HomeMy WebLinkAboutPermit Building 1991-4-22
. SPRINGFIELD
RESIDENTIAL ~-
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK' 5':?6,~ In.,, -':... hi
ASSESSORS MAP: /7 (j 2: ? -3 :Ob
LOT: CA? ( '?/ BLOCK:
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OWNER: '
ADDRESS'
CITY'
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STATF'
I'J"K:
DESCRIBE WORK: m ~ Avt/,A/ / ~
~ it=. .:L~L/P .'F', .
NEW'- REMODEL ADDITION DEMOLISH
CONTRACTOR'S NAME
GENERAL: r;;.Y'~d
-- -
, ,PLUMBING'
MECHANICAl'
e
1!03~7
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
.LAX, LOT' /3" '5
SUBDIVISION:
J
PHONE:_1Y7-UZX..~
ZIP: 'l7 Lf 7) ~
/)/ ~ 2-< ti.....d~.R
- ,- .-
OTHER
ADDRESS
L.J.L?~II} /h, H, ") ~
CONST,
CONTRACTOR'
5 () V{ ~~-f
EXPIRES PHONE
(1-12.4/
'fi<>'n:> ~-
ELECTRICAl'
- OFFICE USE -
QUAD ARE...' LAND USE: FLOOD PLAIN:
. OF SLOGS' . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR, TYPF' . OF SDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: SQUARE FOOTAGE:
To request an inspection, you must call 726-3769. This 15 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
-0
Si_te 1.nspection - To be made.
after excavation, but pdor 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.
o Post and Beam - Prior to floo'r
Insulation or decking.
o Floor Insulation"':'" Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - .Prlor to
.. cover.
D Electrical Service - Must be
approved to obtain permanent
electrical. power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
D Wood Stove - After installation.
D 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 s~b.base r:naterial in place.
o Fence':"': wtie.n completed,
o Street Trees -'When all~required
trees are planted. .
o
Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electri~al 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.
~Qther \'\\~t\\'4
. ~~~o~()
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.
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 ap.proved and
.,,' 'porches, skirting, decks, and
,venting have been installed. .
Lot faces
.
lot Type "-
lot sq, ftg,
Interior
Setbacks
I PL HSE GAR ACC I
IN
Is
Iw
IE
~ 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.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
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 o~ revoked at any time
upon violation of any provisions of said ordinances.
Garage
Carport
/J!~ AwP/~ -2'1 ~ Plan Check Fee:
r; CD. Date Paid:
Total Val ue
Receipt Number'
Building Permit Fee Received By:
/, ~
State Surcharge
Total Fee (Al 2/,.0 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)
N'
Sanitary Sewer
FT.
FT,
FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
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 1 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 StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
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 the approved set of plans will remain
~slg all times during cons~n, ,
"""~ ~-
,Date 1- j2i?q/~ffi1& ~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcu't
ft
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, S, C, 0, and E Combined)
..z;tHJ
VALIDATION: I 0 I 0'
RECEIPT NUMBER I g 6
DATE PAI('\ 4 .2Z.0f ! U
AMOUNT RECEIVEDc$/ . U /J
RECEIVED BY / _
I'
State Surcharge
Total Miscellaneous Permits (E)