HomeMy WebLinkAboutPermit Building 1999-4-15
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
.
SPRINGFIELD
LOCATI~N OF PROPOSED WORK: _'J ;;;t ? '7
17 (J?-. 3'5"" '3 L/
ASSESSORS MAP'
LOl'
BLOCK:
OWNER: (' ,,^ u t 'IL
ADORES'" "'7 .?. :)..;,
CITY: S fI'
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DESCRIBE WORK:
/Y1 S hur
NEW
REMODEL
CONTRACTOR'S NAME
GENER^' .
STAT'" .
oe
'f e..t<) 'f t4tV 0
.flu?.p flk .D
ADDITION
DEMOLISH
OTHER
.-
JOB NUMB~R -.9 Cj
o .'fs9!p
225 Fifth Street
Springfield. Oregon 97477
TAX LOT'
SUBDIVISION:
J "f~ '-i t ) 8
PHONE:_7.0- ~I
. ,
ZIP:
,
., ~.PA-r- OJ}!I (.:I1.f)n
,I J 1....,..--
ADDRESS
CONST.
CONTRACTOR'
EXPIRES ~ PHONE
PLUMBING:
MECHANICAL: In[,, V' t '(")3 u .()
ELECTRICAl'
QUAD ARE'"
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
7DYo~'" - //-~9
tSJC;LJ--W\Z
- OFFICE USE -
LAND USE: f ATTE~TION:Oregon la~[!lIilIW'i\iXrtlli.IO
e~I~. ..~I~~ aJUfJiBd by Ine"bregon Utiiity
. OF UNITS: NOllflcallon ('&!Iter. Those'ffill!~~i' ..
In OAR 952-001-0010 IhrOljQh nIlRo"".o01"
CONSTR. TYPE: -0099:-\'- . OP'BDRM6.-
'. ~~ ."ay UUlarn copies of Ihe rules b
HEAT SOURCE: callina the cenlAr. (NOleSff1Nllllil~ftd'rlilEXT:
number for the Oregon U~~ I\lntlfu.~ti
RANGE: - ^. . . '800 A"R'E'I'cr0~AGE'
~~""', '" ,- -33 - 344): .
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. Inspecllons requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical I
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
placemont.
o Underground Plumbing - Prior
to filling trench.
o Underlloor PlumblnglMechanlcal
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking. .
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
CQver.
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.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Inserl - After fireplace approvlll
and Installation of unit.
o Curbcut & Al,proach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is comp;cte, forms
and sub.base material In place.
D Fence - When completed.
D Street Troes - When all required
trees are planted.
o Final Plumbing - When all
plumbing w9rk Is complet.e.
D Final Electrical - When all
electrical work Is complete.
~I Mechanical .- When all
mechanical work Is complete.
o FInal Building - When all
required Inspections have been
approved end building Is
completed.
~er
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
porchos, skirting, decks, and
venting have been Installed.
-
,
':...., .: '( : ,'. ,:' ~;~ ,;..
Lot f.acos Lot Type. Setbacks.
Lot sq. flg. Interior I PL. HSE GAR ACC I
IN I
Lot coverage Corner
Is I
Topography Panhandle !'
Iw I
Total height Cul"de"sa~
IE I
"
BUILDING PERMITi
ITEM sa. FT.
\
"
.~
x $/SQ. FT. =
VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
State Surcharge
TOlal Fec
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Rcsldentlal Bath(s)
N'
Sanl tary S~wor
Water
FT.
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsertlFlreplace UnIt
Dryer Vent
Mechanical Permit
.:\Ii/b", -
$10, -
,7<) 't ,l/\
~J(P";}O
Issuance
State Surcharge
Tolal Permil
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demoilllon
State Surcharge
Tolal Mlsceilaneous Permi ts (E)
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C. 0, and E Combined)
. (.THE PROPOSED WORK IN THE.
. "HISTO!'iICAL DISTRICr. OR ON
THE HISTORICAL REGISTER?
If yes, this appilcatlon must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
..
BUILDING VALOE, PLAN CHECK
AND BUILDING PERMIT
This permit is granled on the express condition lhat lhe said
construction shall, In all respects, conform to the Ordinance
adopted by the Cily .of Springfield, Including the
Dovelopment Code, regulating the construction 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:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Developmcnl Charge Is due' on ail undeveloped
properties within the Cily limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that ell
Information hereon Is true and correct, and I lurther certlry
that any and all work performed shall be done In accordance
with the Ordinances of the Cily of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY wlil be made of any
slructure wilhout 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 !lddress 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
:~g:::u:~e a~"2dur4o~s~~c~n. _
Date (/ L/-/,;V9 L
VALIDATION:
RECEIPT NUMBER 0 3 '3SO b
i}-j4;""l "l
AMOUNT RECEIVED 1P_)(~. iYO
d>(~
DATE PAID
RECEIVEO BY