HomeMy WebLinkAboutPermit Building 1992-5-26
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RESIDENTIAL
PERMIT APPLICATION
lnspl:clioll:j: 1~6.31G0
Office: 726.37:;9
LOT: ____.
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OTHER ~~ ~-,,,"-< () g - - -
CONST.
CONTRACTOR N
6!..lJ"-l
.
SPRINGFIELD
~
BLOCK: __.
OWNER.. ..R OY/1.(..__W~uJ&:.~___
ADDRESS (2.-P--JSQL _._J!L$$
CITY: ~.U.MtJ!~
DESCRIBE W.)RK: _._1-< ~L.1j Ct::3'
NEW.__ REMODEL ~DDITION
STATF.
OR-
.WC;:!\;- -
DEMOLISH
CONTFIACTO,rs NAME ADDRGiS ~~~fr
GENERAL . RLC-Il/U..f)))~tJtJ/Ilt.r.L8~--e-.J!~iJ
PLUMBING:
MECHANICAl.: ___
ELECTRICAl.: ____
OUAD MILA
II or- OLOCC,.
OCCY CHUUI'
N OF STOFlIE:';:
WATER HEArER: _ _
- OFFICE USE.-
LAND USE:
11 OF UNITS: +___
CON::TR. TYI'I,:
HEAT SOUIlCE:
RANGE: __ _
~OB NUMBEIl__C]ZQ2Sq
225 Fifth Street
Springfield, Owuon 97477
(f?dC{1)L Cjf&fMd AJ?Jr)
TAX LOT en_S.dl -t ~C}2-o~c
SUBDIVISION:
PHONE:
EX~IlES PHONE
CJ"'@ILq2.J:z t1-()9?~
FLOOD PLAIN:
ZONING CODE:
. OF BDIlMS:
SECONDARY HEAT: ____ .
SQUARE FOOTAGE: ___ _
To ruqllCSI on inspection, you must call 72G.3769. Tills Is a 24 hour recording. All inspccllons requested before 7;00 a.m. will be
made the :,i11110 WOl'Idllg clay. inspections requested after 7:00 a.m. will be made the following work day.
o TenlllUlill'Y Elcctlic
CI
Site Inspection - To be rfl:1dc
after ,~:.:,;avation. 1,'Llt pliol to
scttill{j lonns.
o
Undclslab Plumhing/Electricall
Mechanical - Pdor to cover.
~
CI
Foolin~1 - Aftel trenches are
excavall~d.
M,,~oIHY - Ste,~1 locatioll, bond
beaHl~, uroulillU.
CI
Foulld:llion - Aflur forrns are
erecle:11 but pliol 10 eonclelc
pI3c'~lIlcnl.
o
Under{Jround Plumbing - Prior
to fillin~J trencll.
o
Undclfl(Jor Plumbing/Mechanicul
- Pliol to insulation or clecking.
o
Post and Beam - Prior 10 floor
in::>ulalion or (lecl-.ing.
o
Floor Insulation - Prior to
dcckinu.
o
$nnitalY Sewer - Prior to fillin~J
trench.
o
Storm Sewer - Plior to filling
trencll.
o
Water Lino
trench.
Plil~,r to Iii ling
o
Rou{Jh Plumbinu - Prior 10
cover.
REQUIRED INSPECTIONS
I=.J Rough Mecll<lnical - Prior to
cover.
I::::J
Rough Electrical - Prior to
Gover.
o Electrical Service - Must be
approved to obtain permanent
cluctrleal power.
I::::J
Fi.-cplace - Prior to facing
materials and framing Insp.
o
Framing - Prior to cover.
o Wall/Ceilil1{J Insulation - Prior to
cover.
o Drywall - Prior to taping.
D Wood Stove - After Installation.
o Insert - Arter fireplace approval
ami Installation of unit.
o
Curbcut & ^pproach - Arter
forms are t:r(~cle(l but prior 10
placement (,If concrele.
[::::J
Sidewalk & Driveway - After
excavation is complete, forms
ami sub.base Inatcrlal in place.
o
Fence - Wh(:11 comj..>reled.
o
Street Trees - v\''11en all required
Irens are planted.
o
Final Plumbing - Wilen all
plumbing woil< is COlllpllJle.
o
Final Electrical - Wlwn all
electrical wOII, is co.llplule.
o Final Mechanical - When all
mechanical work is cOlllplett~.
r-\7l Final Building - When alt
Lf\t required Inspections have bt~ell
approved and buildinU is
completed.
o Other
MOBILE HOME INSPECTIONS
o
Blocking and Set-Up - WIlUll all
blocking Is eOl.l1plete.
o
Plumbing Connections - When
home has been connected 10
water and sewer.
o
Electrical Connectiolt - Wlll..:n
blocking, set-up. and plumbinu
inspections Ilave t)ccn approved
and the home is connected 10
the service panel.
o Final - Arter all requirecj
inspcctions are appruvecJ and
porclles, sl<illing, decl,s, ami
venting have been installed.
Lot faces
LOI ::;q. fin.
LOI coverage
Topography
Tutal height
BUILDING PERMIT
ITEM
50. FT.
Main
Garage
Carport
TOI,II Value
Building Permit Fee
Stale Surcharge
Total Fcc
Lot Type.
Interior
Corner
Panhandle
Cui-dc-sac
X $/50. FT.
(A)
3q3D.~
,
'lIS.SO
10.7 r?
7.-2-6.2E?
....
~elbacks _
PL H5E GAR ACC
----.--
.; THE 1'1101'0:;1:0 WORI< IN THE
HI5TOllICAL DI:3TRICT, 011 ON
THE HISTORICAL nEGISTr:n? ____
If yes. this application must be signed
and approved by the Historicill
Coordinillor pri(lr to permit i~;suance,
N
-~--
5
W
--~--
-E-____
APPROVED.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the snid
construction shall, in all respecls, conform 10 tile Ordinance
adopted by the City of Sprinufield, including Ihe
Development Code, regulating tho construction and use of
buildings. and may be suspended or lovoked at any time
upon violi"ltion of any provi:~ions of said ordin':lIlces.
Plan Check Fcc:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
Systems Development Cll<.HVO is due on all undeveloped
properties within the Cily limits which arc beiliU improved.
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath{s)
S<Ji,i!ary Sewer
Water
StOI rn Sewer
Mobile Home
PlurnlJino Pcrmit
SI':,lIO Surcharge
T; d:lI Ch:1I !I(~
MECHANICAL PERMIT
Furnacc
Exhaust Hood
Venl Fan
(B)
N'
FT.
FT.
FT.
(C)
Dryer Vent
Wood Stovellnsert/Flreplace Unit
N'
Mechanical Permit
IS~;LJance
Slale SUI'c1lnrge
Tolal Permit
(D)
Mobile Horne
MISCELLANEOUS PERMITS
Stalc Issuance
Slate Surcharge
Sldcw:Jlk ___ It
Curbcllt __ fl
Dcmolition
State SU,lchi"lrge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, S, C, 0, and E Comblnod)
ADDITIONAL COMMENTS
FEE
By slgnalure,l st"lle and aglr~(J. thatlllavc careflllly examined
the completed applic<1!lon and do Ile1eby c(~rtify IIlal nil
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 Cily or Sprinuficld, ami the LilWS
of the State of Oregon perlainlng to the WOI\{ dG~;cribed
herein, and that NO OCCUPANCY will be Illade of any
structure without permission of the Building Safety Division.
I further certify lhat only contractors and employees who
me in cornpli;lI1ce wilh QRS 701,055 will be used on tllis
project.
I further agree to ensure 111:)1 all requiled irlspcl:lions me
requested at the proper lime. that each nddres~; is readable
from the street, that the pCllrllt card is localer.! :II the front
of the properly. and lIw . ve ~ Ian::; will remain
on the ~ tlllll'; dUllllg con!;lruction
5ignaIUl~_~ "",-_ ~ -.---
S'~ '2-6'.- '1 Z-
Dale
VALIDATION: L(
FlECEIPT NUMBER c::c:>_L/- {S.__
DATE PAID '" ~/.dl-::.cr2-~ -.-
AMOUNT RECEIVED Z2-.6-._'Z,j::{>
'-- ~ .!:-OLJiEL
RECEIVED BY