HomeMy WebLinkAboutPermit Building 1995-4-27
P/P<.77.AL ,JJ6f~/T"
.'
JOB NUMBER..:i!:i / &, I !
.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
225 Flllh Street
Springfield, Oregon 97477
j/ t7fAJ~/l.J "'p,1
TAX LOT: ~ ~c;:l, C) 2-
SUBDIVISION: ."/NT I/c-A'" )t'),,)
LOCATION OF PROPOSED WORK'
/~O '2
L
ASSESSORS MAP'
LOT' """)
BLOCK:
t' !~J:=.' kLC7-1ST.E-n)
'P_ CJ" ~'l'><: ,S?'r""
!A~~V/t'~r:
PHONE: 7~'7 -/")/A ~ #0.-1>
~"'7" --93 ,?'''i' 7#7"J?~ ,.o)-,.:,c;.~
71"0 -O<o~~
OWNER'
ADDRE"'"
CITY'
STATE'
~' -
DESCRIBE WORK: I~ "'," r ~
NEW V-- REMODEL ADDITION
/N)~MP;;"M
, .
/"Vf )L V
I
~
DEMOLISH
OTHER
CONST.
CONTRACTOR #
CONTRACTOR'S NAME
ADDRESS
EXPIRES
PHONE
a&JA.lA4
GENERAL:
PLUMBING'
MECHANICA' .
ELECTRICAL'
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
# OF BLDGS' # OF UNITS' ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested belore 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.
REQUIRED INSPECTIONS
o Temporary Electric
o Rough Mechanical - Prior to
cover.
o Final Plumbing - When all
plumbing w9rk Is complet.e.
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Rough Electrical - Prior to
cover.
D Final Electrical - When all
electrical work is complete.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Final Mechanical - When all
mechanical work Is complete.
o Electrical ServIce - Must be
approved to obtain permanent
electrical power.
o Footing - Alter trenches are
excavated.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Fireplace - Prior to facing
malerlals and framing Insp.
D Masonry - Steel location, bond
beams. grouting.
o Framing - Prior to cover.
o Other
o Foundation - After lorms are
erected but prior to concrete
placement.
o Wail/Ceiling Insulation - Prior to
cover.
o Underground Plumbing - Prior
to filling trench.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
O Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
-;
~Post and Beam - Prior to floor
~nsulatlon or decking.
o Wood Stove - After Installation.
o Blocking and Sel.Up - When all
blocking Is complete.
o Insert - After fireplace approval
and Installation of unit.
o Floor Insulation -. Prior to
decking.
o PJumblng Connections - When
homo has been connected 10
water and sewer.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Sidewalk & Driveway - After
excavation Is campietc, forms
and sub-base material In place.
D Storm Sewer - Prior to fllUng
trench.
O Waler Line - Prior to filling
trench.
o Fen~e - When completed.
o Final - Aftar all required
Inspections are approved and
porches, skirtIng, decks, and
venting have been Installed.
D Rough P!umblng - Prior to
cover.
o Street Trees - When all required
trees are planted.
Setbacks.
HSE GAR AcOI
I
I
Iw I I I
lLL --'--J
LOI faces
Lot Type
Interior
I P.L.
IN
Is
LOI sq. fig.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de:sac
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT. = VALUE
Main
Garage
"
Carport
~T/~
(P~774 ".e'~/T)
~1tO
Total Value
Building Permit Fee
Slale Surcharge /,93 -f- //"
Total Fcc (A)
,<g<;;:o
3, Zl'1
41 :Sf
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
FT._______
~
------
Water
Storm Sewer
~
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Issuance
State Surcharge
Total Permit
(D)
MISCELL_~NEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
State Surcharge
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
.4/. "51
, 1
,".,' ':.,. .: :~~:'t;~ :Lkr;~~;.
, 'il: ~
'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 Is~uance.
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 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 Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
-.Itfr'!; .Af1b<?AI?/T /'C;:S' Hb) I'" .AAI7',,(}~?A. V-
~J J"}/./A7r.~~ ~ ,~m...l/,(D
J)E;p/H~ WJ71fV 7b1?J MJ~f ~
/ - .
pIl= ~ 7JHS..I1~// /f !5S.tl'~,
_( AI A1tJ.r N6 ~hoHy ~A 1 . J~
~,.,..~)
J
By slgnalure, I state and agree, that I have carefully examined
the compleled application and do hereby certify that all
Information hereon is true and correct, and I further 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 lhe Building Safety Division.
I further certify that on!y contractors and employees who
are In compliance with ORS 701.055 will be used on this
prolect.
I further agree to ensure thai all required Inspections are
requested at the proper time, that each address Is readable
from the streel, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
S~ </.04- ~
Date
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
J 7 / 5~
4/2 Y!'J
4/')5'
~
RECEIVED BY _