HomeMy WebLinkAboutPermit Building 1998-1-12
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK: ~~ .'?\ ~} r
ASSESSORS MAP: / 7~ 2.. .7 ~ D.o
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SPRINGFIELD
. JOB NUMBER
9$&J-~J
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W /52.
225 Fifth Street
Springfield, Oregon 97477
. TAX LOT:
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SUBDIVISION:
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~'e,7'J.\ STATE: ~ .
LOT'
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9W!'JER:
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ADDRESS:
CITY:
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PHONE:
q35'-~76Z-
ZIP:
9. 7~ ~ 7
DESCRIBE WORK: . '/114' ,'5t!?~ /AJ ;/JMR: "
NEW
REMODEL
ADDITION
OTHER
CONTRACTOR'S NAME
GENERAL:
.PLUMBINC3:
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-L~. kJlI{~
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MECHANICAL:
ELECTRICAL'
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DEMOLISH
ADDRESS' .
CON ST.
CONTRACTOR #
/21)11 ~.
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EXPIRES .~~. PHONE
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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.
o Temporary ~Iectrlc
\
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
,excavated. .
D Masonry - Steel location, bond
. beams, grouting.
o Foundation ~ After forms are
erected. but, prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
, 0 Underfloor Plumbing/Mechanical
. - Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or deckIng.
D Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to Hlllng
trench. .
o Water Line - Prior to filling
trench.
D Roug~ Plumbing ~ Prior to
cover. . .
REQUIRED INSPECTIONS
. . .
o Rough Mechanical - Prior to
cover.
o Final Plumbing - When all
.plumblng W9rl< Is complet.e.
D Rough 'Electrlcal - Prior to
cover. .
D Final Electrical ~ When all
electrical work Is complete.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Final Mechanical - When all
mechanical work Is complete.
o Fireplace - Prior to facing
materials and framing Insp.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
o Framing - Prior to cover.
D Other
o Wail/Ceiling Insulation - Prior to
. cover." .
o Drywall - Prior to taping.
MOBilE HOME INSPECTIONS
D Wood Stovo - After Installation.
o Insert - After fireplace approvlll
and Installation or unit.
- ~
I><LBlocklng and Set-Up - When all
~Iocklng Is complete. .
o Curbcut & Approach - After
. forms are erected but prior to
placement of concrete.
"'1'71 Plumbing Connections - When
~home has been connecte~ to .
water and sewer. . .
D Sidewalk & Driveway - After
excavation Is complete, forms
and'sub-base material In place.
k71' Electrical Connection - When
~ blocking, set-up. and plumbing
Insp~ctlons have been approved
and'the home Is connected .to'" ~
the service panel.
D Fence- When completed.
~Flnal - After all required
.. Inspections are approved and
. . arches. skirting; decks, and
. ,venting have .been Installed.:
o is,t~eet Trees - When all required
. trees are planted. .
,
Lot faces
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( IS THE,PROPOSED WORK tNTHE _ .
'''''HISTOI:lICAL DISTRICT, ORON
THE HISTORICAL REGISTER?
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Lot sq. ftg.
. .
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Interior
Lot coverage
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Corner
>r
~"
Panhandle ':
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Topography
Total height
Cul.de'sac
0,
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APPROVED'
~.,
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BUILDING. PERifllT ':f1. ,':'?il ;~,
ITEM sa. FT. X $/sa. FT. '" VALUE
BUILDH~-G VA10E,PLAN CHECK
AND' BUILDING PERMIT
Garage
"
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, of Springfield, Including the
Development Code, regulating the constru.ctlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Carport
\/
Plan Check Fee:
Date Paid:
Total Value
Receipt Number:
Building Permit Fee
State Surcharge
Total Fee
Received By: '
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
.~
ADDITIONAL COMMENTS
~,4-JAfUL6 ~3,~/fj
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S!3wer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
/ .1). /rYO
Plumbing Permit
Total Charge
(C)
1.2.'0
/6 4'0
State Surcharge
I ? r- ..,. , ~J
J
MECHANICAL PERMIT
Furnace
Vent Fan
NO
By signature, I state and agree, that I have carefully examined
the completed application and db hereby certify that all
Information hereon is true and correct, and I further certify
that any and ali work performed shall be done In accordance
with the Ordinancl;1s 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
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
State Surcharge
Sidewalk
~!-S" T ~,')
-L05~
~.I'J 0-0
~fP
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.
~I~nat",e ~ _ ~_ :d',L
D~te /J'~/?/f'/
, / . /
Total Permit .
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Curbcut
It
It
I
Demolition
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VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
State Surcharge
Total Miscellaneous Permits (~)
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, D, and E Combined)
RECEIVED BY
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