HomeMy WebLinkAboutPermit Building 1991-10-17 (2)
,~
~
.':
RESIDENTIAL
PERMIT APPLICATION
.
SPRINGFIELD'
Inspections: 726-3769
Office: 726-3759
LO~ATION OF PROPO~ED WOFjK' ' . ~\ _0 \ 00
ASSESSORS.MAP: \~G,~nL\ '\\., '.
LOT:
, '
,
, BLOCK:
tit
Q\()l,<3
JOB NUMBER
*'
\)) ~~ IR.X ~ lc4 .
- - \.JTAX LOT\ Q \ n~ Yz.Lo lat
'. ,,' S~BDI~I'~I~N; \\\\;t, \)l 0 ll.-") ,
225 Fifth Street
",
Springfield, Oregon 97477
P.HONE:~rr ~lol{/~
I
OWNER: ~. \:'Y\ \\irr{\ 1- ,,'
ADDRESS~ O\.~~~ ~~c:iU~
CITY: . C(.~)~ STATE: (t))\Cnr?P'
DESCR!B7\WORK: \-.;\1)\.l N Q... \ ,l') \C1 Om M
NEW \.V REMODEL ADDITION . DEMOLISH OTHER
ZIP:
q~l
'-'
CONST,
CO T C OR #
to\"
i) "lA,4
.u/- l~, .
, .
. , .
Co \c~ \ ~/')
CONTRACT~'SNAM~ L\^, A~DRESS
GENERAL: l::1.rc-r~~ ~)..\\j\ ~~
PLW.MBING' ~C\ ~ ~~
MECHANICAL:
,.ELEC~R'ICAL: M~ ~ ri1O.-~
QUAD AREA: ~~ ~~
\
OCCY GROUP: R ~
\
~
# OF BLDGS:
# OF STORIES:
WATER HEATER:
6f~XiCf2- \o~'7bL~
,\~gL ~:_
. ". i."" .
, " , :. " "-
lZ!Z7/l! ~~~~/OC(I
.:....:. OFFICE USE -
LAND USE: \ \ c:=-n FLOOD PLAIN: -
# OF UNITS: \ ZONING CODE: Vl) \ ')
-3
CONSTR. TYPE: # OF BDRMS:
HEAT SOURCE: \=s SECONDARY HEAT:
RANGE: G 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.
~nderslab Plumbing/
~echanical - Prior
~ Footing ...;... After trenches' are
excavated, ,
, ,
. ,
o 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 Underfloor Plumbing/Mechanical
, - Prior to insulation or decking.
o Post and Beam - ~rior to floor
Insulation or decking,
o Floor Insulation - Prior to
decking.
r:-C:J Sanitary Sewer - Prior to filling
~ trench.
r;f}>Stor~ '~ewer ~ prio'r to filling ..
~ trench. .
, ,
rnWater Line -:- Prior to filling )
~ trench, .
D. Rough Plumbing -:- Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover,
o Electrical Service - Must be
,approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
, 0 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.
'0 Sidewalk & Driveway - After
excavation Is complete, forms
,and ,sub-base material in place,
'D Fence'- When co~pleted.
o Stre~t.Trees -:,' Wheri""all require'd
trees are planted.
o 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.
'0 Final Building - When all
required Inspections have been
, '.
approved and building is
completed,
o Other
MOBILE HOME INSPECTIONS
. ,
, , ,
~ Blocking and' Set-Up - When all'
_'. blocking Is complete.
en Plumbing Connections - When
~ home has been connected to
water and sewer.
rn Electrical Connection - When
~ blocking, set-up, and plumbing ,
Inspections have been approved
and the home Is connected to
the service panel.
rr7f1:inal - After all required
~inspectlons are approved and
'. ' . porches, s'k:irting, decks, and
venting ,have been Installed.
,;'
. ~~
. ~ THE PROPOSE'? YVORK 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 e Setbacks
Lot sq. ftg. Interior I P.L. HSE GAR Accl
IN I
Lot coverage Corner
Is
Topography Panhandle
Iw
Total height Cul-de-sac
IE
BUILDING PERMIT
ITEM
sa. FT.
X $/SO. FT. = VALUE
~
Main
Garage
Carport
)
-
\5X)
c91E;CD
!~.(fJ
, .'75
/Q.~
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
. , - ~"(B).~
PLUMBING PERMIT
ITEM
FEE
Fixtures
~
Residential Bath(s)
NO
Sanitary Sewer
FT,
~-~
~
;::)6
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
f) CS.(j)
'3.1C,
f\ '6 ' 'l:S
State Surcharge
Total Charge '
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
f\Ja
Rq .~CS
J~.15
5.cG5
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
~~;~ N\ c~
Total Miscellaneous ~\its~' (E)
Nt) ,co
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
..~/}. ~
APPROVED:
BUILDING VALUE, PLAN' CHECK
AND BUILDING PERMIT
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.
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
I. n - vAd 1DLmJUfE
10)\n ~ .'. ~ .q()
- ~ ~ (\tl.Q -=\:+ ,. l [) - \~S
....
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 pertai ni 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.
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 'rocated at the front
of the property. and the approved set of plans will remain
on t ite"atJl\ times ~urin~construction.
natu e U f/;) !8JLT'1 oJ-
~ c$ OtIvn
IO-f/}-q/ (/
\
"-
.;,
_.-__r'
SpAFIELD
DEVELOPMENT SERVICES
PUBLIC WORKS
METROPOLITAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD. OR 97477
(503) 726-3753
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield
that with the approval of the attached
manufactured homes will be placed at
Springfield, Oregon, City Job Number
Development Code, I understand and
Pg~ (;; One C) ~\e ~~\lO~t n4
G\ \ D,""){ -;- ~
agree
,
o
Class A Manufactured Home. A manufactured home of not less than 24
feet in width and 16% (n6t less than 2:12) roof pitch, with exterior
dimensions enclosing a space of at least 960 square feet, with roofing
and siding materials that are commonly used or compatible with site
built homes. ~
D
Class B Manufactured Home. A manufactured home of not less than 12
feet in width and 16% roof pitch, with exterior dimensions enclosing a
space of not less than 500 square feet, with roofing and siding
materials that are commonly used or compatible with site built homes.
I further state, by my signature below, that I have been provided with the
following information:
- Mobile home blocking
- Sanitary sewer- connection
Vater line connection
- Electrical connection
- Street tree standards
- Minimum requirements for permanent steps
(
10,- /1 '- q (
Date