HomeMy WebLinkAboutPermit Miscellaneous 1994-11-10
RESIDENTIAL
PERMIT APPLICATION
~.
Inspections: 726.3769
Office: 726,3759
LOCATION OF PROPOSED W,QRp: /4q ~
ASSESSORS MAP: '\ 0()-:'J:;j. 4-~, ~
LOT:
BLOCK:
OWNER:\.J~~~ \'1\)\\\\0_
ADDR~<"\,~.\40: ~ llD \~~~<)f
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DESCRIBE WORK: \ r\f\-\r'\ \ ~\ ~ ' \
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
\
PLUMBING' f\ \1\ 1\ r7 )
MECHANICAL' \.1)\ 1')\ ~
ELECTRICAl'
i\l \ ~ ~fJY\ ZIP:
N~0 (WJ:\\\J\Q 1\1 ~
DEM~L1SH OTHE~
STATE: .
ADDITION
.
JOB NUMBER q 4~n.~)
225 Flflh Street
Sprlnglleld, Oregon 97477
TAX .LOT:
SUBDIVISION'
OLoO{)()
. PHONE:
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ADDRESS
CON ST.
CONTRACTOR'
PHONE
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o 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.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior 10
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approvlIl
and Installation of unit.
o
Curbcut & Approach - After
forms are erected but prior 10
placement of concrete.
EXPIRES
,
- OFFICE USE - ....
QUAD AREA' LAND USE: FLOOD PLAtN'
. OF BLDGS: . OF UNITS: ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE' SECONDARY HEAT:
WATER HEATER' RANGF' SQUARE FOOTAGE:
To request an Inspectll)n, you must call 726-3769. This Is a 24 hour recording. All Inspections requested bofore 7:00 a.m. will be
made the same working day, Inspectlons requested aHer 7;00 a,m. will be made tho following work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, bul prior to
setting forms.
o Underslab Plumbing/Electrical!
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel locatlon, bond
beams, groutlny.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to IIIl1ng 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
decking.
o Sanllary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water line - PrIor to filling
Irench.
o Rough Plumbing - Prior to
cover.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
o Slroot Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing w9rk Is complet,e.
D Final Eleclrlcal - 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.
MOBILE HOME INSPECTIONS
....
'. ,
o Blocking and Set-Up ~ Wh,en all
blocking Is complete. ,
" .
o
Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Conneclion - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
t he service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and'
venting have been Installed.
Lot ~yp_ \~. . .'
,'..
Lot faces
Lot sq. fig. Interior I'P.L.
IN
Lot coverage Corner
Is
Topography Panhandle
~ Iw
Total height Cul-de-sac IE
.,',,"
.r'; :~.J~~.;\f~i'
~S'THEPROPOSED 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.
Setbacks .
. HSE . GAR' Acc'l
BUILDING PERMIT
ITEM SQ. FT. X $/S{}. FT. ~ VALUE
MaIn
Garage
Carport
"
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N'
Sanllary 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/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
c1<:}.&).00
J () 00
/.:JO
r5)(O .~O
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slate Surcharge
Sidewalk
II
Curbcut
II
Demolition
State Surcharge
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
c!11{) . 'l[)
I
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perm II Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the Clly.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
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 theOrdlnanc~s 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 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 front
of the property, and the approved set of plans will remain
on the~lt~~~~2.2onS~~
SlgnatWD~ 4~ ~(7"
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Dat( \ II-in-CfL(
VALIDATION: \ c...../L "'l!\
RECEIPT NUMBER ' )\.' 1 )
DATE PAIf' 1(, I!) .q.q .
AMOUNT REC3tVtf' _,,') I (j , rxJ
RECEIVED Bf ~ '
,