HomeMy WebLinkAboutPermit Miscellaneous 1997-2-3
OWNER: ~ ~ev;f\c:\\1\.llU'lfL- \\1\Nl.\&'
ADDRES~'C\ \ \ aID \.Ji\rose. A~
CITY: -,q.J~. ~ . STATE: f.),\ Q '0,tr{'\
DESCRIBE WORK' llt1 tvl,41 t ()\n r' Q ,
NEW REMOD~ 1fDDIT~N DEMOLISH
RESIDENTIAL
PERMIT APPLICATION
'-e
Inspections: 726.3769
Office: 726.3759
LOT:
SPRINGFIELD
BLOCK:
OTHER
. CG~
JOB NUMBER en D2.Ol
225 Fillh Street
Springfield, Oregon 97477
12./
TAX LOT:
m\nl
SUBDIVISION'
PHONEI4\~ l\()?-
_ ZIP:
{.\14-17
ADDRESS
CON ST.
CONTRACTOR'
PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANIC~~ o{Wf- ~r~}
ELECTRICA' '
QUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER:
EXPIRES
'1 '1 (Pl.1
I D. ~ \L{1 454. 9-brt
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE: _
HEAT SOURCE:
RANGE: _
FLOOD PLAIN:
ZONING CODE:__
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an InspectIon, you must call 726-3769. This Is a 24 hour recordIng. All Inspections requested before 7:00 a,rn. will be
made-the same working day, Inspections requested after 7:00 a,m. will be made the following worl< day.
D Temporary Electric
D
Slle Inspection - To be made
after excavation, but prior to
setting forms.
D
Underslnb Plumbing I Electrical f
MechanIcal - Prior to cover.
D
Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D
Foundation - After forms are
erected but prior to concrete
placement.
D Un'derground Plumbing - Prior
10 filling trench. .
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or deckIng.
D Floor Insulation - PrIor to
decking.
D Sanitary Sewer - PrIor 10 filling
trench.
. I
o Storm Sewer - PrIor to filling
trench.
D Water Line - Prior 10 filling
trench.
D Rough Plum'blng - Prior to
cover.
REQUIRED INSPECTIONS
~. Rough -M't!chnnlcol - PrIor to
cover. ~
D Rough Electricnl - Prior 10
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - PrIor to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/e'clllng Insulntion - PrIor to
cover.
D Drywall - PrIor to taping.
D Wood Stove - Arter Installatfon.
D Insert - After fireplace approval
and InstallatIon of unit.
D
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is completc. forms
and sub.base material in place.
D
Fence - When completed.
D
Street Treos - When all requIred
trees are planted.
o Final Plumbing - When all
plumbing w~:HI( is complet.c.
D Finnl Electricnl - When all
electrical worl< Is complete.
GC{,O...I
CE(FinOI ~nnlcal- WIlen all
mechanical worl< Is complete.
":
o Final Building - When all
requIred InspectIons have been
approved and building Is
completed.
DOthcr
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Wilen all
btockln~J 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 tile home Is connected to
the service panel.
)
D Final - Arter all required
inspections are approved and
porches, sldrtlng, decks, and
ventIng have been installed.
Lot faces
Lot Type
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
TOlal helghl
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM
SQ. FT.
X $/SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolar Fcc
(A)
.
'..,.
"
.HE PROPOSED WQRK iN THE
. "HISTORIGAL DISTRIGT, OR ON
THE HISTORICAL REGISTER?
If yes. this application must be signed
and approved by the Historical
Coordinator prIor to permit issuance.
I P.L.
IN
Is
\W
IE
Setbacks
IHSEIGAR'ACG'
I
I ~
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential 8ath(s)
N'
Sanitary S~wcr
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
WOOd Stovellnscrtl Fireplace Unit
Dryer Vent
Mechanical Permi I
Issuance
Stale Surcharge --I aCb
Total Permit (0)
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
State Surcharge
Sidewalk
II
Curbcut
II
Damoll lion
~tate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricol)
(A, B, C, 0, ond E Combined)
FEE
f S6.D
IO,vU
__/.ao
~~Q
&if). :Jl)
APPROVED:
BUILDING VALUE, 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 Gily 01 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'
Dote Pold:
Recel pt Number'
Received By:
Plans Reviewed By
Dale
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, 1 state and agree, that I have carefully examined
the completed application and do hereby certHy 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 perlalnlng to the work described
herein. and thai NO OGGUPANGY will be made 01 any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
arc In compliance with OAS 701.055 will be used on this
project.
I further agree lo ensure that all required Inspections are
requested at the proper time, that each address Is readable
from tho 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 ~urir1 c/,struction.
Slgnatur~~d~
'" r:
Dato
VALIDATION: "';\ ;\ \ I~
RECEIPT NUMBER- ra \v
DATE PAID .:J., ~:q 7..
AMOUNT RECE~ -;;;0. ~1D
RECEIVED BY , ) 1 J)'l.,)