HomeMy WebLinkAboutPermit Building 1995-4-7
RESIDENTIAL
PERMIT APPLICATION
.
Inspecllons: 726.3769
Ollice: 726.3759
LOCATION OF PROPOSED.WORK: \ ~\J)
ASSESSORS MAP' I '7{),~;J d l~
OWNER' ~\)r\~ ~~ ~ PHONF'
ADDRE~~ '2,~4\O \ ~ ~J\f'1 ~ ~ t. _
CITY: '- ,Jt::l ",,\fo On . STATE: t U~lIY\
DESCRIBEWORK:\ A OV'i\I'f'lO l er1...ill1 {.1\11ri..~
~/ I
NEW REMODEL ADDITION DEMOLISH OTHER
/
LOT:
CONTRACT~'~ NAMA \ ~~,
GENERAl' un )\0.. ..yj\\i(\SlJY\
PLUMBINI"
MECHANICAl'
ELECTRICAl'
QUAD AREA: JJe.-Nl0
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER'
BLOCK'
.
qc:iJ\~'
JOB NUMBER
SUBDIVISION:
~ \'Llo -'\<\lo It-1
ZIP:
L1'L411.
ADDRESS
\\)~1\ln \jtlfl~
CON ST.
CC\~~
ry7ro~q~ '~5~~
- OFFICE USE -
(\(\
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
FLOOD PLAIN'
ZONINGCODE:~
. OF BDRMS'
SECONDARY HEAT: __.
SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspecllons 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 Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D 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 Plumbing/Mechanical
- Prior to Insulation or decking.
~ Post and Beam - Prior to floor
I2j~SUlatlon or decking.
Floor Insulation .. Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D 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.
c::k}Framlng - Prior to cover.
WWall/ce~~ ~;C:,.:{) ;:Ior to
cover. . ct~
[]j'oryWall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvel
and Installation of unit.
D Curbcut & Approach - After
forms Bre erected but prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation Is compietc, forms
and sub.base material In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbIng work Is complete.
D Final Electrical - WIlen all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
~al Building - When all
required Inspections have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking is complete.
D
PJumbing 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
Ins"pectlons are approved and
porches, skirtIng, decks, and
ventlng have been Installed.
.... ,..l:'\:~.\,{\; ;. t IS THE PROPOSED WORK IN THE.
Lot TY.
Lot faces Setbacks.
Lot sq. fig. Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total height Cui-dc-sac IE I
APPROVED'
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City. 01 Springfield, Including the
Development Code, regufatlng the construction and use 01
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Carport
Plan Check Fee'
Date Paid:
Tolal Value
-
I~.Q)
/.W
10. 2f)
Receipt Number'
Building Permit Fee
Slate Surcharge ~~ ~o/O
Total Fec (A)
Received By:
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmcnt Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
Stato Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, 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 01 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.
Exhaust Hood
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permil
(D)
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
Irom the street, that the permit card Is located at the front
of the prop ty, and the approved sel of plans will remain
on the site I all limes during construction.
Slg ature r-;-)~-'1 - .(t:l ~ .-. L_
"l
Date 1./ - ? - 9,,\
MISCELL.~NEOUS PERMITS
Mobile ,Home
State Issuance
State Surcharge
Sidewalk
ft
fl
Curbcut
Demolition
State Surcharge
VALIDATION: 011..-
RECEIPT NUMB}R IlOm
DATE PAID q- , } .4.:::J'
AMOUNT ,REC~V~ ~j(/J' f.LJ
RECEIVED BY~
Total Miscellaneous Permits (E)
/10"2/ )
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Cor;nblned)