'7 'iT
DEMOLISH ,/'" OTHER
,1.?/lr.P#
$4/}V
ADDITION
ZIP;
9.7c/'7>?
,
ADDRESS
&,J"~~~~
V--
CONST.
CONTRACTOR .
tPt695tf
EXPIRES PHONE
~-~9:? 7C/'99d:'K"
- OFFICE USE _
LAND USE;
# OF UNITS:
CONSTR, TYPE:____
HEAT SOURCE:
RANGE:_
o Rough Mochanlcal - PrIor to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Flreplaco - Prior to facing
materials and framIng Insp.
~ramlng - Prior to cover,
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - Afler Installation.
o Inserl - After fireplace approval
and installallon of unit.
o Curbcut & Approach - After
forms are erected but prior 10
placement or concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - Wtlen completed.
o Slreot Troos - Whun all required
trees are planted.
FLOOD PLAIN:
ZONING CODE:__
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE: _
WATER HEATER:
To requesl an Inspection, you must call 726.3769. ThIs Is a 24 hour recordIng. All Inspections requested before 7:00 a.m. wilt be
made the same working day, Inspectlons requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Final Plumbing - When all
plumbing w9rl< Is complet.c.
o Final Electrical - When all
electrical work is complete.
o Final McchnnicaJ - When alt
mechanical worl{ Is complete.
~Inal Building - When all
required Inspections have been
a proved and building is
completed.
OOthar
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.
QUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES:__
o Temporary Eloctrlc
O Site Inspection - To be made
after excavation, bul prior to
selling forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ootlng - After trenches are
~xcavated.
o Masonry - Steel locatlon, bond
beams, grouting.
o
Foundation - After (orms are
erected but prior to concrete
placemont.
o
Underground Plumbing - Prior
to filling trench,
o
Underlloor Plumbing/Mechanical
- Prior to Insulation or decl<lng.
o Post Dnd 80am - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
. decking,
o Sanltury Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Waler Line - PrIor (0 (iJj;ng
trench. .
D Rough Plumbing"':" Prior to
cover.
o
Final - After all fCquired
Inspections are approved and
porches, skirting, decks, and
ventIng ha.ve been Installed.
Lot coverage
. f,,;; :i ~HE PROPOSED WORK iN THE
'..,.
Lot Type Setbacks
I P.L. 'HSEIGAR 'Accl .... HISTORICAL DISTRICT, OR ON
InterIor IN I THE HISTORICAL REGISTER?
Corner If yes, this application must be signed
Is I I and approved by the Historical
Panhandle Iw I Coordinator prior to permit issuance.
CuI-dc-sac
~-- -.J APPROVED'
~ot faces
Lot sq, ftg,
Topography
Total height
BUILDING PERMIT
ITEM
SO, FT,
X $/so, FT,
VAL\JE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Carport
~~
J 7~A/j()
. .
This permit is granted on the express condition that the said
construction shall, in all respects, conform to ttle Ordinance
adopled by the City 01 Springlleld, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Garage
"
Plan Check Fee'
Dale Paid:
Total Value
Building Permi t Fcc
Stale Surcharge I,~S -t , 1$'7
Total Fcc (A)
29. S-,o
Receipt Number'
Received By:
?/,$7
Plans Reviewed 8y
Dale
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Balh(s)
N'
Sanitary S~wcr
Water
FT.
FT.
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, I slalo and agree, that I have carefully examined
the completed applicallon and do hereby certify that aW
Information hereon is Irue and correct, and I further cerllfy
that any and all work performed shall be done in accordance
with Ihe Ordinances of the City of Springfield, and the Laws
of the Slate of Orc~on pertaining to the work described
herein, and thai NO OCCUPANCY will be made of any
structure wllhout permission of the Building Safety Division.
I further certify that only contractors and employees who
arc In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Wood StovellnsertiFlreplace Unit
Dryer Vent
MechanIcal Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all required Inspections are
rj3quested at the proper time, that each address Is readable
from the street, that the permit card }s located at the front
of the property, and the approved set of plans will remain
on the site '))111 11m>> du~~onst ctlon.
Slgnalure /1/2?F 0/A %_ /:;;J
, -~ Yp?ltl;,
Datt"
MISCELLANEOUS PERMITS
Mobile Home
. State Issuance
Stalo Surcharge
Sidewalk
It
Curbcut
II
Demolition
Slate Surcharge
VALIDATION:
RECEIVED BY
2-it;~ /
2/2..~ 7
r -Q J:B ?
-/J~-v
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C, D, and E Combined)
31'~?
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
Total Miscellaneous PermIts (E)
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