HomeMy WebLinkAboutPermit Building 1994-11-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP' /~2-
LOT'
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ADDRESS: ;A? d?" J'y~
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OWNER'
CITY'
DESCRIBE WORK:
7::
NEW x:
REMODEL
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JOB NUMBER
225 Fifth Slreel
Springfield, Oregon 97477
;/ BeCdH 7 /p);_
BLOCK'
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TAX LOT: _~ ~ <acJ 2-
SUBDIVISION' ?n:r'a, 4:'._~
PHON'"
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STAT'" .
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ADDITION DEMOLISH
OTHER
ZIP:
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CONTRACTOR'S NAME
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CONTRACTOR .
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PHONE
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GENERAl'
PLUMBING:
MECHANICAL:
ELECTRICAL:
ADDRESS
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EXPIRES
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- OFFICE USE -
QUAD AREA' 3~rc.. LAND USE: /U/ FLOOD PLAIN'
· OF BLDGS: I · OF UNITS: I ZONING CODE:_ L~4
OCCY GROUP: ~ ~ -t-~ CONSTR. TYPE: VA) . OF BDRMS: :?
· OF STORIES: I HEAT SOURCE:---. F2. SECONDARY HEAT:-F~
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WATER HEATER' c:; RANGE: SQUARE FOOTAGE: /7ft:.53
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requesled before 7:00 a.m. will be
made the same working day, Inspections requested aller 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
O Underslab Plumblng/Electrlcal/
Mechanical - Prior 10 cover.
~ Footing - Aller trenches are
}A.t excavated. :
o Masonry - Steel location, bond
.beams. grouting.
'l?(FoundBtlon - After forms are
~~rected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
o Underlloor Plumbing/Mechanical
- Prior 10 Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior 10
decking.
o Sanitary Sawer - Prior 10 filling
trench.
D 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 RoughEleClrlcal - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
i
o Wail/Ceiling InsJlallen - Prior to
cover.
o Drywall - Prior to laplng.
o Wood Stove - After Inslallallon.
o Insert - After fireplace approval
and Inslallallon 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 Street Trees - When all required
trees are planted.. .
o Final Plumbing - When all
plumbing work Is complete.
. .
D Final Electrical - \lV.hen all
electrical work Is complete. (.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and bUilding Is
completed.
OOlher
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - Whe(l all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel.up, and pluroblng
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.
.~. ~ '~ .
,
LOI TYP. ,
Lot faces
I'
Lot sq. ftg. InterIor ' PL.
IN
Lot coverage Corner Is
Topography Panhandle Iw
Total ~elght Cul-d.e-sac IE
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. a VALUE
l\1aln.
Gacage
"
Carport
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Total Value
Total Fee
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(A) ~(.""I"
DEVELOPMENT CHARGE (SDC)
Building Permi I Fee
State Surcharge
SYSTEMS
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
.
Residential Bath(s)
Sanltery Sewer
Water
N'
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove! Insertl Fireplace Unit
Dryer Vent
MechanIcal Permit
Issuance
State'Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
t/5<j
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as 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.
Selbacks .
HSE GAR ACC'
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 City. 01 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 Charge Is due on all undeveloped
properties within tho City limits which are being Improved.
ADDITIONAL COMMENTS
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By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further cerllfy
that any and all work performed shall be done In accordance
with the Ordinances of Ihe City of Springfield, and the Laws
of the State 01 Oregon perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of Ihe 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 Inspections are
requested at the proper time, that each address Is readable
Irom 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 a~mes during c~r;:tr?IV ~
,X:lgnatur~ ( /a-.? L ~"" -
,
/t/2.-/f~
Date
VALIDATION:
RECEIPT NUMBER
/S 32-5"'
/~2-/9~
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DATE PAl"
AMOUNT RECEIVED
RECEIVED BY _