HomeMy WebLinkAboutPermit Building 1991-5-9
.t"
~.,I" --.::''=
~ -- ~
RESIDENTIAL
PERMIT APPLICATION
-e
.
q\~:~
SPRINGFIELD
JOB NUMBER
Inspections:,726.3769
Office: 726~3759
LOCATION OF PROPOSED WORK: tJ\J2\oD
ASSESSORS ~AP: ~ O'~,83 ~:i-
OWNER:\ J\ U7\lUfu
ADDR~S; , \ _ ~ 00 QJ\ L9- ' ~(\ n
CITY: ~ <:.JJ ,uN., 'STATE' ( \..l.JtJ
--=--, ,: -\) - -
DESCRIBnW~RK JJOJJ.)LL rn H
NEW \.LJ REMODEL ADDITION DEMOLISH
I
,
LOT:
CONTRACT)U1'S NA
GENERAL:<,J(
*'
fl)9.[)lJv
o
~ 1()'.
TAX LOT: 141 ~. '
SUBDIVISION: ~ \LLQJ u' \Jl)D
PHONE: c4r-RlJJ
225 Fifth Street
Springfield, Oregon 97477
. --. '.
BLOCK:
ZIP:
474,r7
OTHER
CONST.
CONTRACTOR #
lolo\4'1
\ 0 ld\'\-f")
ADDRESS
.
n f)J ~N1.J
\\
PLUMBINf::'
, -
"
EXPIRES PHONE
"p)It-f /q2- LD~-11102
o)r({q-v LD~ .11~-z.)
MECHANICAL: e-
ELECTRICAL~()] D~ ~f()\{Jn
., "
QUA~ AREA: ,,~-0Q..
,
OCCY GROUP: ~ '=)
\
# OF BLDGS:
# OF STORIES:
WATER HEATER:
p-,
l.o~\ (37
\ Q. \ 'd'J fq I 34-4.. \SJ)
. , . ' , , ,
- OFFICE USE -
, 1 E)()
(
LAND USE:
FLOOD PLAIN:
ZONING CODE!l1lf!-- PUD
.3
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCI='
RANGF' ,&
# OF BDRMS:
FL
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. '~ ,
'-". {~ :
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made,
after excavation, but prior to
setting forms.
O Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
rtA Footing '- After trenches are
LP 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
- Priortq insulation or decking.
o
Post and Beam - Prior to floor
insulation or decking.
..
o Floor Insulation - Prior to
deckl ng.
rP1 Sanitary Sewer - Prior to filling
\ trench.
. .,' . . ."
I v2 Storm Sewer - Prior to filling
L(:J trench.
r--n/water Line - Prior to filling
L4:f ;;ench.
o Rough Plumbing - Prior to
cover.
'. ,';
.'
.,'
o Rough Mechanical - Prior to
cover.
o
Final Plumbing - When all
plumbing work is complete.
-0 Rough Electrical - Prior. to
cover.
,
D Final Electrical - When all
electrical work is complete.
o Electrical Service - Must be
approved to obtai n permanent
electrical power.
o Final Mechanical"":' When all
mechanical work is complete.
o 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.
, ,
~1~Cking ~nd Set-Up -' When all
LfI blocking Is complete.
o Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
~IUmbing Connections - When
home has been connected to
water and sewer.
D' Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
r<=2!?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.
rr7"lA:inal - After all required
~ Inspections are approved 'and
, porches, sklrting,decks, and .
venti ng have. been installed.
~ Street Trees":': When' all required
~ trees are planted.
~ -----~
Lot faces
Lot Type
~ Interior
Lot sq. ftg.
Lot coverage
Corner
.
.. ' .,--, q~
~ THE PROPOSED WO~K IN THE
HISTORICAL DISTRICT, OR 9_N1l\ f)
THE HISTORICAL REGISTEVll "'''
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I P.L. HSE GAR ACC I
N I.
Is I
Iw I
I'E I
Topography
Panhandle
Total height
Cul-de-sac
I '
J" ;
..1
. J
BUILDING PERMIT' "
ITEM sa. FT. x $/so. FT.
McI1n m M
Garage
Carport
~~
<:9104 .
Total Val u
Building Permit Fee
State Surcharge
Total Fee
(A)
= VALUE (JJ
~ Il)CO/
I
Wl
~ QDD .
c931~5lXJ '
8,B.~)
1.Q.3
~D~:~
SYSTEM~ DEVELOPMENT(~HARM~~
PLUMBING' PERMIT
ITEM
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
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Fireplace Unit
Dryer ~ent
,
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
FEE
c05. CD
Q5.Cfl
<95.00
q 6.'00
l~~5
1] <;) I '}S
"
r25
e,~
J5.~
1C:).~5
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
5~l-33
, APPROVED:
I
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 Ijmits which are being improved.
ADDITIONAL COMMENTS
.
~D,()\ ,\ \ ;C;.fl)JlP
r
l'DllmQ \(\t \ )\llitsLLcl-\()()
~ ~<L ~\Crv\QJ'~ ~ ~tDfdtcl
\ OJ) 1 OY -h)~~D~_)( m.tL~.
1\ AO 001JIPd) 5 Ala \
" - 'I( ~
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 requi red 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 all times during construction,
JeAA- rV/VJ7
C -~-q I
Date
v
VALIDATION: ~
RECEIPT NUMBER t1~\....;' \
DATE'PAID 5 .q .q I
AMOUNT R~CEI~I' B.$-OB
RECEIVED BY ~ l/) CA.....J
-
t"
..." , .'----..
.
.
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
per~t~, one 0 the'foJ.lowinlI,?
. OlP&n . ~-'YU xr-
agree
,
,0
Class A Manufactured Home. A manufactured home of not less than 24
feet in width and 16% (not 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. ;
o
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
- Yater line connection
- Electrical connection
- Street tree standards
- Minimum requirements for permanent steps
~CLe
@VV)
g-~q-q /
Date