HomeMy WebLinkAboutPermit Building 1996-5-28
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.'~
SPRINGFIELD
,
JOB NUMBER 9o//~'9-
.
225 Fifth Slreet
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK' /~~ U/=~/ ~l: o/./?>.P/C -?:Y
ASSESSORS MAP' /'7"V'::??j~,?-;>'-=?/ TAX LOT' .o.I'Y.t'~
LOT'
BLOCK'
SUBDIVISION:
OWNER' / A.dcE' / 72. j~ y PHONF' ~'7"t./ -~.:?<::' 0/
ADORE""" ~ 5- C- -5?'?1~.T ~/
CITY' d;~0' STATE: ~~ - ZIP' q?</:::>?
DESCRIBEWORi<' ~:'">~L ~~~ ~'p,~A~~ k-~S-
NEW REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME
GENERAL: )?~~j,/
PLUMBING'
MECHANICAl'
ELECTRICA' .
ADDRESS ~
~4-~
"
CONST.
CONTRACTOR' EXPIRES PHONE
~~;;:::". //-z ~ 7'Y'Y '''72.c> Y
,
- ,
- OFFICE USE -
QUAD AREA- LAND USE: FLOOD PLAIN:
. OF BLDGS: "# OF1)NITS' ZONING CODE:_
OCCY GROUP' CONSTR, TYPE: # OF BDRMS'
# OF STORIES: HEAT.SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' 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.
o Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting,
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
O Underlloor PlumblnglMechanlcal
_ Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulatlon.or decking.
o Floor Insulation - Prior to
deckl ng, '
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - PrIor to filling
trench.
O Watar Line - Prior to filling
trench. .
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mochanlcal - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
CE Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approvllI
and Installation of unit.
o Curbcut & Approach - 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 - ,",Vhen completed.
o Street Troes - When all required
trees Bre planted.
o Final Plumbing - When all
plumbing w9r!< Is complet,e.
D Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Sat.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
Inspecllons 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.
Lot faces
Lot sq, ftg.
lot coverage
Topography
LotTI
_ Interior
Corner
Total height Cul.de.sac
Panhandle
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT.
Main
Garage
Carport
Total Value
Building Parmi t Fee
Slate Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
~
(A)
(B)
N'
FT.
FT,
FT.
(C)
Wood Stove/lnsert/Flreplace Unit
N'
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
Mobile Home
MISCELLANEOUS PERMITS
State Issuance
State Surcharge
Sidewalk
ft
It
Curbcut
Demolition
State Surcharg~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
I P.L.
IN
W
IE
VALUE
"
FEE
0"'1.'..,.':;:.,.
;,1.'
_..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 Issuance.
Setbacks
HSE GAR'ACCI
I
S
L
.
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
By signature, I state and agree, that f have carefuliy 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 tho 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
(rom th reet,.that the permit card Is located at the front
of the ropertY~I~~Zheapproved set 0 pi ns will remain
on th site at ~"es during onst . n,
Signature ~ 'ftJ??--
Date~/}Arl ~~
L /
l
VALIDATION:
RECEIPT NUMBER
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DATE PAIP
AMOUNT RECEIVED
RECEIVED BY