HomeMy WebLinkAboutPermit Building 1995-5-11
~\( . ~\Ql'f\~\-(\ , ,PHONE: ('At'.(j \O()~
\0(\ \~tLffi\O Q'3\'1.51q. 144 .\q9j.~, "
' ~ \J~(\l. STATE: \..1\lr" ZIP: l\f}\ t::51
DESCR,'~ WORK' ~ N\~. 0 ) ~ ~ .I. J \ _~l'('(\(').
NEW 'x.. REMODEL ~ ADDITION DE'" dLISH OTHER
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOT'
OWNER:
CITY:
.
BLOCK'
.
q4 H O\,q
JOB NUMBER
225 Fifth Street
~;d;~egOn 97477
. m, = o-blJ
SUBDIVISION: \J.... \.. \\..t\(\\0Y\
R'S NAME 11, -ADDRESS
GENERAL:' :\\ ,{\~Y. .~_O M~~ (\~.
PLUMBING: l A \ \ , '
()\. &. \J\ _ _ (~i: r./
ELECTRICAL: C\. \.. .
CONST,
c,gJ;l-,T~~r;TOR .
, L1JJ!L1)
<ffi!:1-
'l1.(l4/) ~
il:l::1-1 -
r-QElL1t5 lfi1'Jlm
<..l),liLo.{q 4~it,
,~?~ ~~
IT, 13(.t:l:__~h ~
QUAD AREA: ~CS(' ./
· OF BLDGS' - \
OCCY GROUP: ,\-\,~ ~
I
r.-./
· OF STORIES'
WATER HEATER:
- OFFICE USE -
LAND USE: V '. \
. OF UNITS' \
CONSTR. TYPE: V j\J
~E..
HEAT SOURCE:
p.J
RANGF'
FLOOD PLAIN: _
ZONING CODE:ll~
. OF BDRMS: ' ~ ..
SECONDARY HEAT: f'fJ
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. I"spectlons requested after 7:00 a.m. will be made the following work day.
, .
REQUIRED INSPECTIONS
~porary Electric
~ ~)!~. Inspection - To be made
after excavation, but prior to
setting forms.
1\
D Underslab Plumbing/Electrlcell
Mechanical - Prior to cover.
I'll Footing - After .trenches are
~ excavated. ~
r\Tl Masonry - Steel locatlon, bond
~ ,beams, grouting.
m Foundation - After forms are
~ erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
m Underlloor Plumbing/Mechanics'
'---t' - Prior to Insulation or decking.
m Post snd Beam - Prior to 1I00r
'i"" Insuletlon or decking.
I\Tl Floor Insulation - Prior to
~ decking.
LSIJ Sanitary Sewer -- Prior to filling
\ trench.
~ Storm Sewer - Prior to filling
I trench.
N Waler Line - Prior to tilling
,trenCh.
r'21 Rough Plumbing - Prior to
, cover.
m Rough Mechanical - Prior to
~ cover.
. iV"l RoughEleclrlcal - Prior to
L.p:-J cover. .
I'll Electrical Service - Must be
~ approved to obtain permanent
electrleal power.
rV1 Fireplace - Prior to facing
l-fJ materials and framing Insp.
$ Fr8~lng - Prior to cover.
I
rYl Wail/Ceiling InsJlatlon - Prior to
~ cover.
III Drywall - Prior to taping.
o Wood Slove - After Ins lallation.
o Insert - After fireplace approvsl
and Instellatlon of unit.
o Curbcut & Approech - After
forms are erected but prIor to
placemont of concrete.
O Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When completed.
rm Street Trees - When;all requIred
Lt.aJ trees are planted." \ _
m Final Plumbing - When all
'-f-' plumbing Work Is complel,e.
f'll Final ElectrIcal - \lVhen all
, electrical work Is complete. C
F;7l Flnel Mechanical - When all
L....t:::J mechanIcal work Is complete.
r1cl Final Building - When all
I 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, sel.up, and plu"lblng
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 faces
Lol Type.
~Interlor
_ Corner
!P.L,
IN
Is
\W
IE
Setbacks .
HSE'GAR'ACc'1
I
I
I
I
Lot sq, Itg.
Lot coverago
TOPOgraPh~Y. /
Total hel gh
, . 4fY
BUILDING PERMIT
ITEM sa, FT.
~
Panhandle
Cul-de-sac
X s/sa. FT. ~ VALUE
~(o,~o ~
\~.)D ..!;QfA
) .
-Lf.6oo?A!r.cl~ ~~..,eA.d f
/&;rl ~~ ~4(I#ITr.
Ne1(7{e--'7) M
Building Permit Fee (3.5f;~) ~,
Slale Surcharge +- !:.~(/ 7.'"-{-- /tJ 7{)
'3e,C,;.~".i- ,- (')~,o~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) 1 :Z3Zt!> ,tJq
~aln
Gacage
Carport
Total Val ue
TOlal Fee
PLUMBING PERMIT
ITEM
Fixtures
. .l.
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Slorm Sewer FT.
Mobile Home
Plumbing Permit
Slale Surcharge * e.~
Tolal Charge (C)
MECHANICAL PERMIT
Furnace
Exhausl Hood
Vent Fan N' 3
FEE
\(;.,o.~
LbO.~
I ~ .'ee..
\.'7~.~
~.CQ.
I..l,@
'\ . CC!L
Wood StovellnsertlFlreplace Unit
Dryer Vent
('r~ ~t ~\~
~,UJ
s..UJ
~.:U;O
\\,:).00
.1.:)..\
'6<1.11
Mechanical Permit
lssuahce
State :Surcharge -+ '3. <=t
Tolal Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale surchargb
Sidewalk rt It
Curbcut 'C....~) ft
('r<<~ /I,/9f -&.O.':{)
l"1.W
Demollllon
State Surcharge
Tolal MIscellaneous Permits (E)
~ ,
TOTAL AMOUNT DUE (excluding elect rice,!) ; ~3'dl 7,",
(A, B, C, D, and E Combined) ~/\ O. ;
. , : ;. ~,;., ,', '" '~,.'
.".' '. .,,'
. .:. '~i.; ~
'. THE PROPOSED WORK IN THE. '
HISTORICAL DISTRICf, 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 granted on the express condition that the said
construction shall, In all respects, conlorm 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 01 ~n profslons of said ordinances.
Plan Check Fee: _ 4.. A n~
Date Paid: \\ ,I) ).9
Receipt NumberU I 1lS..1 to \ _
~~e~ S1\\~ _) -
Plans RevTewed By
1Dl2Bi-
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS (
......
\ \11 ~ 'f\~\_C'i .lb'~\ _~911 ~
\j}::T: 4.~l.o?~:t (~)
{~lruXTl1to,; I o/I~"
\.,~(\ ~
\
~ f\\\S\\\i \ tt\on
By signature, I state and agree, that I have carelully examined
the completed 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 Ordlnanc~s 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 Ihe Building Safely Division,
I further certify Ihat only contraclors 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 Ihe proper time, that each address Is readable
from the street, that the permll card Is localed al the front
of Ihe property, and the approved set of plans will remain
on Ihe slle a~mes during construction.
Slgnatur~/~L L'~~
Datp
.s-4 ~.J
VALIDATION:
RECEIPT NUMaER
DATE PAID
AMOUNT RE
RECEIVED B
173 '12-
,<:////9r
~500?2-
)~~