HomeMy WebLinkAboutPermit Building 1994-9-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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SPRINGFIELD
....-.... .
9#;?f;(;,
JOB NUMBER
-
..PCJ 1,< )l ~t
225 FI fth Street
Springfield, Oregon 97477
66 rl'Y;r3-0eIJ
V I rJ~
, TAX LOT: l nl ~ '"
SUBDIVISION:
LOCATION OF PROPOrED WA~: ,,") .;z J q
>ASSESSORS MAP: '7 ~~~~.
$J-trl Y /) &; 17_
. /
'ADDITION
LOT:
OWNER: YrlLYl k. cI-:;;;;;'; 'r I e'l
ADDRESS~ 5.d2.J 9 JJa/...< y
CITY: ~ 1"".1 YJ Cj 51 e. I cL
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL: (Jp. LJO !
PLUMBING'
MECHANICAl'
ELECTRICAL:
(lll '\I"fC'. "
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
~~./
\
,U
\
# OF STORIES:
WATER HEATER:
BLOCK:
tcLi vl1S u) Or ~
s:r.
PHONE:
STATE:
/'JjJ"
ZIP: CJ?tf?!- ~'it,tL
SA eri .
l
DEMOLISH
OTHER
ADDRESS'
CONST.
CONTRACTOR #
\D\~
~~~
EXPIRES
PHONE r)
tGA.m.~
- OFFICE USE -
\\\ \
LAND USE:
FLOOD PLAIN:
ZONING CODE:-1J)~
# OF BDRMS:
~
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
vv
SECONDARY HEAT:
SQUARE FOOTAGE: ~t{J
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.
REQlJlRED 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.
~Footlng - After 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 Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post 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: \ '.' .
D Rough Plumbing - Prior to
cover.
o Rough Mechanical ~ Prior to
cover.
o Final Plumbing - When all
plumbing work Is complete.
. ,
D Rough Electrical - Prior to
cove~ '
D Final Electrical - I.^./.hen all
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.
1Vf Final Building - When all
~equlred Inspections have been
approved and building Is
completed.
~ Framlng- Prior. to 'cover.
D Other
o Wall/C'elllng Insulatlo,n - Prior to
cover.
D Drywall ..,.. Prior to taping.
MOBILE HOME INSPECTIONS
, ,
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Blocking and Set.Up - Whep 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 plu~blng
Inspections have been approved
and the home Is connected to
the service panel.
o Fence, - When completed.
o Street Trees - When all required
trees are planted.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
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Setbacks '
I ~P.L. HSE GAR ACC'
IN
Is
Iw
IE
~/
Lot faces
Lot ~ype.
Interior
Lot sq. ftg.
Lot coverage
Corner
Topography
Total height
.
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ. FT. X $/SO. FT. = VALUE
t'0al n
Gacage
"
Carport
5~ ~><Ifo
~l/7Jo <)7JteHcr. 2.'2.0
/4-/10
, ( '
/0 /0
J. ? ') .cj.
-2-2...2..2-
.7S'? ("
-44.9()
. '2. 3.'
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/.'J.
I -4b-. f)7
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) 1 ~I " ,
Total Value
Building Permit Fee
State Surcharge
;
Total Fee
(A) .
PLUMBING PERMIT
ITEM
FEE
Fixtures
,
. .
Residential B~th(s)
Sanitary Sewer
NO
FT.
Water
FT.
FT.
/
/
\
Storm Sewer
.
Mobile Home
Plumbing Permit
State Surcharge
..
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
/
/
Mechanical Permit
Issuahce
State :Surcharge '
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
/
/
/
Curbcut
ft
ft
Demoll tlon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) -'ft. /4-
(A, B, C, D, and E Combined)
. THEPROPOSED WORK tN THE _
'HIST081CAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
'~
'. APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, In ail respects, conform to the Ordinance
adopted 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.
t2-,~ ,!3
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/1'7<:;1
Received By: ~~
#"/~
Plans -Reviewed By
Plan Check Fee:
Date Paid:
Receipt Number'
~(~~
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~/~/~ 1tCJ:J:~~ IAJdL
~ A ~~ ~~'.r:
.
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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.
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 slte%/ all time~dU onstructlo
V r,::t../
r Slgnature~ ~ r:> ,
Date
VALIDATION:
RECEIPT NUMBER /f Cj~2..
DATE PAID )t>/#')'~
AMOUNT RECEIVED t:, 9J~
d,
RECEIVED BY ~,.~
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