HomeMy WebLinkAboutPermit Building 1995-6-16
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP: /"7 /? ~
LOT:
OWNER:
ADDRESS:
CITY:
;8/. AJC Co
c..~7 '5'
.~rd
1.0.'57?f-L- L
DESCRIBE WORK:
NEW
,/
REMODEL
CONTRACTOR'S NAME
GENERAL: R~'?7"f"
'PLUMBING'
MECHANICAL'
ELECTRICAl .
.
BLOCK'
..L/ ~ / &1Ou.-Ll)
nrt"'5 (7A.T&:: J'(,. '/.1~Attl??
'" 'T: ,M. ~r:/,
STATE: ~
,17!Jh.u ()7f""77~ _7
ADDITION
DEMOLISH
OTHER
-
9so",oCc,
JOB NUMBER
225 Fifth Street
Springfield, Oregon 9747.7
,t/,e- .u
I .J
TAX LOT: / n ~/"rn
SUBDIVISION:
PHONE:
741-~~
.. .
ZIP: 9-74'7:7
ADDRESS
,,~.;>- '-'7' /~
CONST,
CONTRACTOR'
'7'~3.z "7
EXPIRES PHONE
~h~r ?#-7.9~,~
QUAD AREA: / /{JJvtJ
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE:
/1//
FLOOD PLAIN:
ZONING CODE: ~
. 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. Inspectlons .roquested rifter 7:00 a.m. will be made the followIng work day.
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electricall
MechanIcal - Prior to cover.
I'\7f Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting.
r57r Foundation - After forms are
~erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
O Undorlloor Plumbing/Mechanical
- Prior to InsulatIon or decking.
k-;;("Post and Beam - Prior to floor
j2SJ Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
~ Storm Sewer - Prior to filling
;..o..l trench. {Ut.ll)/}(/'~
O Weier Llno - Prior to filling
trench.
o Rough P"lumblng - Prior to
cover.
· OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o 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 Well/Ceiling Insulation - Prior to
cover.
o Drywell - Prior to taping,
o Wood Stovo - After 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 compiete, forms
and sub.base material In place.
o Fence - When completed.
o Slreel Trees - When all required
trees are planted.
o
Flnel Plumbing - When all
plumbing w9rl< Is complete.
o
Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanIcal worl< Is complete.
~Flnal Building - When all
~ required InspectIons have been
approved and building is
completed.
OOthor
MOBILE HOME INSPECTIONS
o Blocking and Set. Up - Wilen 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
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 TY_ . "'f!oj; \' _ IS THE PROPOSED WORK IN THE.
Lol facos Setbacks
I P.L. HSEIGAR ACC I HISTORICAL DISTRICT, OR ON
Lot sq, ltg, Interior IN I I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total height Cul.de.sac IE I
APPROVED'
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Building Permit Fee
Slate Surcharge 3 f ~ +:2..~
5.1-"l
7').9'1
This permit is granted on the express condition that the said
constructlon shall, in all respects, conform to the Ordinance
adopted by the City 01 Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon viola lion of any p~rOVISI0;;31 said ordinances.
Plan Check Fee: _ .
Date Paid: ___ -=1.\Q.q c:;
\ -1'670
( LA;VHL-
Receipt Number:
Main
Garage
"
Carport
~J
~r') ,dd>
Total Value
t:.,~SO
Total Fcc
(A)
Received By;
Pla~q:~
~ ~d')-
SYSTEMS DEVELOPMENT CHARGE (SDC)
-er
(B)
Systems Developmenl Charge Is due on all undeveloped
properlles within the City limits which are beIng Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Rosldenllal Balh(s) t'J'
Sanitary Sewer FT.
Water
FT,
,
FT. <. 5Q,..
qNdO!I;:U>zx W'r
25.dC
Storm Sewer
Mobllo Home
Plumbing Permit
Z~
State Surcharge
Total Charge
/.2"r.7~
(C)
':2-760
MECHANICAL PERMIT
Furnaco
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 of the City of Springfield, and the Laws
of the Stalo 01 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.
Exhaust Hood
Wood Stovellnsert/Flc.cplace Unit
Dryer Vent
MechanIcal Permit
Issuance
Slate Surcharge
Total Permit
(D)
I (urther agree to ensuro 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 tI[Jfs durl.7g cons>,9~on,
Slgnature~~ Ko-tk.
f- I' a -I -
10- I,Q-t')
Date
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
State Surcharge
pLAAJ tf-a'lCw
44.5~
VALIDATION: 'i? 'S
RECEIPT NUMBER i1 f.
b - UP -c,c:;
AMOUNT RECEIVED IAr::' - ClZ-
(~
DATE PAIr>
Total Miscellaneous Perml ts (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
L,4'.-C; . 5""2..
RECEIVED BY