HomeMy WebLinkAboutPermit Building 1991-4-25
OWNER ~f\~, \ \r1frtQ01~)\'{(\n)t\'\wro
ADDRESS: \44 \ WCXfu ~nu, qy, [\j l\
CITY CC- \. "(\~ xl' Q 1 \J' . (j STATE: &)
\))~,nQ.. ~\)V~Q ~ N\.\1,-
'RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,375.9
LOCATION OF PROPOSED WORK'
ASSESSORS MilP'
LOT:
DESCRI~l1 WORK:
NEW -fL REMODEL
ADDITION
OCCY GROUP:
. OF STORIES:
WATER HEATER:
.
SPRINGFIELD
.
en ()4(Y\-
BLOCK'
DEMOLISH
OTHER
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LClT:
SUBDIVISION:
( oR"{;, - S 1 c;::n
ZIP:
C{ 1'=+0 ~ d--J
~
, '1;\
CONST,
CONTRACTOR'
CONSTR. TYPE:
HEAT SOURCF' r:::: f.
t..:,..;,
RANGF'
EXPIRES
PHONE
FLOOD PLAIN'
If)rc0
CONTRACTO~ NAME c:::::' ADDRESS
GENERAL' r Yfll ~c:i\-~t\'f\S
PLUMBING: (11'("(\ D n cGd1) \\\\1 scru
M~M~I'~\ '
ELECTRICAL: q,~~ t~.... r \)<L..f\T
" '- OFFICE USE -
QUAD AREA: ~ R ~ LAND USE: \ \ SO
. OF BLDGS: - . \ . OF UNIT"" I
~(')
\
f../
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 work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms. .
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated. .
o Masonry - Steel location, bond
beams, grouting. ,
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 decking.
D' Post and Beam., - PrIor to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D 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.
o
Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover. .
o Drywall - Prior to taping,
o Wood Stove - After installation.
o Insert - After fIreplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
o ,Fence -'-When completed.
o Street.Trees ~"Wheri all req'ulred
trees are planted.
o
Final Plumbing - When all
plumbIng work Is complete.
o Final Electrical - When all
electrical work is complete.
o
Final Mechanical - When all
mechanical work Is complete.
o
Final Building - When all
required inspections have been
approved 'and building is
completed.
o Other
MOBilE HOME INSPECTIONS
~OCking and"'set.up ~ ~hen all
00Cklng is complete.
~umbing connect~ons - When
home has been connected to
water and sewer.
~Iectrical Connection - When'
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
~nal - After all required
.' . Inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces Lot Type. Setb,cks _ THE PROPOSED WORK IN TI'l"; .......;,. !
I PL. , GAR'ACCI HISTORICAL DISTRICT, OR ON
Lot sq, ftg, Interior HSE
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance. ,j
Total height Cul-de-sac IE I
APPROVED'
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City 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.
Garage
Carport
Plan Check Fee:
Date Paid:
Total Val ue
Receipt Number:
Building Permit Fee
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
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 Bath(s)
Sanitary se,Jer
-"
N'
Water
FT,
FT,
Storm Sewer
FT,
Mobile Home
(S.W
Total Charge
(C)
l :;,W
.r)~
(n,V)S
Plumbing Permit
State Surcharge
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, I state and agree, that I have 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 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 Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS'701.055 will be used on this
project.
Exhaust Hood
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
MISCELLANEOUS PERMITS
~q,fJ5
/~,3~
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
of the property, and pproved set of pi s will remain
on th~e,1t at all" "......""...... in 0 t
Signat
Date , 4-- 25- 9 /
Total Permit
(D)
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
I CfC(;(o 3
DATE PAID .L\ " /::,2~.Li I
AMOUNT RECEIVED ; \ l Q~ '7::>
CJ\ U~QJ
RECEIPT NUMBER
VALIDATION:
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
RECEIVED BY
, ~'I
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