HomeMy WebLinkAboutPermit Building 1994-4-25 (2)
OWNER: .fJI1-LI'; ~(/II/v-
ADDRESS:' . 9;2 ~ /Y :J ~ PC
CITY: __)//rJ'0be/!
DESCRIBE WORK:.~c/.LL,iH ~~lct-. ~S'a/t:L {.I'~';-
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NEW REMODEL ADDITION ""'-----DEMOLlSH
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP:
LOT: .
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL:
ELECTRICAL:
, "".
Q~Ao"AREA: 2J~~~
II OF BLDGS:
\\\?J
OCCY GROUP:
II OF STORIES:
WATER HEATER:
SPRINGFIELD
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: ~~\ fj)n
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BLOCK:
SUBDIVISION:
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. PHONE: 7((')-63 SI
Y6'/-()/9/
STATE: --.0,..
ZIP: Qr;YP7
ADDRESS
M'Z 'loW' , ~/, ~"\ A,$-4 'loS'
OTHER f&-l~~~j tllj.(l'~11
'CONST.
CONTRACTOR II
PHONE
10 Coa;o.
,
EXPIRES
,. .
, .
';;'" OFFICE USE -
LAND i.i~E: _, (l )
FLOOD PLAIN:
ZONING CODE: WJ2..-I
# OF BDRMS'
# OF UNITS'
CONSTR. TYPE:
HEAT SOURCF'
vrJ
SECONDARY HEAT:
SQUARE FOOTAG E:
RANGI:'
To requl:;!st 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. .
REQUIRED INSPECTIONS
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
J5<j Footing - After trenches are
j -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 Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
~lpost and Beam - Prior to floor
~nsulatlon or decking.
1'iv'1, Floor Insulation - Prior to
pJ 'decking.
o Sanitary Sewer - Prior to filling
trench. .
o Storm Sewer - Prior to filling
trench.. .
o Water Line - Prior to filling
trench. ~
o Rough Plumbing - Prior to
cover. .
o Rough Mechanical - Prior to
cover. .
o Final Plumbing - When all
plumbing work Is complet.e.
FXI Rough Electrical - Prior to
~over.
~
T)<.J Final Electrical -. .When all
jy"-" electrical work Is complete.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Final Mechanical - When all
mechanical work Is complete.
o Fireplace - Prior to facing
materials and framing Insp.
~inal Building - When all
equlred Inspections have been
a roved and building Is
completed.
~Framing. - Prior to cover.
D~ther
~ Wall/C.e/ling Insulation - Prior to
. cover.. .
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Wood Stove - After I~stallation.
o Insert - After fireplace approval
and Installation of unit.
o Blocking and Set.Up - When all
blocking Is complete.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Plumbing Connections - When
home has been connected to
water and sewer. .
o Sidewalk & Driveway - After
. excavation Is complete, forms
and sub.base material In place.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home Is connected to
the service panel.
o Fence ~ When completed. .
o Final - After all required .
Inspections are .approved and
. porches, sklrtln'g, decks, and
venting have been Installed:
D Street Trees - When .all required
trees are planted. ..
~ --..-
;.
Topography
Total height.
Panhandl.e
Setbacks
I P.L. HSE GAR ACC
IN
Is
· ~ THE PROPOSED WORK IN T~;- ",
.,uHISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Lot faces
Lot Type.
Lot sq. ftg.
. Interior
Lot coverage
Corner
,
Cul~de-sac
W
E
"". ' '~
,
. .
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APPROVED:
"
BUILDING PERMIT
. ITEM ,sa. FT.
'.}d~.
X $/sa. FT. = VALUE
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BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
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This permit is granted or. the express condition that the said
.... . .' ".
construction shall; In all respects, conform to the Ordinance
adopted by. tt)e City. o( Springfield, Including the
Development Code, regulating the construc~lon and use of
buildings, and may be suspended,'or."revqked at any time
upon violation of any provisions of said ordinances.
,
Plan Check..Fee:. N/A.
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Garage
Carport
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\ . , ", .... Date Paid:
~ t, .' .\ , ' _...l
Total Value ,
,. //4,5 a Receipt Number'
Building Permit Fee
I , 73 Received /By:
State Surcharge 3. ;ii/A
Total Fee (A) '7,ss .23
Plans Reviewed By Date
.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) N/A
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
, ITEM
.
i
I Fixtures
!.
i NO
! Residential Bath(s)
I
! Sanitary Sewer FT.
I
i
Water FT.
Storm Sewer FT.
Mobile Home
FEE
ADDITIONAL COMMENTS
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Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
I
.
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,
.;
!
I
,
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
/
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 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.
Exhaust Hood
.I
Vent Fan
NO
Mechanical Permit
'!
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all required inspections are
requested at the proper time, that each address Is readable
from the street at the permit card Is located at the front
of the prop ty, an1d uhe proved set of plans will remain
on the site at all time d ring construction.
X-gnatu~e (\/~ '-I- ~~ -..'
. Date 0 ~?~ --/w ./
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MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
I'
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
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,
Total Miscellaneous Permits (E)
VALIDATION:
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RECEIPT NUMBER
/2 -(.~2-
4/2 r/;5'~
( ( ,
/2 ~.2-3
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DATE PAID
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
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AMOUNT RECEIVED
RECEIVED BY