HomeMy WebLinkAboutPermit Building 1993-12-16 (2)
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LOCATION OF PROPOSED WORK: 5""660 .t?.A2/'5 // ~A::J
17-C;2 -? ":f -~t/
. - ....
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT:
OWNER'
ADDRESS:
CITY:
.
, SPRINGFIELD
.
JOB NUMBER ~:.:r / '/ 7<7
225 Fifth Street
Springfield, Oregon 97477
Jy'2_~
TAX LOT:
SUBDIVISION'
NEW
REMODEL
ADDITION
OTHER
BLOCK:
b~,
DEMOLISH
PHON F'
?y"/- 3"'cGS~
. -
'p~~~C:LL F~~~~~
~ ~./?7~ ,..
, ~/LP;._ STATE:
ZIP'
9::> y..> g
DESCRIBE WORK:
C~~,/~,pc:~ /6X-Z$L' ~~...-? ~~,~q ~~~?~r.~~C"
CONTRACTOR'S NAME
GENERAL: ft'~4~A.'
.'
"
pLUMBING'
MECHANICAL:
ELECTRICAl'
ADDRESS
CONST,
,CONTRACTOR #
PHONE
EXPIRES
..
"- OFFICE USE -
QUAD AREA: 2;.(Rs r.. LAND USE: FLOOD PLAIN:
',' ! ., LOR.
# OF BLDGS: ' ' # OF UNITS" ZONING CODE:
OCCY ~'ROUP: M 'CONSTR. TYPE: IN # OF BDRMS'
1 ,
# OF STORIES' , HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG~' SQUARE FOOTAGE: 3'9.4
-.J:" 'c
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 request~d 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.
o Underslab Plumbing/ Electrical/
, Mechanical - Prior to cover,
r.v1 Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting,
, ,
~ 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
deckl ng,
D 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.
D Rough Mechanical - Prior to
cover. '
D Rough Electrical - Prior to
cover,
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover, '
o Drywall - Prior to taping,
"
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
, excavation is complete, forms
and sub.base material In place,
D Fence - When completed.
D Street Trees - When 'all required
trees are planted. " '.
D
Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
~ Final Building - When all
.............'cequlred Inspections have been
approved and building Is
completed.
D Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
, porches, sklrtln'g, decks, and
venting have been Installed.
Topography
Total height
Panhandle
Setbacks
I P,L. I HSE I GAR ACC
N
Is
Iw
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.
\
, \
Lot faces
Lot Type.
,
Lot sq. ftg.
.. ",
_' Interior
Lot coverage
Corner
Cul-de-sac
, "ApPRdvE8:
.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
~, Thl'spermlt Is ~iranted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Sprin,gfield, 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.
Plan 'Check Fee: ,~6. ;? ~'?
Date Paid: / /..~ ~~ ~"3'
Receipt Number' /(/)~/
Received. y: ~. .
, ~ p//JA-l
s Reviewed Bf / Dpte
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT. = VALUE
Main
Garage '=?.Ji?7I
,/~/p
~st/~9'o
, ,
Carport
.... .~
,
. ., ..~- .
'....
Total Value
Total Fee
(A)
q;,,5o
-- -sa3
2.
cg,ll
- "
Building Permit Fee
State Surcharge
SYSTEMS DEVELOPMENT CHARf{; (SDC) Jb
15 1'P
(B) 9'1-
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved,
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Residential Bath(s)
NO
~ e~/OfL, li1J'?I<<d/ltlVS
fi /tt ,~/(J.t'!, . .
,t/KA'M ',r:
Fixtures
Sanitary Sewer
FT.
FT.
FT.
Water
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 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 9RS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove/Insert/ FI replace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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 con~tl~.
X;gnat~..4 -W. ~
/ '
Date /2 II U 17',~
( I
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
VALIDATION:
RECEIPT NUMBER 1==*-' II 'lcf1
DATE PAID 1;}11/...IC1 ~
. AMOUNT RECEIVED ~ \SqD~
/c::q.t:Je;
, ..... , , RECEIVED BY ~~
.
State Surcharge
Total Miscellaneous Permits (E)