HomeMy WebLinkAboutPermit Demolition 1993-6-11
\ RESIDENTIAL
PERMIT APPLICATION
,Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD'
LOCATION OF PROPOSED WORK'
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ASSESSORS,MAP:. 1'1 O-,L,~c:,4 \
LOT:
BLOC.... _
CONTRACTOR'S NAME
GENERAL:.K tl, k ~\L.n,..O<"
. I . ,
PLUMBING:~' \:"'-:!- I~". 0) I ~,~!_ ~l~ _
MECHANICAl'
, : ELECTRICAL: :E:2u ""-
'.
.
JOB NUMBER
Q~7;'"
, 225 Filth Slreill
Springlield, Oregon 97477
....
. TAX LOT: ~
'SUBDIVISION:
REQUIRE!;> INSPECTIONS
o Rough Mech~nlcal ~ .s:rior to
cover. . ,'. .
'),.L; 'ROUgh Ele~;rlcal' - p;ior'to
~ cover. .
.
~' .'
Electrical ServIce - Must be
approved toO, obtain perman,ent
. . . electrical power. .
, .
o Fireplace -:- Prior to. facing
mater.la~s and', framing Insp.
o Wood Stov~ - AI.ter l.nstallat1~:m.
o In~ert - After firepl.ace approval
and Instatlation 01 unit. .
D' Curbcut & Approach ~ After
forms are e:rected bl:lt prior ,to
placement of CO.r:yre.~e. .
o Sidewalk & ,Driveway....:... After
excavation Is complete, forms
and sub.base material in place. .
o Fence - W~en completed..
. .
o Street Trees'- When all' required.
trees are plante~:L ..
PHON~:
~.(.
..~,..,.
, .,
. .
OWNER: O~~~' ~~I..:>tfr<
ADDRESS: lnID:l, lv\.A.-i.J
CITY: ~ f' e..\ /0(",\= ,~.'-P ,
. ,("\\vt'
DESCRIBE WORK:1Se~")~"~ \)~""()\-\S\D~ ~s;: Q~ci\~ol'\~O;-
NEW _ REMODEL'-::'- ADDITION DEMOL;~H $-- OTHER:"
STATF'
. OIL--
ZIP' q 14-7-:"1..
'EXPIRES
~rl,!q~:>,
. .i;'HONE
.. 4&4.~'5SS.
ADDRESS . ..
"":;A""l- fZ....'!.'T\<:..... 3>
o\'O~. V'_. .~
CON ST. .
CONTRACTOR'
~..,
QUAD AREA' I.!AND USE: ':( FLOOD', PLAIN:
, OF BLDGS' ' OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYPE:' '.OF BDRMS: "
, OF STORIES: HEAT SOURCE: SECONDARY HEAT:, '..
WATEF\ HEATER: RANGE: ,SQUAR'E FOOTAGE:
_ OFFICE USE ...:.
. . . " , ., .' . ~ -' '.' ,
To request an Inspection. you must call 726.3769. This IS a 24 hour.reco~dl.ng. Alllnspectjons ~equested before 7:00:,a..m:' will be ..'
made the same working day, Inspections requested after 7:00 ~UT~: .wlll'be.' ~CI;de th~ f?lIowing work day. . .
. . . . '
o Masonry - Steel, location, bon'd
. beams, grouting. '. " 0 F' PI
. ramlng -:. r or ~o c~ver.
. " ' "-7l-Foundatlon - After forms are ~ :: . .'
,,:, ~ ,erected but prlo'~ to co~crete Wall/Cellhig Insulation -i Prior to
'. placement. cover.' :'.
M Undergro~nd Plumbing - Prior ~ D' II p'. \," I · .
~ to filling trench, ~ rywa - nor 0 aping..
o Tempo,rary Electrl~ .
1:::21 Slto Inspection' - To be made
~) after excavation, but prior to
'.:' setting forms.
:.
o Underslab Plumblng/Electricall
Mechanical - Prior to cover.
~'FOOting - Afte~ trenches ~re'
excavated. . .
. ' . . .
,
f ..
..
rxI Underlloor Plumbing/Mechanical
... .....: Prior to Insulation o,r decking.
~ Post and Beam - Prior to floor
~sulation or decking.
r;,,5 Floor lpsulatlon -:- Prior to
.~ecking. . .
\
:~
~ .:~ .">
~ Sanitary Sewer - Prior to fllting
.~rench. .
~, :. '.
, .'
~. .~";':: ;
QJ Storm Sewer - PrIor to filling
trench, . .
h Water Line -"Prior to filling
181 trench. .
~ Rough PIUmbl~g - Prior to
I . tj cover.
1, . ~_: ....
~: ~ .: ".,
f~"" ' .,
iF('.
1\'
,.
: ~
0..
Final Plumbing - When all
. plumbing 'Work Is complet.e.
. ""i5Oi Final Electrical - When all
~ electrical work is complete. . .
o Final Mechanical - When all
mechanical work Is complete.
~ Final' Building - When a!l .
~ required Inspections have been
approved and builqing is .:
completed.
o Other.
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all--
blocking is complete.
. 0 PlumbIng Connections""': When
home has been connected to-
water and sewer.
, 0 Electrical Connection"- When
. . blocking, set-up. and:.plumblng
. inspections have been approved
and the home 'is connected "0
the service panel. .
. 0 Final - After all reQ~lred '.
- inspections are approved and
porches, skirting, decks. and
venting have been installed,
I
. Sc t bac ks
lot Type
Interior I P.L. HSE GAR ACC
IN
Corner
Panhandle S
Cul-de-sac W
E
lot taces
lot sQ. Itg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SQ. FT. X $/SQ, FT.
VALUE
\4ooo~
Main
Garage
Carport
Total Value
14 1I--aU e.-
i04.~
&;.1..';
-V''1 " ~
Building Parmi t Fee
Slate Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures (0
Residential Bath(s) N'
Sanitary Sewer FT. It;O
Water FT. 10D
Storm Sewer FT.
Mobile Home
FEE
(,O,6"/)
'40, l.5t>
40.00
Plumbing Permit
JAn. C1l> .
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolltion
l&.OD
State Surcharge
Total Miscellaneous Permits (E)
.'?D
i~,q/)
~15.h7
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
.
IS 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.
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the Cily of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
, Received By:
Plans Reviewed By
Date
Systems Development ~harge is d~e'on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
AppVf>v4v CoIA.M{A.Q. c.M1tv1t9~.
h, JWLWiMAYv,,"-
By signature, I state and agree, that I have carefully examined
the compleled application and do hereby certify that all
~nformation hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances or 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.
,
I further agree to ensure that all required inspectiofls arc
requested at the proper time, that eactl 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
, on the site ~s dU:~Cllon.
XSlgnatur~~ :/ _ 4<..
Datp ~- //- fi?3
VALIDATION: . Q"ld
RECEiPT NUMBER' \\ D:I..J{
DATE PAIJ"l l fl- . q ~
AMOUNT RECEIVE: ~ _ .-?Y,
RECEIVED BY ~\l~ ' )