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.. RESIDE.IAL" .'
SPRINGFIELD
APPLICATIO PERMIT ~
225 North 5th Street
Slwing[ield, Ol'egon 97477
Duilding Division
72(:-3753
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,rob LOC:lti::m:
10.3C:1:101':: ,\'ap
MdilJ~sion:
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Tc:r Lot U 02; l 7f7)
Phone:
Zip:
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.1ddi ticrI
Rcmo;!p.L
.'!obi 1,(1 Hom:!
Address
Lise 0 /I
Illel rs lIoa rd ReI!.
~l")C"""rL;,.l~Eleetr~ci."n /). r'/ (.1 "'//__.:.
It. is ~hc rcnporlDibiZity of the p/rmit holder to 886 that all. inapaationB are r.lade at the proper time"
[rom thu utI'cct. and that the pCl'rm.t card is looated at the front of the propel'ty.
l!lld!di.'11) D~.tJi:;i()~: approt:ed plan 81u:Ll l~emain on the Bu.-:.ldin(1 Sit:: at all times.
r.'WCSDlIPE FOR /fISPECTION RE'pUEST.:CALL 726-3769 (l'caorder) state your' City designa.ted job nwr.ber. job acdress. type of in:Jpea:iclI
"(HIl4i::Jtcd a.-:d Wherl yO!1 wiLL be ready fOl' irlspccHon. Contractors 01" Owners ncme and Fhone number. Requests receit:ed before 7:00 a':'I
~ill he ~l(lc the Game day. l'equests made aft~r 7:00 am will b~ made the next ~l'ki~J day.
All pr'o,feet conditions, :mc.J: aO tIle ~',rlstallation of 8~I'eet trees. "co.'~pleti.:m of tite
r'equil"ed lmld:;ccpir:o. etc.. mUlJt be satisfied before the BtHLDINC FINAL can be r:1quest3d.
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FINA(, BUILDING: The firlal Building Irlnpcction tmlOt be requeGted after tIle Pinal PlwnbinJ
Electrical. and Mechar:ic(:l IrlspectionD have beerl made and approu-,d.
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~AU, nlNffOU.'.'; MI.') r.r.".'ANOfJ'r:: t1/1.<;T m: IiCr.,....';.r;fm,F.', AD,lUSTW",'/'!' TO .'JE f.f.1nF. .i1.T /.'0 r,ST TO cr'!'Y
Date o[ lipplicaticn
~
~JI\l' r;Il;[ors
[;eneral
Plumbing
i-icchan lC..ll
ELt;.'l: t r i.!;.II
.ft~{/ljt"I,(1 rf1!l!>,.,'t.;r.'J<'I
I !...['l...... lrJSN:enON: 'fo be IMde after
~ e.ccav.lti,:m, !Jut prior t~ 8e~ up of
[orm:J.
'I mIlJEUS[,All Pf,L',\/BINr;. ELECTHIC.1L .{
_1 ".!r:C!I..!,'Ilr.:IIL: To be made bcfol'~ any
- IJ(Jf',l.: ill ;Jovel'ed.
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rOOTING ~ FOUND-iTION: To be made
aft."!I' tl'imdwtJ are cxcavated and
form:; aI'C cr'ccted. but prior to
r"'IlI.i'I'.1 r.:C!ICz'et.;.
::-J
1!:,~g.2!!??OII,'!D p[.w.mrNCJ s.r;;WE:R. W.iTF.,~
UH,1!!1AI,'r.': 1'0 be madc prioJ' to fiL-
Tt,~--!-:;:erlC!:,z!:.
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~'l:'J.!!::~'!}'[,OOR Pf.!I.'.!BJ,VG <~ MECHANICAL:
1'0:) !J,J mild,"] pz'iaz' to ill:Jtallation" of
f/,:,',:I/' iWlIdc:t'ion or decking.
/', l::,/, ,WO {Jf.'AM: To be made prior to
"~;~il:7'rC;Trc,~of [loop insulation 01'
,!,',:~iI1F'
S,ll/::.'! !'[.f.'.'.r!1 {;'/C. f..'f,ECTR rCA!".. ,~ UECfI-
X:,jJ::l!.~:'~' ,,/,,- ~lOr'J: i:J to be eOl.'eped
l~;'ll' (' : Jr,.'I:.:::ll:Jpect-ior:s have beer:
"~I.!" ,!w! arJpl'ove:!.
rI ".~'!'l...l' 'f;: Prior to placir.IJ facing
lI~f. ;.,,;!~;- ,'Ilt! befor'c fmming iunpec-
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:(:!r::.l1'.:..I.:I!~: ,'.,'11:;(. ')c requeDted al~ep
d['}<I' .,I.tI l.'f ('OIIUIJ plwnbiflO, 8lcct).i-
ei!t :; ,r.,',:h'llli::{ll. ,1Z! r'ooj'irlg
1'/';/,'/11:) ..; ehimrlc!J9. ct.::. m:wt be
C:'IIII,J,,{,.,1. .....0 w.:JJ'k is to be con-
(:,:1:': ,..j Ill!!. i ,. Oda inspcction has
'li,;,"j "7,..;.... ,tIl,! ap[Jl"ol,.'cd.
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o tt::,l/, !'!Y("~':,'IC.,~{,
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DescPibe f.'oI'lc
Value
/ /1/ _ ,C;
Your City DeDigr.atcd Job Nwnbcl' 10:
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INSULATION/V/lPOH HARRIER INSp.r;;CTION:
To be made after all insulati:,m a.'xi
rcqu:.ped Llapop bar'r'iers Q1'e in place
. but cefore any latll. gypSWTf board or
wall covering is applied. and before
any inDuLation is concealed.
DRYWAf.L IflSPECT!ON: Tc be made
aftep all drywall ia in place.
but pr'iol' to allY taping.
O ~MSONRY: ,Steel location, bond
beamD. gl'Out;iug or' vertioals in
accopdal1ce IJith U. B. C. Section
2415.
,
DWOODSTOVE: Aftep installation is
ccmpleted.
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CURB .( Af'PROAClJ AP.'?ON: After- foms
are eJpec:ted bu.t p,'ior' to pourirlfl
,zon,zrete.
SIVF:r/ALX ,~DRII'EUt.Y: Fop all con-'
cr'ete paving witllin street right-
of-u:::y.. to be made after al! e%ca-
vating cunplete & form lJOT'k & aub-
baae matel'ial in pLa;:)e.
o
o
rENCE: M~er. compl~te -- Provide
gatcs 01' movable sections thl"ougr,
P.U.r:.
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Siqr.cd:
Data:
gxp':i-ces
Phonp
,(//,~/q/
that ~ach ~eBB is
readabZe
I DEIIOLITIO!/ OR ;'.,'OVE!J SUILDI,7GS
~ Sani ~Ql'y BeJel' :!apped :It pl'op~rtEi tir:e
--1 .' " ',' ,'lo.l...',"hll'tl";'I\>II'I,."";11 ~}i i~.i,. ,~
:J Septi;) tank p:lmpcd and fill;:d with aroa:Jel
::J Final - rl~en abeLle itc:.'1s are completed
ar.d when'd~litior. is complete or struJ-
ture mouee. and pp;:r.rises ;)leane:! up.
.0
I Mobile Hemes
::J Blocking and Sat-up
::J Plumbing connections .- scwc~ and ~:er
::J Elcctrical Connection - Blocking, set-up
and plwnbing connections rrr...8 t te approvad
bsfor'c pcquesting elec~rical inspectio~
::J Ac;)cs[;opU 8uiZd~ng
::J Final - Ilftl:l' f.':Jrc1:es.
etc. are c~plet~d.
skil'ting. decks.
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I r.",,'
of "
I JOB NO.
Izone'
Lot Sq. Ft,;.
~ :>1 lot C:>u81'ag&
,1/ of Stones
Total Height
Topography
SOLAR AaESS
Occupancll C'"
I
11TEII
I Main
I GcJ"ace
LOT TYPE
Interior
Cornel'
Panhandle
Cut-de-sac
SQ. FTG
X Value
Caroort
A~cep80rlJ
I' .
I
TOTAl, VAWE
Is.v.c.
IVCt.UCJ
1.5 z
Bui l.dina Permi t
State SW'charge
Total Charges
IITEII
I Fix.tures
NO. I FEE
Residentia! (1 bathl
sanitary Sewer
I Watel'
I
PLumbing Permit
Stat" SUI"cr.arqe
Total Cha1'nOB
CHARGE
REQ.-
l.-Cl,ll:'
...":-.~
Type/Cor-.t: _I
1
I Acc.'., I
11
11
RI?GrOQm3 :
E~12r(1." SO:lrC(!G
!Ieat
Water !',.at,."
Hatlac
fircnlar:r.
Wood;;tor.:e
T;/I'I:
I wt Faces -
I
I P.I..
NOl'th
lEast
ISouth
:Went
Set.backn
'lIou8p. r Cara'll?
Faes
Building Value & Permit
This permit ia granted on the erpreDB condition that tho Il,Il~,j ;:..}.'U:II'/lI:t.I:')11
ShaUl in allro8epcctD, conform to tile ordinance adoFtr.J l)'y dlt> t'il!! oJ[
Springfield, inc!udi.ng the Zoning Crd'inallca, reguLatillg tll.} ,;(..'/1:: f 1'11.'1 ::';'1
and UDe of buildings, and rrcy be sUDpended or revoked at (;/:y t.;:r-:,' :/;-"1: IIj.;-
tation of any provisions of said OrdinancoD.
I Plan Check
Cote Paid:
Recdpt H:
Si!J!1ed:
fee:
Plumbing Permit
No percon chall. con3truct, install, aZter or change any neW c,' 'J:i3tl~1I~;
plumbing or drainags syste:n in ",hole or in part, ur.les8 GUc11 pernoll 1~3 f.l1'1
'Legal posseBsor of a valid pl.umber's license, except that a par3011 maiJ (iLl
plumbing lJOrk to property which is owned, l.ea3ed or operated by tJU! appU.-
cant.
.
.Iln~f
/ Res. So. fto.
I Haw/EXtend Circuita
I Temporary Service
I
'NO. [
I
I
I
fEE
Electrical Permit
Ete~tricat Permit
State SurcMr{fS
Total Charqes
IITSM
1 F'urtUJCP !!TU' S
I E:haus t Hood
I Vent fan
I W:xJdsto;;6
NO.
FeE
Permit I38uanca
Mechanical Permit
State Surcharrc
Total. Charaeo
__ EIICROACRIIENT --
ISc~~rit~ Daooott
I Storage
I l.fr1in tenan.'!/'!
I pcnnit . .
I
I Curbcu~
I Sidm.uLk
I F,.."ce
I ElectricaL Cabel
I Mobile Ilome
I
I
Totat Chamcs
l",n'l''''T. .4JJfllJNT ME:-4
CHARGt"
CIIARCE
Jlhers State (AbJ requires ch.at the electrical work be done by all ELectJ"ir.:tlL
Controctor, the eLectrical portion of thi3 permit shall r.ot ba valid ulltiL
the labeL has b6en Dig7led by the El.ectricaL ~011tractor.
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I .
Mechanical Permit
va,.
PLan EXclflL7Ier
I HAVE CAREfULGr EXAMINED the compLoted application for permit. and do
hsreby certify that all i:-;fo:<mation 'lerGon is true and correct, and I
further certify that any ar.d alt IJOrk psrfo~ed shalt be dOile in. acC'or'-
danc6 witl1 tha ordin:utce8 of the City of springfield, and t}1~ La-...:s of tho
.4 Seate of Ore9"71 pertaining to the IJOrk described heroi.n, c1uf th.'l: NO aeel)
PANcr lJill be rmde of any struetUl'2 witho;;.t p.2rmis3ion of Ole SuiLdinp Di
uinion. I furthar certify th:1.t o~ly contractors QJuI c:npl"yocs w1:o arc ill
compliance with ORS 701.05t wiLL bo used on this project
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