HomeMy WebLinkAboutPermit Building 1998-1-20
.. .
SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK' 4&0 tV O,-:,!mf'c-
ASSESSORS MAP: --.L.1 O..:s "2-( 4 J
LOT' BLOCt<.
.
'14t1~ 807
JOB NUMBER
0;71761
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT:
OWNER: CLA VI 'tlE.... -sh... R 85
ADDRESS: ---I~4 uJ (!)Ll.lthfJ,(,
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CITY:~QJM)3.c) ~L'b '
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SUBDIVISION:
PHONF-
'344 - .2.810 7
ZIP'
~7~77
DESCRfBE WORK'
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'R<Jo-F','.v':>.: .:rN$I./.L~;-ON
J08
NEW
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REMODEL
CONTRACTOR'S NAME
GENERAl' STI WlCl/'-k'
PLUMBING'
ADDITION
DEMOLISH
OTHER
"::-,11-1<-
ADDRESS
5p{? .c,W.~Ll\;!\J
I
CONST.
CONTRACTOR'
6:t-_ 124\57
EXPIRES <':\ PHONE
72ft?-9<?o S
MECHANICAl'
ELECTRICAl -
~%/"~~, .
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS: . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
D Temporary Electric
D SUe Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Fooling - After trenches are
excavated.
D Masonry - Steel location. bond
beams, grouting.
D Foundation - After forms are
erected but prior to concret~
placement.
D Underground Plumbing - Prior
to filling trench.
D Underfloor Plumbing/Mechanical
..:- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking,
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~ cover.
'f:;z1 Rough Electrical - Prior to
~ver.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
K:;i(Wall/Celllng Insulation - Prior to
~ cover.
~ Drywall - Prior to taping,
D Wood Stovo - After Installation.
D Insert - After fireplace approvl$l
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prIor to
placemont of concrete.
D Sidewalk & Driveway - After
excavation Is complete. forms
and sub-base material In place.
D Fence - \i\lhen completed.
D Street Treos - When all required
trees are planted.
D Final Plumbing - When all
plumbing W9rk is complel.e,
J::;:zf Final Electrical - When all
~Iectrlcal work Is complete.
'F>2I' Flnel Mechanical - When all
~echanlcal work Is complete.
~ Final Building - When all
~requlred Inspections have been
approved and building I.
completed.
D Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
VALIDATION:
RECEIPT NUMBER
. . DATE PAID
',.
Lot faces
,
L~l TY.
Interior
I PL.
IN
Is
'. ... ~
Lot sQ. Itg.
Lot coverage
Corner
Panhandle>
Topography
Total height
Cul-de-sac
W
,E
BUILDING PERMIT 'I, '& 't
ITEM SQ, FT, X $/SQ, FT, = VALUE
Main
Garage
"
Carport
~,A!iY~,
j.5.~
Total Value
II~ ,S-~
9,)/
l2S: ~ I
SYSTEMS DEVELOPMENT CHARGE (SDC)
Building Permit Fee
State Surcharge $';S a. 7- J:I")
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
~/A1.
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
J'&:j t><)
It) .'"
/,2...0
?? 2/0
Issuance
State Surcharge
Total Permit
, 7 f' of' , "fI
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
"
State Surcharge
Tolal Miscellaneous Permits (E)
'."
, ,
:., ~:: :;k~"i/~'~;
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'IS THE PROPOSED WORK IN TH~ ,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
" yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks.
HSE GAR ACC"
I
I
I
1----
APPROVED'
'. t... . ,/
BUILDING VALtlE, 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.
N/A.
1/2~/9 B
Receipt Number: Z~ l5' ~
/~
'C
Plan Check Fee:
Date Paid:
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
By slgnatl!re, I state 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 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 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
prolect.
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 set of plans will remain
on the site at all times during construction.
/Slgnature 14~{A~ <P L ~ ~
//.2.0 Af2r,
/ /
Date
?-0S//
/I?/)h~
/11!:j'?" .o~
p~
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
J 52.. ~cJ AMOUNT RECEIVED
RECEIVED BY
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