HomeMy WebLinkAboutPermit Building 1999-11-18
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759 :
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SPRINGFIELD
"
.
JOB NUMBER
qq IS 8'.3
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: r-Y2-,DC\
ASSESSORS MAP' It 0').. 35?J 4
S\:('\ .rv.po \ rl) oR- ('IIL("~
TAX LOT' (;) ':? ~ o-V
LOT-
OWNER'
C -(....< \ '-\Y'1
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ADDRF':<"
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CITY'
BLOCK'
C' ("'()\. O\ULL\
STAT'" '
DESCRIBE WORK. \{'\O..,\.(\ \ \ ~ (\~ ~\..\.\IY"\- \:
NEW REMODEL' ADDITION' DEMOLISH
CONTRACTOR'S NAME
GENERA' .
OTHER I tflilr)or 1f'n9 1J:\t/:~-!m.f
CON ST.
CONTRACTOR .
ADDRESS
SUBDIVISION'
PHON'"
ZIP'
EXPIRES
,~
PHONE
PLUMBING'
MECHANICAL:\kpe~).r\-~ '10~CJ\Y'~,Eu~'~1 ~7.!W2 ~4' \04
ELECTRICAl'
QUAD AREA: '3etl:t3" MU O!H ANV"ND USE:
· OF i!l~BN00"':',]':'~1~8939N3~~O~OF UNITS:
o<WNGmllI)~3rl ~IH I H=ln~ln n=ml::lOH1090NSTR. TYPE:
. ~~g~i'\\1k;l13l::1ldX311\fHS11~l::I3d SIHlkEAT SOURCE,
WATER HEATER' :30110MANGE:
- OFFICE USE -
I'''.
c.
"!lnOt" 'I)
()/,{Of ["'~IJ:>"'-l'::'\- U~
-
.m '"4U""':; you Iv
..,. l(jpn'"fi by the Oregon Uti.lity
'hoOD' P"['AIN"Gf are set/nrtl
. . .' I' ':"Ul'l'f~ OAR 852-001.
ZONING CODE: ." ,
, .', - -' ',...-'L.... U! LlIo_ 'UIC~ u)'
'.'OF' aDRMs.tllE' relenhnnA
,. Q:epun Utilitv Notification
SECONI.)"RY~,tiEAT"
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SQUARE FOOTAGE.
To request an Inspectlon, you must call 726-37fiS. This Is a 24 hour recording. All Inspections requested before 7:00 3.m, will be
made the same working day, Inspections requl}sted after 7:00 a,m, will be made the following work day.
FlEQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, groullng.
o Foundation - After forms are
erected but prior to concrete
placement.
o Undorground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decking,
o Post and 8eam - 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.
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Elactrlcal Sarvlce - Must be
approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/CeJlJng Insulation - Prior to
cover,
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approvlll
and Installation of unit.
o Curbcut & Approach - After
forms are erected bul prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and'sub.base material In place.
o Fence, ~ When completed.
o ,Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing W9rl< is complet,e.
~al Electrical - When all
electrical work Is complete.
c;:;a';'nal Mechanical - When all
mechanical work 15 complete.
o Final Building -,When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel,Up - When all
blocking Is complete.
D 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, skirting, decks, and
venting have been Installed.
r
,
"
,
Lot faces
,.
,
L~t'~yP.
Lot sq. Itg.
Interior
. Lot coverage
Corner
Topography
Total height
Panhandla \,
Cul'de'sa~
.;
BUILDING PERJtlJIT 'II " .~
ITEM
sa. FT.
X $/sa. FT. =
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fec
(A)
SYSTEMS DEVELOPMENT CHARGE (SDe)
(B)
PLUMBING PERMIT
tTEM
Fixtures
Resldenttal Bath(s)
Sanitary S~wer
Water
N'
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flraplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
'...
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
,~~:,\. \
. . '... ,:~
.....::,. "; .... ._!'.'i;,.:- 1., '~.~t,
1.,. ".' ~"".('r-;~ '[1 \, ~,~ I\i ~t~.'..
\...:',1,: :' , '_':'" \;"~J~~::'~",: '.
Setbacks,
HSE GAR ACe' I
I
I
I
I I\. A,PPR9VED:
BUILDING Vhu!1E, PLAN CHECK
AND BUILDING PERMIT
"
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N
S
w
----
,E
VALUE
"
FEE
{Pl~. -
$10. -
ilb' + . w-S-
d... (P. S()
'IS THE' PROPOSED WORK IN THE. '
.",,, . '. I
HISTORICAL DISTRICT, OR ON
THE HISTORICAl REGISTER?
If yes, this application must be signed
and approved by the Historical
, Coordinator prlot to permit Issuance.
This permit is granted on the express condition that the said
constructton shall. In all respects, conform to the Ordinance
adopted by the City, of Springfield, including the
Development Code, regulating the constructton and use of
oulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Recel pt Number'
Received By:
Plans Reviewed By
Dale
Systems Development Charge Is due on all undeveloped
properties within the City limits whlch'are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examlnad
the completed appllcatton and do hereby cartlfy 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 tho 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 OAS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper time, that e~ch 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 ~.-7 , -7
Slgnature~~. ~ ~-->
Date' //-/2'"'7=7/ ~
~
VALIDATION.
RECEIPT NUMBER
~(.;.. ::> "i
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gj; ~(o . (:;7)
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY