HomeMy WebLinkAboutPermit Demolition 1997-8-29
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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OWNER: ~\\{\ (1rrt(Yl(ll) \
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DESCRIBE WOR.... \ \:)0 C'4\n \ I J\X\ ~.\-
LOT'
CITY'
NEW
REMODEL
GENERAL:
PLUMBING'
MECHANICAl'
ELECTRICAl'
BLOCI"
STATE: '
UrfCtf)Y \
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ADDITION
DEMOLISH
OTHER
.
JOB NUMB~~ ct1 \~()
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225 Filth Street
Springfield, Oregon 97477
TAX LOT: 1)OQ Cf)it'
SUBDIVISION' -
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PHON'"
ZIP'
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CON ST.
CONTRACTOR .
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co~~~'R~~ ~RCE:
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QUAD AREA:
· OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER'
EXPIRES
PHONE
,~
FLOOD PLAIN'
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.
REQUIRED INSPECTIONS
D Temporary Electric
D SlIe Ins paction - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Eleclrlcall
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Undarlloor Plumblng/Machanlcal
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanllary Sawer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. .
D Water Line - Prior 10 filling
trench. .
D Rough Plumbing - Prior to
cover. .
D Rough Mechanical -..:. Prior to
cover.
D Roug'h Electrical - Prior to
cover.
D Electrlcal Service - Must be
approved to obtain permanent
eleotrlcal power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior 10
cover.
D Drywall - Prior to taping.
D Wo'od Stovo - After Installation.
D Insert - Alter fireplace approv.1
and Installation of unll.
D Curbcut & Approach - Alter
forms are erected but prior to
placemont of concrete.
D Sldewatk & Drlvaway - After
excavation Is complete, 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 w9rk Is complet.e.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
D Final BUilding - When all
required Inspections have been
approved and building Is
completed.
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MOBILE HOME INSPECTIONS
D Blocking and Sat.Up - Whon all
blocking Is complala.
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 - Alter all roqulrod
Inspections are approved and
porch os, skirting, decks, and
venting have been Installed.
Lot faces
Lol ~ype' .
Lot SQ. fig.
Interior
Lot coverage
Corner
Topography
Total height
\'
Panhandle "
Cul.de.sac
BUILDING PERMIT '11
ITEM SO. FT. X
'5 't
$/SO. FT. a
Main
Garage
Carporl
Tolal Value
Building Permit Fee
Slate Surcharge
Tolal Fee
(A)
...
. ( 'THE PROPOSED WORK IN THE.",
..'..HiSTORiCAL DISTRICT, OR ON >
THE HISlORICAL REGISTER?
If yes, Ihls application musl be signed
and approved by the Hlslorlcal
. Coordinator prIor to permit Issuance.
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Setbacks,
1 P.L. HSE GAR Acc'l
I N I
I S I
Iw
IE
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S~wer FT.
Water FT.
Storm Sewer FT.
~J~
Plumbing Permit
State Surcharge +Z1'Io
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Woed Stove/lnserllFlreplace Unit
Dryer Vant
Mechanical Permit
Issuance
State Surcharge
Total Permll
(D)
MISCELLANEOUS PERMITS
Mobile Heme
State Issuance
Stale Surcharge
Sidewalk
fI
Curbcul
fI
Demolition
Slate ~ge
Total Miscellaneous Permlls (El
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C, D, and E Combined)
FEE
\~po
1.2V
lh'7D
tf6 .(X)
.qo
.~
.tL~
APPROVED'
BUILDlN'G VALOE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on Ihe express condition that the said
construcllon shall, In all respects, conform to the Ordinance
adopled by lhe Clty.of Springfield, Including lhe
Development Code. regulating the conslructlon and usa of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Dale Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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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 cerllfy
lhat eny and ell work performed shall be done In accordance
wllh.lhe Ordinances of the City of Springfield, and Ihe Laws
of the State 01 Oregon perlalnlng to the work described
herein. and lhat NO OCCUPANCY will be made of any
slruclure withoul permission of the Building Safety Dlvlslen.
I further certify that only contractors and .employees who
are In compliance with ORS 701.055 will be used on lhls
project.
I further agree to ensure that all required Inspections are
reQuesled allhe proper time, that each address 18 readable
from the slreet, that the permll card Is localed at the front
of the proMty. an~he ap roved set of plans will remain
on lhe slle "" al tI e8 ~Ing con tru I n.
I ,
........... '
Slgnatur"". I' "'--.
Date I tJ-- .;!tl- '? 7
,
VALIDATION: ~ n.Mf
'RECEIPT NUMBl1f' ~ : j(," \\ ,
DATE PAir' \ '1"1 -I .
AMOUNT RECEIV~q_\ ,fh~ .\..oLt
RECEIVED BY Th~ ~ '
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.
f'Il-158
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DEPARTMENT DF FIRE & LIFE SAFETY
OPERATIONS
TRAINING BURN AUTIlORll..ATION
, li"te: if 129 / Cj 7
:!,,'S (IF iii smEE I
SPfUN(irIFLU on 97;J77
(50:;) 72G.3737
fA\ I:"il)'"?,l /2(i..?297
AriJa Corie changes 10 (541)
NO\'t~mbcr 1995
TO: City or'Springiield, J Municip31 Corporation, actJllg by and through its DcpanlllCII( of Fire
, and Life Safely
You afC hereby authorized and permitted 10 bum under supervision and for education and instruction
purposes thai cenain house or building loc.11ed on:
Tax Lot # 17-02 .3;<'4,2. 00"10 I
.' in
Addition to Springfield;
Oregon whieh is designaled as '::/585 f.1A It.!
Slreel. Springfield. Oregon,
I/Wc, expressly warrant and represcnt to )'ou lhal lAVe, the undersigned, arc the oWllcr(s) of said property,
and lhat the same is free and cleaf of any and alllicns, encumbrances, judgments, and an)' interest, right,
tiuc or claim in any other person other than lhe undersigned. and t1~llhis consent is frecly and
vo:unl.1rily given. and 0411 we will ",we the Cily of Springfield l41nnless from an,' liobilit\, to any person
whomsoevcr by reason of any Sl:ItClllcnt or \..'arranty cOflt:l.i !led in this lettcr.
J/\Vc,the undersigned. also agree to thc follO\...'ing requiremcnts imposed by the Department of Firc and
Lifc s..'lfct)' to assure completion of all rcgulations,
I, The propeny owner(s) shell remove all debris on the lot(s) involved in this burn
,ViOtin sixty (60) d.1YS aner completion dale of Ihe burn by lhe Depanment of Fi re
and Life Safely,
2. TIlC propcny owncr(s) is to sccurc}hc required demolition and plumbing Glp
'permiL5 from the Building Departri,ent when inside the City LimiL5.
J. OuL5ide Cily pmits. Counly regulations apply,
4, The propeny owner(s) sl",1I l41ve lhe structure inspected for asbestos, ThiS
includes:
a. An internal and cxternal inspection of the structure by an asbestos or
environmcntal consulting finn,
b, Removal of asbestos conL1ining materiels. as indicated by the inspecting
firm, .
I.
c.
An Owncr-occupant may ~rforlll aslx:stos rcmoval.
a. '111e Waste Shipment Record (ASN-4) must be filled oul
b, SelUp an appointmenl wilh Shon Mountain landfill '
687-4120 ,fordispo""1.
If not an owncr-occupant. a rCIlloval company must perform
asbeSIOS removal and disposal.
The propeny owner(s) sl4111 submit a copy of Ihe original asbestos inspection as wril'ten
by the inspecting flnH and a signed nOle stating thallhe asbestos h"l$ been removed,
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OWNER(s)
ADDRESS J U'2
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