HomeMy WebLinkAboutPermit Building 1995-2-27
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JOB NUMBER 9.6 ()2-!'/
225 Fifth Street
Springfield, Oregon 97477
SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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TAX LOT: O. </ <"1hO
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LOCATION OF PROPOSED WORK'
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ASSESSORS MAP'
LOT'
BLOCK'
SUBDIVISION'
OWNER: . C. / / J?'Jr./;'7U~?
ADDRESS: /. ~ ~ '7,- I"J, B l? . /..'y
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31l~--O C 3 Y'"
PHONF'
STATE: () 1/..,.
ZIP' '7'?? 0/
CITY'
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ADDITION DEMOLISH OTHER
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DESCRIBE WORK: h/ifJ3
NEW REMODEL
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CONST.
ADDRESS CONTRACTOR'
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CONTRACTOR'S NAME
GENERAL: __/::::. { /....".s
PLUMBtNG' ;::: A IT'..._"
A.,,~
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: RANGF' SQUARE FOOTAGE:
To requesl an Inspecllon, you must eall 726,3769. ThIs Is a 24 hour recording. All Inspections requested belore 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.
REQUIRED INSPECTIONS
"t9(Flnal Plumbing - When all
~Iumblng wc;>rl< Is complete.
D Temporary Electric
D Rough MechanIcal - Prior to
cover.
It7'I Rough ElectrIcal - PrIor to
.J.2:5=..lcover.
D Slle Inspection - To be made
after excavation, but prior to
settIng forms.
~Inal Electrical - When alt
electrical work is complete.
o Understab Plumblng/Electrlcal/
Mechanical - Prior to cover.
D Final Mechanical - When all
mechanical work Is complete.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Footing - Alter trenches are
excavated.
'M Final Building - When all
~qulred Inspections have been
approved and building Is
completed.
D Fireplace - Prior to facing
materials and framing Insp.
~ramlng - Prior to cover.
o Maaonry - Steel location, bond
beams, grouting.
DOlher
D Foundation - After forms are
erected but prior to concrete
placement.
I'V"i Wail/Ceiling Insulation - Prior to
~cover.
D Underground Plumbing - Prior
to filling Irench.
m- Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Wood Stovo - After Installation.
D Blocktng and Set.Up - When all
blockIng Is complete.
o Post and Beam - Prior to floor
Insulation or decking.
D Insert - After fireplace approval
and Installation of unit.
O Floor Insulation - PrIor to
deckl ng.
D Plumbing Connecllons - When
home has been connected to
waler and sewer.
D Curbcul & Approach - After
forms are erected but prior to
placemont of concrete.
o Sanitary Sewer - Prior to filling
treneh.
D Electrical Connection - When
bloeklng, sel.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D SIdewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
D Storm Sewer - Prior to filling
trench.
D Fence - When completed.
D Water Line - Prior to IIIUng
trench.
D Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
D Rough Plumbing - Prior to
cover. .
D Street Trees - When all required
trees are planted.
I PL. HSE GAR ACC
IN
Is
Iw I I I I
~
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Lot faces
Lot TY~
Interior
LOI sq. fIg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul,de,sac
BUILDING PERMIT
ITEM SO. FT
X $/SO. FT. ,.
VALUE
Maln
Garage
"
Carport
bde JA#;(z::iZ ,::Ii?~,//7/
a..f--r4r ~A7A'
TIO!)D()
2~ZTr7 ~T:I .
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~~1J12
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SYSTEMS DEVELOPMENT CHARGE (SDC)
Total Value
Building Permit Foe
State Sureharge 4,071--2.'-').,
Total Fce
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
~
Sanitary Sewer
FT.
/
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Totar Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
Wood StovellnsertlFlreplace Unit /
Dryer Vent /
/
MechanIcal Permit
Issuance
State Surcharge
Total Perml t
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
Slate Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, 0, and' E' Combined)
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Setbacks
-t IS THE PROPOSED WORK IN THE _
'...HISTORICAL DISTRICT, OR ON
THE HISTORtCAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED:
This petmllls granted on the express condition Ihal the said
construction shall, In all respects, conform to the Ordinance
adopted by the City.of Springfield, Including the
Development Code, regulating the eonstruetlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Cheek Fee:
Date Paid:
Receipt Number-
Received By:
Plans Rcvlewed By
Date
Systems Development Charge Is due on all undeveloped
properties within thc City limits which are being Improved.
ADDITIONAL COMMENTS
5~M~ ~T ~~mr.r /(
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By signature, I statc and agree, that I have carcfully examined
the completed appllcallon 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 thc work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of Ihe Building Safety Division.
I further certify that only eontractors and employees who
are In compliance with ORS 701,055 will be used on this
proJect.
I further agree to ensure that all re~ulred Inspections are
requested at the proper time, that each address Is readable
from the street, that the pcrmlt card Is loeated at the front
of the property. and the approved set of plans will remain
on the site at all times during construction.
Xlg~:~ ~~__
Date~A" /9r--
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VALIDATION:
RECEIPT NUMBER !r.A-3 7
DATE PAID 2.. /2~ r
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AMOUNT RECEIVED _ _ =??
RECEIVED BY . ~