HomeMy WebLinkAboutPermit Fire Damage Report 1995-11-17
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
-e
.
JOB NUMBER
9:5'/:/;::><;;,/
SPRINGFIELD
IIIL. tip
225 Fifth Street
Springfield, Oregon 97477
",po' ..........-2
LOCATION OF'PROPOSED WORK: R// /H/-=7/ ,A'./L':;'-~.z>./C
ASSESSORS MAP' /?''It!!>7 '2?-ij'"2. TAX LOT: ~/c:::'/3
,O~NER' //'?~ i ;qE~/HA7 ~./72
ADDRESS:~.// /#k~r .-o.c~/0~C
.c:;R>/XV
I'
LOT:
CITY:
- r
BLOCK'
STAT~'
c::77?
SUBDIVISION:
PHONE:
77~-~Y~
ZIP'
.q? 9??
DESCRIBE WORK: /Y.7f?;1;: ~.I:~7~€;qC-~~ ~/~, 6'-,;i!>~.
, ~.-; {~. I , '/', , - ,. ,
NEW REMODEL ADDITION DEMOLISH OTHER
~~~~~
. .
CON ST.
CONTRACTOR'S NAME AD~ CONTRACTOR' EXPIRES -, PHO,NE
/_ ../' .2~7 c.~r'
GENERAL: ~#~_-~/E!7.:::s; ,.~9'?'::>_~2':? ~.t"%'. ~....:;;-;......~
,. - . - - - -/ r r ' , -
PLUMBING:
MECHANICAl'
ELECTRICAL: ;47~~.?>c::;;~
, - - -. -
- 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. Tills Is a 24 hour recording. All Inspections requesled 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.
o Temporary Electric
D Silo Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab PlumblnglElectrical1
Mechanical - Prior to cover.
.'
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumblng/Mechanlcal
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior \0
decking.
o Sanllary Sewer - Prior 10 filling
trench.
D Storm Sewcr - Prl~r to filling
trench.
D Water Line - Prior to tilling
trench.
~OUgh Plumbing - Prlor.to
I'fIJ 'cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover. '
IZl Rough Electrical - Prior to '
cover.
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.
[L] Wallle'clllng Insulation - Prior to
cover.
~ Drywall - PrIor to taping.
D Wood Stovo -.: After Installation.
D Insert - After fireplace approval
and Installation of unIt.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is compieto. forms
and sub.base material In place.
D Fence - When completed.
D Slreel TrODS - When all required
trees are planted.
~Inal Plumbing - When all
fU!.II (Plumbing W9rk Is complet.c.
lZJ Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
:.' mechanical work Is complete.
!;l] Final Building - When all
required Inspections have been
approved and building Is
completed.
OOthor
MOBILE HOME INSPECTIONS
D Blocking imd Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
homo 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.
D F,lnal - After all requIred
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed,
Lot faces
Lot TYP.
Lot sQ. fig.
Interior
lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
Setbacks
P.L. I HSE 'GAR ACC I
I I
I I
Iw I I I
lLLLLJ
.
N
Is
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT. ~ VALUE
/1'--C/
j /&. -!i2:J
5' '5' '=';
?~2
//'t'. '3~
SYSTEMS DEVELOPMENT CHARGE (SDC)
Main
Garage
Carporl
-frf?$" ~~~
Total Value
Building Permil Fee
7"5'
r~
Stale Surcharge
Total Fcc
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Rcsldentlal Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanlcaf Permil
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
"
FEE
Total Miscellaneous Permits (E)
TOTAL 'AMOUNT DUE (excluding elec\[ICal) . //9 '? S-
lA, B, C. 0, and E Combined) ,
,:
.
.'
IS "rHE PROPOSED WORK IN THE.
'''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, lhls application musl be signed
and approved by the Hlstorfcal
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thfs pcrmil is granted on the express condition Ihatlhe said
construcllon 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:
Recel pi Number:
Received By:
Plans Revlcwed 'By'
Date
Systems Development Charge Is due on all undeveloped
properties within tho City limits which arc being Improved.
.'
ADDITIONAL COMMENTS
By signature, I slate and agree, that I have carefully examIned
the completed application and do hereby eartHy 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 Sprlngflcld, and lhe Laws
of Ihe Slate of Oregon perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure wIthout permission of the Building Safely Division.
I further certify thai only contractors and employees who
arc In compliance with ORS 701.055 will be used on this
prolecl.
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 pcr,.,1t card Is located at the front
of the property, and the approved set 01 plans will remain
on the site at all times during construction.
Signature
Date
VALIDATION:
RECEIPT NUMBER /~%
//-/'3l-5JS
1~"?~"=3
DATE PAID
AMOUNT RECEIVED
RECEIVED BY ~.4''' '-.,e
~~