HomeMy WebLinkAboutPermit Building 1996-11-25
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
.
JOB NUMBER
~~~
~~
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LOCATION OF PROPOSED WOR~' ~.'f':r? /,??~/N
ASSESSORS MAP' /'7-.:?2-~-~e.
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LOT:
OWNER:
ADORi=C:C:.
CITY'
-- -
BLOCK:
STATE:
~.
225 Fillh Streel
Springfield, Oregon 97477
TAX LOT'
~/3b /'
SUBDIVISION:
PHONE: -2.t9l5 -7=-'5r-
ZIP'
<:::::? '7 Y'? -::>
. . ,
DESCRIBE WORK: 1-f/':]7?9tC/ /?(~/~7'o<::'~~.c> /~~ ~ ~,,/)~~ .~
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR'S NAME ADDRESS 0::,-* A ~ONTRACTOR . EXPIRES
GENERAL:~..kn .0h~"""'~,,;--_ ~~~ ~': -<>-.<5'-7'?-
PLUMBING'
MECHANICAl'
ELECTRICAL: h/t?' ~c.:s, c;..../"_
OUAD AREA:
, OF BLDGS:_
OCCY GROUP:
. OF STORIES:
WATER HEATER:
- OFFICE USE
LAND USE: _"_
H Or UNITS:
CONSTR, TYPE:
HEAT SOURCE:
RANGE:__
PHONE
~';:-~L/
4t
FLOOD PLAIN:
ZONING CODE: __,__
. OF BDRMS:
SECONDARY HEAT:
SOUARe, FOOTAGE:
To request an Inspection, YOu must call 726-3769. Tills Is a 24 hour recording. AlIln~peclions rcqucSlc(j before 7:00 a.m. will be
made the some working dny. Inspections requested after 7:00 a.m: will be made the following worl( day.
REQUIRED INSPECTIONS
D Temporary Eloctric
D
Site Inspection - To be made
after excavation, but prior to
setting forrns.
D
Ulldcrslab Plumbinu/EJcclric,i11
Mccl1anlcul -. Prior to cover.
D
FootIng - After trenches are
excavated.
D
Masonry - Steel locatlon, bond
beams, grouting.
D
Foundation - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench,
D
Underrloor Plumbing I Mechanical
- Prior to Insulatlon or decle.ing.
D
POSl and Beam - Prior 10 floor
Insulation or decJe.lng.
D
Floor Insulation - Prior to
decking.
D
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - Prior to filling
trench.
D
Water Une - Prior to filling
trench.
D
Rough Plumbing - Prior to
'cover.
D
Rough Mechanical - Prior to
cover.
D Rough Electriclll - Prior to
cover.
o
Electric31 Service - Must be
approved to obtain permanent
electrIcal power.
D
Fireplace - Prior to facing
materials and framing Insp.
D
D
Framing - Prior to cover.
Wall/Cdling lnsulntion - Prior 10
cover.
D
Drywall - Prior to taping.
D Wood Stove - After Installation.
D Insert - After fireplace approval
and Installiltton of unit.
D
Curbcut & ApprJuch - After
forms arc crccttd bul prior 10
placement of conCrcl(~.
D
Sidewalk & DriveW:IV - After
excavation Is complete. forms
anel sub.base rr3!crial in pr<lCc.
D
Fence - When completed.
D
~;trool Treos - When all required
trees are planttd.
D
Final Plumbing - When all
plumbing w~)rl~ is comptct.c.
D
Final Eleclriclll - When all
electrical worle. is complete.
o
Final Mcch.mical - When all
ITlcctwnical worle. Is cornplete.
D
Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
00locking Dnd Sel.Up - Wilen all
blocle.1nU Is complete.
l2.1
Plumbing Connections _ When
home has been connected to
watcr and sewer.
IlirElectrical Connection - When
~ blocldng, set.up, and plumbing
Inspcctions have been approved
and tile home is connected 10
Ihe service panel.
r1.:;r'Fillnl - After all required
I,.L..J inspections me approved and
porches, sl<lrUng, decks, and
venting have been Installed.
. I_E PROPOSED WORK iN THE ,
~
Lot (aces Lol Type Setbacks
r---
P.L HSE GAR ACC I HISTORICAL DISTRICT, OR ON
lot sq, ftg, Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle I Coordinator prior to permit issuance.
Cul.de.sac W
Total height -.J
E APPROVED:
BUILDING PERMIT
ITEM SO, FT, X $/ SO, I'T
VALUE
Maln
Garage
"
Carport
TOlal Value
Building Permil Fce
Stale SurCl1<lrgc
Tolal Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Resldentl"1 Bolll(5)
N"
StlnHary S~wcr
Waler
1'1".
FT,
Storm Sewer
FT,
Mobile Home ~"'~
/c".....--=:>
Plumbing Permi t
---
/5:
t-~ .. ~C?5-
/6.~
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Slovc/lnsertlFlrcplacc Unit
Dryer Vent
Mechanical Perml t
Issuance
Slate Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
/~~-
Mobile Home
State Issuance
~..~
~.'2~
~./~
, . '7
State Surchargo
1"3'5-
, SIdewalk
It
Curbcut
It
DcmoJltion
State Surcharge
Total Miscellaneous Permits (E)
r?3-'/tP
l~~.<e;O
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, "nd E Combined)
BUILDINGVALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on ttle express condition that the saId
construction shall, in all respects, conform 10 the Ordinance
"do pled by thc City 01 Springlield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plan Check Fcc:
D<J.IC P<J.jd:
Receipt NlJmber:__.___.__
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 slgnalure, I state <Jnd agree, that I have carefully examined
the completed application and do t1ereby 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 Slate of Oregon pertainIng to the work descrIbed
herein. and that NO OCCUPANCY will be made of any
slructure witl10ut permission of the Building Safely Division.
I further certify IIlal only contractors and employees who
are In compliance with ORS 701.055 will be used on Ihls
project.
I further agree to ensure that all required Inspections are
requested at the proper tIme, that each address Is readable
from tll0 street, Ihal the permit card Is located at Ihe front
of the properly, nnd the approved set of plans will remain
on 111e site ~7 dUri~nstructlon.
Signature -;zfP--; ~--t:t, ~ ,
//_~ S--?6 c7
Dal('
VALIDATION:
RECEIPT NUMBER .... ~~ y
DATE PAID //-7.,.-~C;
~MOUNT RECEIVED __1-:72 . 'ire:>
RECEIVED QY /:;?'~-
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