HomeMy WebLinkAboutPermit Building 1995-10-6
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOS,eP/~K: ()O'C:J~
ASSESSORS MAP' t . J UL ~ '1.{YJ .
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DESCRIBE ~p{ ,\'\,!U\\'O't"u
NEW V REMODEL DDITION
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RESIDENTIAL
PERMIT APPLICATION
LOT:
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OWNER:
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CITY:
CONTRA~~.R'SS~\.Nft\~^ ~
GENER~j~lJ~l_\U U_
PLUMBING:
MECHANICAL:
ELECTRICAL:
.
SPRINGFIELD
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JOB NUMBER . \Q
~q
TAX LOT:()(~~
225 Fifth Street
Springfield, Oregon 97477
.
BLOCK:
SUBDIVISION'
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PHONE: \4\ .'L\ \U
ZIP: q-~ rr(
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DEMOLISH
OTHER
DRESS.
CONST.
\~1116{~
5~\c,R.~ lo~ 17Hk;1331
- OFFICE USE - l
QUAD AREA: LAND USF' FLOOD PLAIN:
" OF BLDGS: " OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: " OF BDRMS:
" OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
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 r~.quested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical!
Mechanical - Prior to cover.
~ootlng - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
. - Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking. .
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. .
o Water LIne - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
D Rough Mechanical - Prior to
cover.
D Final Plumbing - When all
plumbing W9rl< Is complet,e.
D Rough Electrical - Prior to
cover.
o Final Electrical - When all
electrical work Is complete.
D Electrical Service - Must be'
approved to obtain permanent
electrical power.
o
Final Mechanical - When all
me nlcal worl< Is complete.
D FIreplace - Prior to faCing
materials and framing Insp.
Final Building - When all
required Inspections have been
approved and building is
completed.
o FramIng - Prior to cover.
D Other
o WalllC'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
o Blocking and Set.Up - Wilen all
blocking Is complete.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Plumbing Connections - When
home has been connected to
water and sewer.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
D
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.
c
D Street Trees - When all required
trees are planted.
o Final - After all required
Inspections are approved and
porches, sklrllng, decks, and
venting have been Installed,
.
. :. . l::~~ ", '{,~i' :;~': .
Lot Type.
Lot faces Setbacks
Lot sq. ftg. Interior p.L. HSE GAR ACC'
Lot coverage Corner N
Is
Topography Panhandle
Iw
Total height Cul-de-sac
IE
. THE PROPOSED WORK iN :THE.
. "HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED:
ITEM
SQ. FT.
X $/SO. FT. =
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
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 construction 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:
Total Fee
(A)
\ 1f0.cO
-V.w
\<b~ t
Date Paid:
Total Value
Building Permit Fee
Receipt Number'
Received By: .
State Surcharge
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
FEE
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewer
..
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
NO
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 Ordinanc~s 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
structuJ:.e 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 Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
State Surcharge
Sidewalk
ft
I further agree to ensure that all required Inspection~ are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the front
o e property, and the approved set of plans will remain
n t e site at all Ii es du" '" "J'rUClion.
",gnatu'iei ~ A i; ~~
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Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State I.ssuance
Curbcul
ft
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
\~4\
AMOUNT RE
State Surcharge
Tolal Miscellaneous Permits (E)
RECEIVED BY
,