HomeMy WebLinkAboutPermit Building 1994-1-11
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT:
DESCRIBE WORt<.
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA" ~~f""'fo';
PLUMBING' (J~/M/'
AlA
ta.'-L1"""~/
MECHANICAl -
ELECTRICAL: ---41 ~
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QUAD AREA:
. OF BLDGS:_\
OCCY GROUP: R'I
~
. OF STORIES:
WATER HEATER'
.
SPRINGFIELD
.
l.A r"_ 8
2-90 De.bzr4
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BLOCt<'
STAT'"
[.!wf /? W1
V DEMOLISH
OTHER
JOB NUMBER
Ct 2.,1 S1 t-,'d
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
b~()() n
PHONE:
7 '11-,,{ fr)?
ZIP: q7Lf7 (
ADDRESS C/71JC6
31tf%M.""",: 6~LN.
CONST.
CONTRACTOR'
~2<{
PHONE
1",'X~7'X ~
2'-3/ J/-m!-. F",.,,,q?/,....:;
IJ!:i l'
7~37Cl
EXPI RES
(."bf1ICi<..i
'2I/l/-60')9>
FLOOD PLAIN:
ZONING CODE:..1JP.-
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE: ~~
To request an InspectIon, you must call 726-3769. This Is a 24 hour :...~6rdlng. 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
,
r:::::;:r Foundation - After forms are
~ erected but prior to concrete
place"me~t.
D Underground Plumbing - Prior
to filling trench,
D Underfloor Plumbing/Mechanical
- PrIor to Insulation or decking.
~ Post and Beam - Prior to floor
yc:s.lnsulatlon or decking.
IVf Floor Insulation - Prior to
t.p decking.
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. .
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
- OFFICE USE -
\\ \ \
LAND USE:
. OF UNIT""\
CONSTR. TYP'"
V 1\\
\A/I.\-
HEAT SOURCE:
RANr.:I='
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cove~ .
r";?1 Rough Electrical - PrIor to
~ cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~ FramIng - Prior to cover.
RJrWall/Celllng Insulation - Prior to
~ cover.
~. Drywall - Prior to taping,
D Wood Stove - After I~stallat.lon,
D Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prIor to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place,
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing work is complet.e.
rY1 Final Electrical - When all
~ electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
I'V'f Final BUilding - When all
~ required Inspections have been
approved 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.
D 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.
Lot faces
Lot sq, ftg,
Lot coverage
Topography
Total height
~
('11.')
BUILDING PERMIT
ITEM SQ, FT.
Main
2.. Sit ~
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
SanltalY Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
Lot Type .
.K
Interior
Corner
Panhandle
Cul-de-sac
I P.L.
iN
Is
Iw
iE
X $/SQ, FT, = VALUE
_ Sl2.E- :) I 1A13
(A)
N'
FT.
FT.
FT.
(C)
Dryer Vent
Wood Stove/lnsertl Fireplace Unit
N'
-2_-/, {q '3
.
15 2. ,S<;;
7,(3
J to,/ 3
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~B
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
/'0,/3
FEE
Setbacks
'HSE'GAR'ACcl
I
I
I
I
~THE PROPOSED WORK 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.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
constructlon 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:
Ci-5-..' ?,
/J./m5?'
lljflb/
.. -
~R
Date Paid:
Receipt Number:
Received 'By:
.1 Gh:> !lVJ~
Plans Reviewed By
1- 6 -9 </ '
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Informatlon hereon Is true and correct, and I further cert1fy
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 the 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 compilance 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 localed at the front
of the property, and the approved set of plans will remain
on the site at all tlmes during construction.
, X;gnature . ~..v~.fL"'Hr-
J/I'f/7? '
Date
VALIDATION:
RECEIPT NUMBER
DATE PAin
I/:?-;K]
/j/,y5'?f.
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A-~;' _
AMOUNT RECEIVED
RECEIVED BY
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