HomeMy WebLinkAboutPermit Building 1993-3-18
LOCATION OF PROPOSED WORK: 6- .J J ) IJ 14 / c; LA
ASSESSORS MAP: .I /"It>2 - -~ ~-<::3e::::> .; . , - /
OWNER: /<) J!J.AJcI' e ~ ~
ADDRESS: ~~ '3 3 ~ /1/ ,# / ;U
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOT:
BLOCK:
CITY:
DESCRIBE WORK:
tlf
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
/(p;U
Ke/V J..
MECHANICAl' Kelt,! 1.. .
/#C/(,
GENERAl'
1.
PLUMBING:
ELECTRICAL:
QUAD AREA:
/I OF BLDGS:
OCCY GROUP'
" OF STORIES:
WATER HEATER:
.
9~~;~ "7
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SPRINGFIELD
JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
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TAX LOT:
SUBDIVISION:
PHONI='
7~7 7"9/9
STATE:~O;V
",
97~?R'
ZIP:
///(?hI'7~ # ~
DEMOLISH
OTHER V
ADDRESS
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CON ST.
CONTRACTOR /I
EXPIRES
PHONE
- OFFICE USE -
LAND USE:
FLOOD PLAIN:
ZONING CODE'
/I OF UNITS:
CONSTR. TYPE:
/I OF BDRMS:
HEAT SOURCE:
RANGE:
SECONDARY HEAT:
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
maele the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
o Footing - 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 PI!Jmbing/ Mechanical
_ Prior to insulation or decking.
D
Post and Beam - Prior to floor
insulation or decking.
D 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.
o Rough Plumbing - Prior to
cover.
. ....
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o
Final Plumbing - When all
plumbing work Is complete.
D Rough Electrical -' Prior to
cover.
o Final Electrical - When all
elE:?ctrical work is complete.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Final Mechanical - When all
mechanical work is complete.
D
Fireplace - Prior to facing
materials and framing Insp.
o Final Building - When all
required Inspections have been
approved and building is
completed.
o
Framing - Prior to cover.
o Other
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Wood Stove - After installation.
D Insert - Aller fireJ..llace approval
-_.~ and installation 01 unil.
rn Blocking and Set-Up - When all .
blocking Is complete.
rOOI Curbcut & Approach - After
forms are erected bll~. prior to
placement of concrete.
[4J
Plumbing Connections - When
home has been connected to
water and sewer.
o Sidewalk & Driveway - After
excavation is complete, forms
and s'-lb-base materiai in place.
rzr Electrical Connection - When
. biocking. set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Fence - When cornpleterJ.
L2D Final - After all required
. inspections are approved and
porches, skirting, decks, and
venting have been Installed.
D
Street Trees ..- W11p.n all req~ired
trees are plc:n~C((.~. .
~.
l
Lot faces
Lot Type.
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle_.
I
Cul-de-sac;:
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT. =
Main
Garage
Carport
Total Value
Building Permit Fee
Slale SlIrcharge
Total Fee
(A)
'.S 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.
"
Setbacks
HSE GART~\C~ol
I P.L.
IN
I S I
I W\ .,
I-E_~I_
VA LU E
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
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
Exhaust Hood
Vent Fan
NO
Wood StovellnsertlFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
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APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Tllis permit is wanted on the express con'dition lhatthe said
construction shall, in'all respects, conform to the Ordinance
adopted by the - Cit'y Q'f Springfield. including the
Development Code, re'gulaling the cO.l:l~truction and use of
buildings, and may be suspended or"revoked at any time
upon violation of any provisions of said ordinances.
': ,
" .
'plan Check Fee:
Date Paid:
Receipt Number:
-~ .
. ,
Received By:
..~. '.
. ,
'.
'.
Plans Reviewed By
/.
Date
'-
Systems Deyelopment Charge is due on all undeveloped
properties will~in "the City limits which are being improved.
ADDITIONAL COMMENTS
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 t1lis
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 site at all times d.~constr lion.
Signature .:?#~ ~
Dale .~-;6' 95/
VALIDATION:
RECEIPT NUMBER
7,$'5"<-
~-/&~~ ..l...
DATE PAID
AMOUNT RECEIVED .z7'6 ---.-:.
RECEIVED BY ~~__.r..
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