HomeMy WebLinkAboutPermit Building 1991-12-3
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ADDRESS: 5"":3 '3 cs- f) Jff / _S C/)
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DESCRIBE WORK: . j#/Yh ?/e ~~
V REMODEL
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RESIIlFeNTIAL
PE'RMiT APPLICATION
Inspections: 726-37,69
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP'
LOT:
OWNER:
CITY:
-
SPRINGFIELD
.
225 Fifth Street
Springfield, Oregon 97477
JOB NUMBER
Cfl/ 71/~
.,
:L) q.I j vi ~f
I
# 1/0- .
TAX LOT: 1.:3 C)-o
BLOCK:
SUBDIVISION'
PHONE:
-
5[1
//5
~C/??r )
/' ~
ZIP:
97;/""7 ??
,
STATE:
9J/IfrN'P~/'
DEMOLISH
OTHER
NEW
ADDITION
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR #
GENERAL: -J/If EJ...(S 13ua;,~ 1{@1{,I'A1 3?JtjQ,K//JltJt~ -6 h 9.7 t(
PLUMBING: \~
, -
MECHANICAL',(
IJIrR E,i e- e ,
ELECTRICAL:
-, '\ .--
,. ,
QUAD AREA:
# OF BLDGS'
OCCY GROUP'
# OF STORIES:
WATER HEATER:
EXPIRES PHONE
o/"2~/9Z, 7~7752~
,~
- OFFICE USE -
LAND USE:
FLOOD PLAIN:
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
ZONING CODE:
# OF BDRMS'
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
made the same working day, Inspections requested after 7:00 a.m, will be made the following work day,
o Temporary Electric
o 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 Plumbing/ Mechanical
-:- Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or decking,
o Floor Insulation - Prior to
decki ng,
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,
o Rough Electrical - Prior to
cover.
D Final Electrical - When all
electrical work is complete,
D 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,
D 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 - After fireplace approval
and Installation of unit,
~ Blocking and Set.Up - When all
blocking Is complete,
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
I"l Plumbing Connections - When
l...;2!J home has been connected to
water and sewer,
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material in place,
Q 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,
Q Final":" After all required
inspections are approved and
, porches, skirting, decks, and
venting have been Installed,
o Stre~t Trees"": WhIm all required
trees are planted.
1
"
Lot Type .,. . . THE PROPOSED WORK INJHE
Lot faces Setbacks
I P,L. ACC I ' . ~
Lot sq, ftg. interior HSE GAR HISTORICAL DISTRICT, OR ON ....
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
\S I
and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance,
Total height Cul-de.sac
IE I
APPROVED:
. BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT. = VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
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,
Garage
Carport
,
Plan Check Fee'
Date Paid:
Total Val ue
Receipt Number'
Building Permit Fee
Received By:
State Surcharge
Total Fee
(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
FEE
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT,
Water
FT.
Storm Sewer
FT.
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 ~xamined
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 pertai nl ng to the work descri bed
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 Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
MISCELLANEOUS PERMITS
4' /o~_ 00
:ZO.lj.o
..r.. z.:>
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 sit~ at;lIne uring ~~tion,
slgnaMe'ft'i 1:'
Date / 2 ~ l-9~
(D)
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
, -
Curbcut
ft
Demolition
Total Miscellaneous Permits (E)
.//
/.3'0 ..2u-
VALIDATION: ~
RECEIPT NUMBER '\.-AJ0 '"2 ') C\
DATE PAID \? - -;:;.:.... C\ \,_
AMOUNTRE~D\'~ ) ~
, ,,- ~
RECEIVED BY'~ ",
, State Su rcharge
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
-
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