HomeMy WebLinkAboutPermit Building 1991-7-22
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORI<' 41/4/
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DESCRIBE WORK: CM"S7?9'~C'?
ASSESSORS MAP'
LOT:
OWNER'
P/I V/7~
ADDRESf"
CITY'
~ '
NEW ;/
REMODEL
CONTRACTOR'S NAME
G EN ERA L - t::)V<./ A/,,!S=;;i1O!"
PLUMBING:
MECHANICA"
ELECTRICAl -
QUAD AREA: \ ~ \\.)\.U
# OF BLDGS: 1
OCCY GROUP: ,,) '6 ~ "^
::;E:T::~::'R_ \ ~
BLOCK'
STATE:
~-.
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9/oY.a;;
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ADDITION
DEMOLISH
OTHER
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
'S'/"- .-
CJ </C6
TAX LOT'
SUBDIVISION'
PHON'"
'?2.€-~Y
ADDRESS
CONST,
CONTRACTOR #
ZIP: 9:?Y'/?
EXPIRES
PHONE
- OFFICE USE -
,,\\
# OF UNITS: \
CONSTR. TYPE: ~A1
HEAT SOURCE:);( ~ 27~.
f"~
LAND USE:
RANG'"
FLOOD PLAIN'
ZONING CODE: U ~
# OF BDRMS: _,.....')
--
SECONDARY HEAT'
SQUARE FOOTAGE: lli~
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspectrons requested before 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.
~
k8.J Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
"-A' Footing - After trenches are
L.A.l excavated.
D Masonry - Steel location, bond
beams, grouting.
I\:"A' Foundation - After forms are
~ erected but prior to concrete
placement.
~ Underground Plumbing - Prior
~ to filling trench.
~ Underflo~lum~ . "
'AI - Prior to .~....l . n Or ue(';Klng.
C"7I Post and Beam - Prior to floor
~ Insulation or decking.
~ Floor Insulation - Prior to
~ecklng,
~ Sanitary Sewer - Prior to filling
).6J. trench.
"'tV1' Storm Sewer - Prior to filling
~trench.
~ Water Line - Prior to filling
~ trench.
c7f Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~cover.
~ Rough Electrical - Prior to
~cover.
f':7I' Electrical Service - Must be
~approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
,g Framing - Prior to cover.
~ Wall/Ceiling Insulation - Prior to
~ cover.
~Drywall - Prior to taping.
D Wood Stove - After installation.
D Insert - After fireplace approval
and Installation of unit.
N'I' Curbcut & Approach - After
~forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
D Fence - When completed.
@)reet Trees - When al/'requlred
ees are planted.
~Final Plumbing - When all
plumbing work Is complete.
~ Final Electrical - When all
~ electrical work is complete.
~Final Mechanical - When all
~ mechanical work Is complete.
K7I" Final Building - When all
~ 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, set-up. and plumbing
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 ~ Lot Type . Setbacks . THE PROPOSED WORK IN THE
~tp ~terior I P,L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
Lot sq, ftg, IN 28' I THE HISTORICAL REGISTER?
2.2.?"
Lot coverage Corner Is I If yes, this application must be signed
~1J V' and approved by the Historical
Topography Panhandle Iw II) , I Coordinator prior to permit issuance.
Total height i2K' Cul-de-sac
IE I:3S~ I APPROVED:
BUILDING PERMIT
ITEM SQ, FT,
X $ISQ, FT, = VALUE
'3'9.,7.:;> .t/:z.g7b
Main
/~.8"
Garage
Carport
--=?? Y
22</
7262.o/'P
? '2"':l- y~
AV~A?
-~)"/~
/t?/i7
,KJ -/ it>
'I:::> l/.a>..~'
r '
?7~DO
L3!O
?$7.10
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) 2l! 01
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residentiai Bath(s)
N"
J
9/. 20
Sanitary Sewer
FT,
FT,
Water
Storm Sewer
FT,
Mobile Home
Plumbing Permit
4'. S'~
qi:;.7~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
.
-4....0
3#-0
Exhaust Hood
Vent Fan
N"
I
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
gOO
Mechanical Permit
1I11,v.
Jfi~
J o."p
J z,5
:z.(f._~S
Issuance
State Surcharge
Total Permit.
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ~ ft
Curbcut
Ie;
-LJ.,!-5
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
)$. 'Z. $"
//3? :i'1
TOTAL AMOUNT DUE (excluding electrical>
(A, B. C, 0, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulati ng the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plan Check Fee: _/ 79.//
';;..yy-~ /
Date Paid:
Receipl Number' 7....~::>
~ -,:1, t3.L
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
<=;.,~?"': ~ ~r7
- - ,
---.$( r.t'x J?" A. _I ~....,
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certlfy that all
Information hereon is true and correct, and I further certify
that any and al/ 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 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
from the street, that the permit card Is located at the front
of the property, and the approved ss~:~;t~S will remain
on the site at ~u, co'LL ";J ~
)(>Ignaturo ~ /-
Date J/~ L /'7/
VALIDATION:
2t9-?5"+
7-2-2 -)'1
AMOUNT RECEIVEr> / ~ ~ 5 <;'tJ
~~_....-_.. .
RECEIPT NUMBER
DATE PAID
RECEIVED BY