HomeMy WebLinkAboutPermit Building 1996-11-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD ,I.k "..
ASSESSORS MAP:
LOT'
BLOCK:
OWNER: U~~ /~.?'7~~:2.
ADDRESS" 05.-5 :F-S-:~....~~~ ~,~t1tGV
~~L.??..... STATE:' ,~A
/' ' ,
DESCRIBE WORK: ~~~ O'a;../":
NEW REMODEL ADDITION ~ DEMOLISH
CITY'
CONTRACTOR'S NAME
GENERAL: ~-'AP
~; - '"
PLUMBING'
MECHANICAL'
ELECTRICA' '
OUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER:
.
,JOB NUMBER
~~5
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
PHONE:
;1'7":;>-/7~~. /?/
ZIP:
~t;l?
1.7" ~ 3~ / ~1;"'~~
OTHER
~,A
~~
-'PHONE
ADDRESS
CONST.
CONTRACTOR'
EXPiRES
- OFFICE USE -
LAND USE: _'_
. OF UNITS:
CONSTR, TYPE:
H EAT SOURCE:
RANGE:__
FLOOD I'LAIN:
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 a,m. will be made the following worl( day.
o Temporary Eloctric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Undersll'lb Plumbing/Electrical I
Mechanical - Prior to cover.
r1"'A" Footing - After trenches are
l,.KJ excavated.
o
Masonry - Steel location, bond
beams, grou II ng.
o 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 decl<ing.
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 Sower - Prior to filling
trench.
o
Water Line - Prlor"to tilling
trench.
o
Rougl1 PlumbIng
cover.
Prior to
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o 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.
I:lJ
o
Framing - Prior to cover,
Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o
Wood Stove - After Installation.
o
Insert - After (,replace approval
and Installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Drheway - Atter
excavation Is complete, forms
and sub.base n:aterial in place.
o Fence - When completed.
o Stroet Trees - When all required
trees are planted. . ,
o
Final Plumbing - When all
plumbing w9rl< Is complet.c.
D Final Electricnl - When all
electrical worl( is complete.
o Final Mcchnnical - When all
mechanical worl< Is complete.
rn Final Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete.
o
Plumbing Connections - When
home hns been connected to
waler and sewer.
o Electrical Connection - When
blocking, set.up. and plumbing
Inspections hnve been approved
and the home Is connected to
the service panel.
o
Final - After all required
inspections are approved and
porches, sl<lrllng, decks, and
ventIng have been Installed.
Lot faces
.
Setbacks
I P,L, HSE GAR
IN
I S I
I
-~-'I
Lot Type
Lol sq, llg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cui-de-sac
BUILDING PERMIT
ITEM SO, FT, X $/SO, FT. VALUE
Main
Garage
Carport t../2t!> / /.itW ~~.~P
,
TOID.I Value
~- 5"Z'?
~~$"3
---/~~2.
8lJilding Permit Fcc
State Surcl1argc
Total Fcc
'5' Y. S-S'
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixlures
Residential Balh(s)
N'
Sanitary S~wcr
Water
F1:
FT,
Storm Sewer
FT.
Mobile Home
PlumbIng Permit
Slate Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/FlrepJace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
, Sidewalk
it
Curbcut
it
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combinod)
.,&7,~g
ACC I
I
I
.
IS THE PROPOSED WORK iN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
Ir yes, this application must be signed
"f1d approved by the Historical
Coqrdinator prior to permit issuance,
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
, .
This porr!li;t js'gra!lled,(;:ln~th'e'cc~prcss.con~ltion that the said
construction shall; in all respects, conform to th'e Ordinance
adopte.d. by .the 'Gity, 01, Sprl~gl;eld', Including the
Development Code. regulating the construction and use of
buildings, and may be suspended' or rc~oked at any time
upon violation of any provisions of said ordinances,
'Plan Check Fee.
'=!'Z ~
Date Paid:
Receipt Number:__..
Received By:
'. '
Plans RcVicwe(j- 8y--"---.-.
Dale
Systems Development Charge Is due on all undeveloped
properties within U10 City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I alate and agree, that I have carefully examIned
the completed application and do hereby certHy 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 Cily of Springfield, and the Laws
of the State of Oregon perlalnlng 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 contractors and employees who
arc in compliance with ORS 701.055 will be used on thIs
project.
I further agree to ensure that all rOQulred Inspections are
requested at the proper lime, that each address Is readable
(rom the street, thai the permit card Is located al the front
of the property, and the approved sel of plans will remain
on the site at all Urnes during construction.
Slgnature~~
C/
Datf'
1/- /9"- 'rc.
VALIDATION:
..??R'Y~
/I-/~,"%'
~MOUNT RECEIVED g A 5' g
/ /-a~ "'_.
(' /f-
RECEIPT NUMBER
DATE PAIr>
RECEIVED BY