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HomeMy WebLinkAboutPermit Building 1996-4-26 ~t@ LOCATION OF PROPOSED WORK'S 3 '? c:; / '7/'72. <"?.3 RESIDENTIAL PERMIT APPLICATION Inspecllons: 726.3769 Office: 726.3759 ASSESSORS MAP' LOT' , SPRINGFIELD ~/f}-/.J S~ ~o BLOCK' OWNER: ADDRESS: CITY: (}.+e/?J ~-~._~ ~,~ '?..r ~:riTh) 'll?~ ,0- -, */7"7 c:::;:t..e' _ $// /4/ ~A<'/ OTHER ..# ~L, ~ ,; STATE: DESCRIBE WORK: /,~,N?T. k.....,A.7/~ NEW ~EMODEL ADDITION ~ DEMOLISH ~ 9' C;05"t!Y" JOB NUMBER 225 Fifth Street Springfield. Oregon 97477 #/77 TAX LOT' SUBDIVISION' 10/ SC7C) \. PHONF' ZIP: q 7~7~ CONTRACTOR'S NAME GENERAL: n'?&L, CONST. ADDRESS CONTRACTOR' /?d~P?-nt:",'_ll>~m.-HA} ~9 s-~ PHONE ~7 -7'.>.8..(" PLUMBING' MECHANICAl- ELECTRICAl' EXPIRES Shop'" A ~ \\i - OFFICE USE - QUAD AREA: LAND US"- 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 Inspection, you must call 726-3769, This Is a 24 hour recording, All Inspections requested belore 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 D Temporary Electric D Sito Inspection - To be mado after excavation, but prior to setting forms. D Underslab Plumblng/Eleclrlcal/ Mechanical - Prior to cover. 1'X1 I""ootlog - After trenches are ~ excavated. D Masonry - Steel location, bond beams, groutln,g. 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. o Storm Sewer - Prior to filling trench. D Water Line _\ Prior to filling trench. o Rough Plumbing - Prior to cover. ... D Rough Mechanical - Prior to cover. D 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. ftramlng - Prior to cover, D Wail/Ceiling Insulation - Prior to cover. D Drywall - Prior to taping, D Wood Stovo - After Installation. D Insert - After fireplace approvlSl and Installation 01 unit, D Curbcul & Approach - Alter forms are erected but prior to placement of concrete. D Sidewalk & Driveway../. After . excavation Is compiete: forms and sub-base material In place. D Fence - When completed. D Street Trees - When all required trees are planted. D Final Plumbing - When all plumbing worl< Is complete. . , D Final Electrical - When all electrical work Is complete. D Final Mechanical - When all mechanical work Is complete. ~Inal Building - When all required Inspections have been proved and building is completed. DOthor 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 plumbing Inspections have been approved and the home Is connected to the service panel. D Final - After all required Inspections are approved and porches, skIrting, decks, and venting have been Installed. Lot faces Lot. Lot sq, ltg, Interior Lot coverage Corner Topography Total height Panhandle Cul.de-sac BUILDING PERMIT ITEM SQ, FT, X $/SQ, FT, = Main Garage Carport . ~/.4'A Total Value Building Permit Fee State Surcharge ;/"'+ .71 Total Fcc (A) Setbacks HSEIGAR ACCI I I wi I II J-LLLJ I P.L, IN S VALUE '. /4t; _(TO , :z. ~ Flt> /,'61' ? .:;-_3'7 (B) SYSTEMS DEVELOPMENT CHARGE (SDC) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' Sanitary S~wer Water FT, FT, FT. Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnaco Exhaust Hood Vent Fan N' Wood Stovellnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance Slate Surcharge Sidewalk II Curbcul II Demolition State Surcharge . Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) - FEE "...:',;'; "'/,11' .~~' 'I",IS THE PROPOSED WORK iN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical . Coordinator prior to permit Issuance. APPROVED' I I I BUILDING V~LlJE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall. In all respects, confqrm to the Ordinance adopted by the Clty.of 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. ,U~ 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 stale and agree, that I have carefully examined the completed application and do hereby certl fy 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 Ihe City 01 Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Satety Division. I further certlty that only contractors and employees who are In compliance with ORS 701,055 will be used on this project. I further agree-Io ensuro that all required Inspections are requested at the proper time, that each address Is readable from the street, that the pormlt card Is located at the front of the property, and the approved set at plans will remain on the site at all times during construction. Slgnatur~ ~~~~_ Date t1 If - :;.. (p - '9 ? VALIDATION: 2~/L DATE PAID ~2.t:P J 6 AMOUNT RECEIVED 5' ,1 r ~p~ RECEIPT NUMBER RECEIVED BY ~