HomeMy WebLinkAboutPermit Building 6-9-27
RESID ENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT:
CITY'
DESCRIBE WORK:
NEW
REMODEL
JOB NUMBER r:76~/'9
225 Fi fth Street
Springfield, Oregon 97477
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TAX LOT: ~ ~~/
BLOCK:
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.'"....:.....
SUBDIVISION:
PHONE:
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OWNER: '!/~LCr:./,?~~~Gc~~Y~L?:>
ADDRESS:' /6 '3:::5,' ~'-""~/,~ ~ ,~
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~/::> STATE: . ~.
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{~ %001'
ADDITION
DEMOLISH
OTHER
ZIP:
--:37Y7..8
"
...,:.1
J- ,"I..
caNST.
CONTRACTOR'S NAME. . ADDRE~.7&> ~6'" "z;d~: 'G,?NTRACTOR /I EXPIRES~.. PHONE
GENERAL: .~-~~v~~..,~/~ 4t?, ,.: .~~ ~....//-97 7'?/-r~~
PLUMBING:
MECHANICAL:'
ELECTRICAL:
QUAD AREA:
/I OF BLDGS:
OCCY GROUP:
/I OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE: _
/I OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANG E:
FLOOD PLAIN:
ZONING CODE:
/I OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAG E:
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.
REQUIRED INSPECTIONS
,0 Temporary Electric
o Site Inspection- To be. made
. after excavation, but prior to
selting forms.
o Underslab Plumbingl Electrical'l
Mechanical - Prior to cover.
D 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.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior t9
decki ng. ,t.'
.
o Sanitary Sewer - Prior to fil~.[1f,
trench. -
D
Storm Sewer - Prior to filling
trench.
\, : ""-, ..".... '::":". t,
o Water Line- Prior to fiTling' c
trench. ' ::~_. <, _
." "<~~: 1 _~ :.... \! '~
D Rough Plumbing < ~riqr.;'to c,...'
cove~ ' .
" .,..."';,..
o Rough Mechanical - Prior to
.cover.
D Rough Electrical -: Prior' to
cove~ .
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing -' Prior to. c'over.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stove....,... After Installation.
o Insert - After fireplace approval
. and Installation of unit.
j.' i
'0 Curbcut& 'Approach - After
, forms are erected but prior to
" . '. ,placement of concrete.
'\ ".
o Sidewalk & Drivewav - After
' excavation Is compiete, forms
and sub.base material In place.
o Fence - When completed.
DStreet Trees - Whl;ln all required
, trees are planted. .
o Final Plumbing - When all
, plumbing work Is complete.
o Final Electrical - When all
electrical worl< 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.
CKl Other~~~~~Y'
. N~_ ~~4of~
/""~;/ ., -+7 . ~
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
plocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - After all requir~d
, inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces
Lot Type
Lot,~q:.ttg." "",
Lot coverage
I PL. I
IN
Is
\W
IE':'
Interior
Corner
Topography
Total height
Panhandle
Cul-d,e,sac :,.
BUILDING PERMIT
ITEM
SQ, FT.
X $/SQ, FT.
VA LU E
Main "':
."~ -'.. -
"
,
".,'
Garage
"
Carport, '.' ,
.. -'..
/~~P/~
Total Value
S-~. c:::sl:S
5'6>. So
. ?:1;~:'h
(A) " :~y'._y-.,:;-
SYSTEMS DEVELOPMENT CHARGE (SDC)
Building Permit Fee
State'Surcharge
.......:...1 ,.:' ,
........,
Total'Fee'
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Resid,ential Bath(s)
Sanitary S~wer
Water
NO
FT.
FT.
Storm, Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
.,
,~ -, .
Mei;h'~ni cal;,Permi i
.'-
~t ..... ''\
'-: . <';" '. ..~.,;....' .. ". ,
Issuance ,-
--;, .
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
. ,'". "
. ',' '. .
Setbacks
I I
HSE GAR ACC
ISTHE.PRO,POSED 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.
I c..'
.,,,
AP!.?,80VED:,
. "';' . - .. ~
BUILDING VAUJE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted qn the e~prEtSS .co[ldition~hat the said
" construction 'shall, 'j'n ail:respects, conform to the Ordinance
adopt,ed_ by,the .Ci.tY..'of Springfield, including the
Development Code, regulating the .constru'ction and use of
bui}dings, and may be sus,pended,or revoked at any time
upon violation of any'provisions of said ordinances.
Plan Check Fee: ,.
Date Paid:
Receipt Number:
Received By:
.....~..~.... ~; '.,
.........,
.,
.,:s~~J,,"
.,' '.,..... ......
. . ';;'.
"I'
Plans Reviewed By
Date
Systems' Development Charge is due on all undeveloped
properties within the Citynmits 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 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 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 compliance with ORS 701.055 will be used on this
project.
I further agree '10 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 front
of the property, and the approved set of plans will remain
on the site at all times during construction.
~~hn;~ ~/~,
Date 'I I
" 9 /C)7/7~
VALIDATION:
RECEIPT NUMBER 2... ?~a> /
DATE PAID '"'7 ~~~
AMOUNT RECEIVED :>7,-5":;;-
FIECEIVEQ BY ~~,
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