HomeMy WebLinkAboutPermit Fire Damage Report 1993-3-23
RESIDENTIAL
PERMIT APPLICATION
Inspections' 726-3769
Office: 726-3759
lOT'
MECHANICA".
ELECTRICAL' .J\")(~
\ .
OUAD AREA'
. OF BlDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
.
SPRINGFIELD
..
C(?{)~
JOB NUMBER
225 Filth Street
Springfield, Oregon 97477
5\51 Dot
T~X lOT~(l)
BLOCK'
SUBDIVISION:
ZIP:
U:E;l7
,
_ CONST.
A\~ \1)~f\LerrN~
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
t:::!JROU9h Electrical - Prior to
T cover.
o Electrical Service - Must be
approved 10 obtain permanent
electrical power.
o
Fireplace - Prior to facIng
materials and framing Insp.
OWNER: \ '\. . ~. ~ ~ '. n.(\, ~ ot~~O~ONF'
CITY ~ _ - :-' ,~TATE l. ~ D~DV\
DESCR~/7WORK~~ 1 D. 1 nrJ\(~!1L ~(LI~
NEW / REMODE' ,') :DDITION - t DEM~l1SH' OTHER
f J
CONTRACTOe;:/7AMI\ f'I.-~_J
GENERAL: L.4S'- Q)L \ n \::U-.
PLUMBING'
- OFFICE USE -
lAND USE:
h OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF-
1/fll-crJ; 4B4~~
FLOOD PLAIN:
ZONING CODE:
.
. OF BDRMS'
SEGONDARY 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.
o Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
o F~oting - After trenches are
excavated.
o
Masonry - Stecl location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or decking.
o
Floor Insulation- Prior to
decking.
o Sanitary Sewer - Prior to fillIng
trench.
o
Storm Sewer - Prior to filling
trench. ,
o
Water Line - Prior to filling
trench.
,
'fD Rough Plumbing"":" Prior to
\ cove~ . :.L
raming - Prior to cover.
all/Ceiling Insulation - Prior to
cove~
WDrvwall - Prior to taping.
b Wood Slave - After installation.
o Insert - After fireplace approval
and installation of unit.
D Curbcut &. Approach - After
- forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete. forms
and sub-base material in place.
o
Ff'nce -. Whcn COMpleted.
EJ
Street Trees - When all required
trees L!.re planted.
~inal 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.
Lot fac'es
Lot Type.
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cui-dc-sac
BUILDING PERMIT
tTEM so. FT. X $/SO, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee (A)
. .
. 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.
Setbacks
P.L. HSE GAR ACC
-----
N
S
W
E
---
VALUE
I
J)
lhb~)
F).53
Liln. m
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
Slate Surcharge
FEE
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) \1\.0 ,OS
(A, B, C, D, and E Combined)
-~
, .
APPR.OVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
,
Tlli~ permit is granted on ttle express condition that ttle said
corlstruclion shall, in all respects, conform to the Ordinance
ad~ptf.:d by tllC City of Springfield, including the
Dcvelopmcnl Code, regulating the construction and usc of
buildjn~l::;, and may be suspended or r cd t any time
upon violation of any P;f, isions of aid ordinances.
i Plan Ctleck Fee:.
,
Date Paid: _
Receipt Nurnber:_t\. \
Received By: , /"
/
Plnns l'tlrviewcd By Date
Systems Development Charge is due on al/ 'undeveloped
properlies witllin the City limits which a'rc b~ing improved.
.
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify thai all
information hereon is true and correct, and t further certify
that any and all work performed shall be done in accordance
with the Ordinancus of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
IlCrein, and thaI NO OCCUPANCY will be made of any
struclure witllOut perrnission of the Building Safety Division.
I further certify thaI only contractors and employees who
arc in compliance willl GRS 701.055 will be used on this
proicct. .
I further agree to ensure Ihat all required inspections arc
requested at the proper time, thai each address is readable
from ihe street, that the permit card is located at Ihe fronl
of the property, and the approved set ot plans will remain
on ~ ~ite ~onstruction.
Signa u~ ~'...---I .,;'AH- _
/. - - -
"J-2.'J- q'1.
/
Dale
VALIDATION: (\ (f(;c'
RECEIPT NUMBER I D'b -
DATE PAID 3 .~~,qr~
AMOUNT R~ _ _ \ l\,., .1....J5
FlECEIVED B _ ,_~