HomeMy WebLinkAboutPermit Demolition 1993-10-13
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
SPRINGFIELD
LOCATION OF PROPOSED WORi<' /'2tt::~ -1?.A'V.N-'
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ASSESSORS MAP'
LOT:
ADDRESS:
CITY'
DESCRIBE WORK:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL: O~~
PLUMBING:
MECHANIC" .
ELECTRICAl'
QUAD AREA:
. OF BLDGS:
OCCY GROUP'
. OF STORIES'
WATER HEATER:
.
JOB NUMBER
9"3/~S-
225 Filth Street
Springfield, Oregon 97477
BLOCi<'
SUBDIVISION:
TAX LOT:
e:'a;.-L.-
STATE: _~A.
DEMOLISH
OTHER
OWNER:_fi~~f(~n E: ~.A"';"LAZ~
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ADDRESS
CON ST.
CONTRACTOR'
PHONE:
"'74,?;-.c=?:2/
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR TYPE:
HEAT SOURCE:
RANG'"
ZIP'
-?''/<Y::>-:::>
EXPIRES
PHONE
~
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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. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspectlons 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 Footing - After trenches are
excava ted.
o
Masonry - Steel 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 nnd Beam - Prior to floor
Insulation or deckl,ng.
Floor Insulation - Prior to
decking. I
o
o Sanitary Sewer - Prior to filling
trench.
o 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.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materlals and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Inslnllation.
o Insert - After fireplace approval
and Installation of unit.
o 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 Fence - When completed.
o Stroet Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing work 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 alt
required Inspections have been
approved and building is
completed.
IZl Other _lJ-..nr'f/"> .;J3__.;;-~ Z'
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79~L
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 connecled to
the service panel.
o
Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
LOI Type
Lot sq. ltg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM sa. FT. x $(SO. FT.
Main
....,
Garage
....
Carport
Total Value
Building Permit Fee
State Surcharge
Totar Fee
(A)
Selbacks
I P.L. I HSE GAR ACC I
I N I
Is
Iw
I~I
.
VALUE
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
~~C ~,.I9cL-
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
EXhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLAN~OUS PERMITS
Mobile Home
State issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
I
l
TOTAL AMOUNT DUE (excluding elect,lcal)
(A, B, C, D, and E Combined) ,
FEE
_L-;;: -
.75
j:5:;?2
/x:- - -
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/$-"71:>
"3~6S"
I
, _~_J'
I_E 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 gran led on lhe express condition that the said
....... ' ,
construction shall,'in all respects, cq'n,form to the Ordinance
adopled 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 or any provisionS' of said ordinances.
Plan Check Fcco,
Date Paid:
Reed pt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due oon, all undeveloped
properties wilhin the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I fUrl her certify
that any and all work performed shall be done in accordance
with the Ordinances of 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 Safely Division.
I further certify that only contractors and employees who
are in compliance wittl ORS 701.055 will be used on this
project.
I furlhcr agree to ensure that all required inspections are
requesled at tile proper time, that each address is readable
from the street, that the permit card Is located at the front
of the proGY' and the approved set of plans will remain
on the oil a all times rItH~g. r~~
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Date V ~(;\-, S I q->
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VALIDATION:
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(-c-~-93
AMOUNT RECEIVEr> ?4I.~~
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RECEIPT NUMBER
DATE PAIr>
RECEIVED BY