HomeMy WebLinkAboutPermit Building 1993-12-9
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
/
LOCATION OF PROPOSEO WORK'
ASSESSORS MAP:
LOT'
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SPRINGFIELD
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33
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BLOCK:
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OWNER'
AOORESS:
CITY'
Aile.-
STAT~'
Of.
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
f:.3~
SUBDIVISION:
PHONF'
rfLJ(P - Cf9IPO
ZIP'
971./7'7
OESCRIBE WORK' JNSrA i-.L
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NEW
REMOOEL
,/' AODITION
CONTRACTOR'S NAME
GENERA' '
OEMOLlSH
OTHER
AOORESS
CONST,
CONTRACTOR'
EXPIRES
PHONE
PLUMBING'
fI () tn. .1...1 "'M s+
MECHANICAL~u$!;55 W. \ ~qe.m,Cj1IiD;)
, I
ELECTRICA" C. ( ') P?'~t'-___
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()oc/uo
4.J,.71Lt./ ~ t/.J. -gID/
,
- OFFICE USE -
OUAO AREA: 5 LANO USE: FLOOO PLAIN'
. OF BLOGS' . OF UNITS' ZONING COOE:
OCCY GROUP: CONSTR. TYPE: . OF BORMS'
. OF STORIES' HEAT SOURCE: SECONOARY HEAT:
WATER HEATER' RANG~' SQUARE FOOTAGE:
To request an inspectton, 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
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/Electricall
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
Underfloor Plumbing/Mechanical
_ Prior to insulation or decking.
o Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prlor to
decking.
o Sanitary 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
"J"";(l' Rough Mechanical - Prior to
~over.
.r-71 Rough Electrical - Prior to
~ovor.
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 Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o
Wood Stove - After installation.
o Insert - After fireplace approval
and installation of unit.
o
Curbcut & Approach - After
forms arc erected IJut prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub.base material in place.
D Fence - When completed.
11 Street Trees - When all required
trees arc planted.
o Final Plumbing - When all
plumbing work Is complete,
~ Final Electrical - When all
~Iectrlcal work is complete.
~ Final Mechanical - When all
~meChanical work Is complete.
o Final Building - When all
required inspections have been
approved and building is
completed.
DOlher
MOBILE HOME INSPECTIONS
o 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
venting have been installed.
Lot faces
Lot Type .
Lot sq, flg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT,
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
I P.L.
N
S
Iw
IE
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
Water
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace If. j/.
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
DemolItion
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
/nM/.1
/~"o
/ t) Q()
?J
75;. 7r
?S,- 7J-
Setbacks
HSEIGAR Accl
I
'THE PROPOSEO 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.
APPROVEO'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Ttlis permit is granted on the express conditlon that the said
construction shall, i,n 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'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
'11'f:c7~ ,cU.~7e/~ ;t:1/N'/7/,- T
) t!- ,,(lGtfY//--ee:L
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 OAS 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 15 located at the front
of the property, and the approved set 07PI ns will remam
on the site at all 'm s durin constructi .
. ~Signature
Datf'
/2-.. '1-73
VALlOATlON:
RECEtPT NUMBER
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/2- -1 -j' J
2. 5", 7">
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OATE PAlO
AMOUNT RECEIVEn
RECEIVEO BY