HomeMy WebLinkAboutPermit Miscellaneous 1996-5-31
RESIDENTIAL
PERMIT APPLICATION
....
'~ -
SPRINGFIELD
l1li: t@
LOCATION OF PROPOSED WORK' ij' ? .7 i..J - '-/ J 80 /J! o~ VI S1-
ASSESSORS MAP,I /()1 ~ -;;S-:S2
Inspections: 726-3769
Office: 726.3759
LOT
BLOCK'
OWNER: r~;--e.,. /1.0 r Sir.? Of)lPAA
ADDRESS: . .. '9 fJ 7 ~ I q ~ 7.-t K_ ~ 1I--P
r, -I-"
CITY: .c.- "; ~~~
DESCRIBE WORK'
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING: -.LJ ~ cf ~
MECHANICAl'
ELECTRICAl'
OTHER I~/ /,.l" "dO 'P~
CONST.
CONTRACTOR' EXPIRES
STATE: -4-1\
ADDITION
DEMOLISH
ADDRESS
jJ /f/ ~ ~? v1 iI/
, /
QUAD AREA:
· OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
- OFFICE USE -
LAND USF'
· OF 'UNIT'"
CONSTR. TYPE:
HEAT.SOURCE:
RANGF'
.-
..
Q(o(}7L(?,
JOB NUMBER
225 Fillh Street
Springfield. Oregon 97477
~/-1V rh eJJ .
~AX LOT: (J'{?t? I
,
SUBDIVISION:
PHONF'
.,g43~ J/~5
ZIP:j7 -J J '2--
. S-e--u <--
?/~
PHONE
A
~~
. 'll
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. Alllnspectlons requested before 7:00 a,m. will be
made the same working day. Inspections requested after 7:00 a.m. will be made the (ollowlng 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.
D Underground Plumbing ~ -Prior
to filling trench,
o
Underfioor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking,
~ Sanllary Sewer - Prior 10 filling
"trench,
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.
o Rough Electrical - Prior to
cover.
o Eleclrlcal Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facIng
materials and framing Insp.
o Framing - Prior to cover.
-0 Wall/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - After Installation.
o Insert - After fireplace approvel
and Installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Drlvewav - After
excavation Is compieto, forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing w~:HI< Is complet,e.
D
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
o Blocking and Set. Up - When 'all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking. set-up, and plumbing
InspectIons have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
. '
.," "
1 ....,.... ~,
Lot faces Lol r'1fI Sett>"cks IS THE PROPOSED WORK IN THE.
I PL. ACC I ,"' HISTORICAL DISTRICT, OR ON
HSE GAR
Lot sq, Itg. Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by Ihe Hlslorlcal
Topography Panhandle Iw I Coordinator prior to permit Issuance.
,
Total height Cu/-de.sac IE I
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
Carport
"
This permit Is granled on Ihe express condition thatlhe said
construction shall, In all respects, conform 10 Ihe Ordinance
adopled by Ihe Cily 01 Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked al any time
upon violation of any provisions of saId ordInances.
Main
Plan Check Fee'
Date Paid:
Total Value
ReceIpt Number"
Building Permit Fee
Slate Surcharge
Received ,By:
TOlai Fee
(A)
Plans Reviewed By
Dale
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the Clly IImlls which are being Improved,
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
(
25,00
! r:; . 6"0
-:{0,UO
Sanitary S~wer
Water
FT.I../)[)
Storm Sewer
FT,
FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
LfO.un
2,00
1,2V
j/ _?. ~:t)
.-
MECHANICAL PERMIT
FurnacQ
Vent Fan
N'
By signature, I stalo and agree, that I have carolully 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 01 Ihe City of Springfield, and the Laws
01 the State 01 Oregon perlalnlng to the work described
herein, and'that NO OCCUPANCY will be mada of any
struclure wllhout permission 01 Ihe Building Safety Division,
I further certify that only contractors and employees who
aro In compliance with ORS 701,055 will be used on this
projecl.
Exhaust Hood
Wood Slovellnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
I further agree to ensure that all required Inspections are
reQuested a~ the proper time, that each address Is readable
from the slreel, that tha permit card Is located at the fronl
of the properly, and the approved sel 01 plans will remain
on the site at all times during construction.
'V Cd.
slgna\2; .. ..,y~. "_V' F tCJ-U.e ~......
Dat(_'
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stato Surcharge
Sidewalk
It
Curbcut
It
DemolItion
Slale Surchargp
VALIDATION: , q (
RECEIPT NUMB~ 5 ~ ? 1- )<:7
DATE PAID J-.I/~ 0
AMOUNT RECEIVED . Vi j, 2. ()
RECEIVEO BY \~--
~
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT OUE (excluding eleclrlcal)
(A, B, C. 0, and E Combined)