HomeMy WebLinkAboutPermit Building 1998-4-17
OWNER: 1/.pJ; [) I~G;e..K
ADDRESS:':J g>(q '/ rJrYifi heV",] Ie (~o J
CITY: '- <)jQt" ,,"C. I,. / ,f f:-I J~TATE:--D;f.J
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NEW RE 0 EL ADDITION' Di!M ISH O~ER :,.<~.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
ASSESSORS MAP'
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CONTRACTOR'S NAME
GENERAl ~-1~~~ ~')_
PLUMBING: :!?k~_-
MECHANICA' .
ELECTRICA' .
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BLOCK:
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT'
SUBDIVISION'
PHONE:
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ZIP:
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ADDRESS
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CON ST.
CONTRACTOR #
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EXPIRES ,~ PHONE
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- 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.
o Temporary Electric
O Slto Inspection - To be made
after excavatIon, but prior to
setting forms.
o Underslab Plumblng/Electrioal1
Mechanical - Prior to cover.
o Footing - Alter 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 Plumbing/Mechanical
- Prior to Insulation or decking.
o Posl and Beam - Prior to floor
Insulation ,or decking.
o Floor Insulation - Prior to
decKing.
O Sanitary Sewer - Prior to filling
trench,
o Storm'Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench.
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Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
"0 Rough Mechanical - Prior to
cover. .
D Ro.ugh Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtaIn permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
fX] Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
[k:l Drywall - Prior to taping.
o Wood Stovo - Aft.er Installation.
o 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 complete, forms
and sub.base material In place.
o Fence - VVhen completed.
D Street Trees - When all required
trees are planted. .
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Final Plumbing - When all
plumbing w9rl< Is camplet.e.
D Final Electrical - When all
electrical work Is complete.
o
Final Mechanical - When all
mechanical work 15 complete.
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Final BUilding - When all
required Inspections have been
approved and building Is
completed.
OOlher
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When al,l .
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel-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 ~yp"
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~IS THE PROPOSED WORK iN THE _
'..'HtSTOI'1ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Ihls application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
Lot sQ. ftg.
Interior
. I PL. HSE GAR
Setbacks,
Lot coverage
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W-l-___
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Corner
Topography
Total hel ght
.,.
Panhandle
Cul.de-sac
BUILDING PERMIT ,',
i! t
ITEM
sa. FT.
X t/sa. FT. ~
VALUE
Main
Garage
"
'Carport
Total Value
/2~-
<2 --
~-
I'~
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7~, :;6
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
2~4:?
Fixtures
::;2.Y/~
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT,
FT.
Storm Sewer
Mobile Home
Plumbing Permit
~ c::ob
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-=<:/.~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/ Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permll
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
.
Sidewalk
ft
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits
(E)
. TOTAL AMOUNT DUE (excluding electrical) .~
(A, B, C, 0, and E Combined)
ACe' I
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APPROVED:
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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
oulldings, and may be suspended or revoked at any time
upon vIolation of any provIsions of said ordinances.
Plan Check Fee:
Dale 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 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 Ordinanc~s of t~e City of Springfield, and the Laws
of the State of Oregon perlalnlng to the work described
herein. and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
J further certify that only contractors and employees who
are In compliance with OAS 701.055 will be used on this
project.
I further agree to ensure that ail 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 th a f plans will remain
on the site at all tl es ru tlon.
Date
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VALIDATION:
2"'3 L,(..C' ':2
RECEIPT NUMBER
DATE PAIP 0/ ,,// '-:?~
AMOUNT RECEIVED '-/~";;;:1<:::;;
RECEIVED BY (/{,......",~
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