HomeMy WebLinkAboutPermit Building 1993-6-21 (2)
..
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769'
Office: 726.3759
LOCATION OF PROPOSED WORK: _ /~7
ASSESSORS MAP: 171l ( /4-
I - '-" 'l
LOT. BLOCK.
SPRINGFIELD
OWNER:_~rl ~./77'r.~
ADDRESS' ~.....2~. (/~T /_.A-Yt..rt=
CITY. ~j"" STATE: /.Itf?
~-c.--.
DESCRfBE WORK.
~~y~~ ~~/??IIP_
ADDITION DEMOLISH
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL:
PLUMBING.
MECHANICAl.
~uM.2~_
ELECTRICAl.
QUAD AREA"
S'VVw
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
OTHER
ADDRESS
CON ST.
CONTRACTOR'
..
"'1" ~,.,. I'
....- D .\L;
~o"':) __._
JOB NUMBER ~ .J() "" ~
225 Filth Slree!
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION.
)2-{)/
- OFFICE USE -
LAND USE:
. OF UNITS.
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
PHONF.
ZIP:
c; 74ZLJ )
EXPIRES
PHONE
FLOOD PLAIN:
ZONING CODE:
. OF BDRMS'
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.
,
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, bend,
beams, grouting.
o Foundation - After (orms are
erected but prior.to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbing/ Mechanical
_ Prior to ins,-!latlon or decking.
o Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to rllling
trench.
O Water Line ~ Prior to filling
trench,
o 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.
~ming - Prior to cove..
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After flreplace approval
and Installation of unit.
o
Curbcul & Approach - Aller
forms are erected but prior to
placement of concrete.
o
Sidewalk & Driveway - After
excavation is complete, forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
tr,;es arc planted.
o Final Plumbing - When all
plumbing work is complet.e.
D Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
~'nal Building - When all
ulred Inspections have been
app ved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Set-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
venUng have been installed.
Lot faces
..
Lot Type
Lot sq, ltg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SO. FT, X $/SO, FT.
Main
Garage
Carport
.~HE PROPOSED WORK IN THE
,
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcatiory must be signed
and approved by ,the Historical
Coordinator prior to permil issuance.
Setbacks
I PL. I HSE GAR ACC
IN
Is
Iw
IE
VALUE
&::;00"
/>>/1() I /500
,7S'
/S-,7S
SYSTEMS DEVELOPMENT CHARGE (SDC)
Total Val ue
Bullding Permit Fec
State Surcharge
Total Fee
(A)
(B)
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
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
lt
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D. and E Combined)
FEE
J <:'. 7,J
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on ttle express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the Ci,ly of Springfield, including the
Development Code, re~ulaling 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 RelfLty
Dale
Systems Development Charge -is due' on all undeveloped
properties within the City limits whictl arc being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certlfy- that all
lnformation hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with ttie Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining 10 the work described
herein, and that NO OCCUPANCY will be made of any'
structure without permission 9' the Building Safety Division.
I further certify that only cornractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspectio.ns 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 construction.
~nature, (1A~ f) a -I,.,....>>-J
/ Data & -2/- 5' ?
VALIDATION:
'7/34-
;;, -2/-; "]
. /):".7-T
/~
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY