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Home My WebLink AboutPermit Building 1991-8-22 ..V~;B) ~ESIDENT(AL PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 ... LOCATION OF PROPOSED WORt<. . .6 ~ 2-- LOT' /7-c>~ -~ - <,1.2 _ BLOCK' OWNER' ,PL-/~ & '/Z?aV79"'#~ ADDRESS: <$"" 6..2 ~,# CF ~~- .<:;;;>..z:-'L7-> _ / DESCRIBE WORK: "R~7l._.-7 /'!;: -?'iI ';!/'-:"':';;" ,,^- __ r-- ';" NEW . FjEMODEL V ADOITION .x DEMOLISH ;' ASSESSORS MAP: CITY' CONTRACTOR'S NAME ~_.A1'~ GENERAl' PLUMBING: ~ ! MECHANICAl' ELECTRICA" ~~ STATE: ~- . JOB NUMBER q/o9~ 225 Filth Street Springfield, Oregon 97477 TAX LOT- SUBDIVISION' ~/<,/ vv- bl:SEoo- 7739 PHONE: 7""":/-7~?/ ZIP' c::??.v:>? _~Z;>.J;>/~._~~ OTHER /D 57='(?';";.-~ AqDRESS CON ST. CONTRACTOR # PHONE EXPIRES QUA~ AREA: ,!)~ ~f)\t)_ - OFFICE \E - LAND USE: \ \. \ FLOOD PLAIN: l rJ(() # OF BLDGS: ~~ # OF UNITS' ~I\J ZONING CODE: OCCY GROUP: CONSTR. TYPE: # OF BDRMS: # OF STORIES: \ HEAT SOURCE: SECONDARY HEAT: . -- WATER HEATER: RANGE: SQUARE FOOTAGE: 1 /-jC ) ~ 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 o Site Inspection - To be made after excavation, but prior to setttng forms. D Underslab PlumblnglEfectrlcal/ Mechanical - Prior to cover. W Footing - After lrenches are excavated. D Masonry - Steel location, bond beams, grouting. [l] Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. o Underfloor Plumbing/Mechanical - Prior to insulation or decking. [Z] Post and Beam - Prior to floor Insulation or decking. ILl Floor Insulation - Prior to decking. o Sanitary Sewer - Prior to filling trench. D Storm Sewer - Prior to ftlllng trench. D Water Line - Prior to filling trench. [K) Rough Plumbing - Prior 10 cover. REQUIRED INSPECTIONS lZl Rough Mechanical - Prior to cove~ . rn Rough Electrical - Prior to cover. D Electrical Service - MuSl be approved to obtain permanent electrIcal power. D Fireplace - Prior to facing materials and framing Insp. [Z] Framing - Prior to cover. !ZJ Wail/Ceiling Insulation - Prior to cover. [l] Drywall - Prior to taping. D Wood Stove - After Installation. D Insert - After fireplace approval and Installatlon of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. o Fence - When completed. D Street Trees - When all requirea trees are planted. . IZl Final Plumbing - When all plumbing work is complete. [2] Final Electrical - When all electrical work is complete. [2] Final Mechanical - When all mechanical work Is complete. I2J Final BUilding - When all required Inspections have been approved and building is completed. DOther 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 Inspectlons are approved and porches, skirting, decks, and venting have been installed. . ~ Lot faces Lot Type . Setbacks . THE PROPOSED WORK IN THE Lot sq. Itg. Interior [ P.L. HSE GAR ACC I ISTORICAL DISTRICT, OR ON I THE HISTORICAL REGISTER? Lot coverage Corner N If yes, this appllcallon must be signed S I and approved by lhe Historical Topography Panhandle Iw I Coordinator prior to permit issuance. Tolai height Cul.de-sac IE I APPROVED: BUILDING PERMIT ITEM SO. FT. X $/SO. FT. VALUE Main Garage Carport /2.&>-I X ~.A<:> ~';/ /1pP Total Value Building Permit Fee ....,-,,:'. "".<? Z.?3 ~'3 03 State Surcharge Tolal Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM FEE -::3..::>.DD Fixtures -:=3 Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permil ~.a ,p~ /. ->.<? 9J. .;;-C"/ State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' / Wood Stove/Insert! Fireplace Unit Dryer Vent Mechanical Permit /4/#' /5".. _0 /~.~ / .:2S -;;U:;.25"" Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) LID.7t:?> (A, B, C, D, and E Combined) 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 adopled 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: -'i":'-.~~ :;<-/-;;>- '9/ - -. .---- Date Paid: Receipt Numbei%;' "La, 9:2... Received By: /2 --~ - /'/--.:>_&.. _ V,....~ - .l"}Jn~ ReviewatJ By p7 . ,$5-/9-9/ Date Systems Development Charge is due on all undeveloped properties within the City limits which ~re being improved. ADDITIONAL COMMENTS By signature, I state and agree, that I have carefuJly 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 project. 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. Slgnatur~ - _ r'\~'l' . ~ " Date ~-::l::l-ql .' VALIDATION: j;) vv'/I ::;:I::I~UMB~ t6~2~qq ~ AMOUNT RECEIVED v-J..( f \ (4J1., {fA ~ RECEIVED BY II \ JJ~ ..... . ~ . . Permit No: q \CC j-Q, Address: ,~\P~ ~ u\()M~ Issued by: 'f1:1[)a ) Date: ~,22.C(\ STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. \ Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: 1. ~I own, reside in, or will reside in the completed structure. 2. A. 'L-J ;Jy general contractor is I Contractor registration number ~ I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. U I will be my own general contractor. / If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and Clo hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. Q_ (\\\ I. d \""" _ Signature oft'er~it A~p-plicanr- '><;. ::l ::l-q( Oate- - CONSTRUCTION CONTRACTORS BOARD 0244J 10/24189 \)u1k-/coPY TO ISSUING AGENCY PERMIT FILE \ r;i(tOPy TO APPLICANT W~ ~,