HomeMy WebLinkAboutPermit Miscellaneous 1992-7-6
,
JOB NUMBER
SPRINGFIELD
e;
RESIDENTIAL
PERMIT APPLICATION
92CJ92::;2._
225 Fifth Streot
Springfield, Oregon 97477
Inspecllons: 726.3769
Office: 726.3759
sy:
LOCATION OF PROPOSED WORK: -;;2 ;::;.. -~ 7 m 17 i AI
/?D7. ;:j("~ 42-.
n '-J!J-t)
~
TAX LOT:
SUBDIVISION:
ASSESSORS MAP'
BLOCK'
LOT'
PHONE: 7~t:.. - EBh/' I
/-..b f', (' tfl ,
ADDRESS' ;J:')(") 9 j/}I} -4//1/
CITY: 5f' ~t-ilf1+i e.1 J
RDshe IYl
OWNER:
ST:
STATE: (() rE .
~
ZIP'
(.J.,,,,IF-lr <~./r() I cuL
DESCRIBE WORK: -U~..A.U
NEW REMODEL )(
OTHER
ADDITION DEMOLISH
CON ST.
CONTRACTOR'
PHONE
EXPIRES
ADDRESS
CONTRACTOR'S NAME
GENERAl.: __
PI.UMBINGS::-C7:_E/~
MECHANICAl.'
ELECTRICA' .
P.fJ, !3.t<>X l'?96 OFf-IE"0 S7S7/f Cl.-J()-'l3 9.3$::riJ./SIa
L
- OFFICE USE -
FLOOD PLAIN'
ZONING CODE:_
LAND USE:
OUAD AREA'
. OF UNIT'"
. OF BLDGS:
. OF BDRMS'
CONSTR. TYPF'
OCCY GROUP'
. OF STORIES:
SECONDARY HEAT:
HEAT SOURCE:
SQUARE FOOTAGE:
RANG'"
WATER HEATER'
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
o Flnol Plumbing - Wilen all
plumbing worl< Is complete.
o Rough Mechanical - Prior to
cover.
o Temporary Electric
D Rough Electrical - Prior to
cover.
D Site Inspection - To be made
after CXl;8vatlon, but prior to
selling forms.
D Final Electrical - When all
electrical work is complete.
o Final Mechanical - Wilen all
mechanical work Is complete.
o Undcrslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Final Building - WllQn all
required inspections hllVC been
approved and building is
completed.
o Footing - After trenches are
excavated.
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
bean,ls, grouting.
o Framing - Prior to cover.
OOthor
D Foundation - Aflor forms are
erecled but prior to concrete
placement.
o Wail/Ceiling Insulation - Prior to
cover.
Underground Plumbing - Prior
to filling trench.
o
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
Undorfloor Plumbing/ Mechanical
_ Prior to Insulation or decking,
o
o Wood Stove - After installation.
o Blocking and Set.Up - When all
blocking Is complete,
Post and Beam - Prior to floor
Insulation or decking.
o
o Insert - After fireplace approval
and Installation of unit.
o Plumbing Conneclions - Wilen
home has been connected 10
water and sewer.
o Floor Insulation - Prior 10
dockinu.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sanllary Sewer - Prior to tilling
trench,
o Electrical Connection - Wlwn
blocking, set-up, and plUlflblllU
Inspections have been approvml
and the home Is connected to
the servlco panel.
o Sidewalk & Driveway - After
excavatIon Is complete, forms
and sub-base material In place.
o Storm Sewer - Prior to filling
Ircnc:h.
~. Water line - Prior to filling
~onch.
o Fence - When completed.
o Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
o Street Trees - When all required
trees are planted.
o Rough Plumbing - Prior to
cover.
J
Lot faces
Lot Type'
Interior
Lot sq. ltg.
Lot coverage
Corner
TOlJography
Panhandle
Total height
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Galage
Carport
Tolal Value
Building Permit Fcc
SI<1le SUlcharne
Total Fce
(A)
. . THE PROPOSED WORI< IN THE
'.: .ISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Illls application must be signed
and approved by the Historical
Coordinator prior to permil issuance.
Setbacks
P.L. HSE GAR ACC
--
S
N
----
W
E
----
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanilary Sewer FT.
Water
FT. /00
Storm Sewer
FT.
Mobile Home
Plumbing Permit
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mohile Home
Slale Issuance
Stolo Surchnrgo
Sidowalk
lt
Curbcul
ft
DC,"olltion
Slale Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding olectricel)
(A, B, C, 0, and E Combined)
FEE
4.0. tr<>
2..<N>
42-0<>
42.00
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition ttlatlhe said
construction shall, in all respects, conform to tho Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildlnns, and may be suspended or revokct.l at any time
upon violation of any provisions of said ordin,1nces.
Plan Clleck Fee'
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Dale
Systems Development Charge Is due on all undeveloped
properties within the Cily limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed applicntlon and do hereby Ci~rtj(y ttlat all
information hereon is true and correct, and I furl her certify
that any and all work performed shall be done in accordnnce
with the Ordinances of the City of Springfield, ;lI1d the Laws
of the State of Oregon pertaining to the worl\ described
herein, and ttlal NO OCCUPANCY will be ",..)(.Ie of any
structure without permission of the Building Safety Division.
I further certify that only contractors and cmployees who
are In compliance Witll ORS 701.055 will bc used on this
project.
I further agree to enSllre that all required Inspections are
requested at the proper tIme, that each add res:..; Is readable
from the street, that the permit card Is locatml a\ the front
of the property, and the clpproved set of pl.JI1:~ will romain
on the site ~t /'Jmes during constrt,clion.
'I SignatulQ~' ( C/"Y';t.€ tJ,
Dale !/4?:L/ 2-
VALIDATION:
5"~~ (
DATE PAID ---7::.? - '7;?--
AMOUNT RECEIVED ..4.2 a\!>
~~
.... -- ..
RECEIPT NUMBER
RECEIVED BY