HomeMy WebLinkAboutPermit Miscellaneous 1998-4-10
LOCATION OF PROPOSED WORK' / / /c?
ASSESSORS MAP' / 7/J'J';l'T ,ry
LO/ //
OWNER' {)V;1'/.7/1 Jf (ba.
ADDRF"'" . --:-W.o;; /jb/,d(.. d~;J
CITY: <;.-?/ /./le:,&.!d ,/ STATF' Of'
-'--/" / /
DESCRIBE WO~' //7.@ // u7/~ / ~ >214/ ir/i./<\YtJ"r Al/?/tl/
,/
DEMOLISH
'..
".
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOT'
NEW
y"
REMODEL
.
BLOCK:
ADDITION
OTHER
.
JOB NUMBER
~~/~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT' 8/0//
SUBDIVISION: , O;;pf,?'d U if'?J -
/ PYL"~,,!-> 17//.77")
PHOI'J'" Y?1?:fl1k!--/-
ZIP'
f'/11/
CON ST.
CONTRACTOR'
CONTRACTOR'~ ~ME ~ / L. ADDRESS
GENERA" /r /.L:J)'1,)'/Yt/d/ul'l'
PLUMBING'
MECHANICAl'
ELECTRICAl'
EXPIRES .,-:1 PHONE
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF UNIT'" ZONING CODE:
OCCY GROUP: CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: 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 Slto Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
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
placement.
o Underground Plumbing - Prior
to filling trench,
O Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
b"Sanltary 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.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtai n permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After Installation.
o Insert - After fireplace approve,1
and Installation of unit.
o Curbcut & Approach - After
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 St~eet Trees - 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.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
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
porches, skirting, decks, and
venting have been Installed.
Lot faces
L~I~_
LOI SQ. Itg.
Interior
Lot coverage
Corner
Topography
Total height
"
Panhandle
Cul-de-sac
.,'. :~..i~'~'~'f:~~'
.
,
Setbacks
P.L. HSE GAR ACC'
N
Is
IS THE PROPOSED WORK tN THE _
'HISTOI'lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
W
E
APPROVE!""
BUILDING PERMIT ':1 '~t
ITEM SQ. FT. X $/SQ. FT. = VALUE
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Tolal Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
Systems Development Charge Is due on all undeveloped
properties within Ihe Clly limits which are being Improved.
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath(s) N'
Sanitary S~wer FT. Go",
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge :2. -r/2.tJ
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk It
Curbcul ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
. .....", '}
BUILDING vALOE, 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 Sprlnglleld, including the
Development Code, regulating the construction and use of
oulldlngs, 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
ADDITIONAL COMMENTS
FEE
4/'J ,a-o
-;0..0
- ~
_41f,
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 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 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 located at the fr:
of the property, and Ihe approved set of pia I
on the site a In co
\ , ~
Slgnatur"" ~ _" _ -::.......,
Da'o~
~- ~~--~/
VALIDATION:
RECEIPT NUMBER 2 <7 -1 ~ h
DATE PAID 4~0/9~
AMOUNT RECEIVED 4~ ?- t?
/~
RECEIVED BY
,