HomeMy WebLinkAboutPermit Building 1991-4-23
LOCATION OF PROPOS,f.D WORK: _~l? (,fJ .5-
ASSESSORS MAP: \<=6 O~ [)L\(y)
,~
(I~~ 0 -- !.J)IR H
~ ~A <9\ ~ 'CL ~JlSUuT
0\ )f\;{\~ _ STATF. (912--
~ \- . \~J:)ldJLX\["O~
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOT:
OWNER'
ADDRESS:
CITY:
DESC~BrrWORK:
NEW.~ REMODEL
J
CONTRACTOR'S NA~E '/1
GENERAL; Wlrn
, ~
.<' ""J_
LI/lvh
~ //Is
PLUMBING:
MECHANICAL:
ELECTRICAL:
SPRINGFIELD
h P Sufh/.4
/
BLOCK'
'"
ADDITION
DEMOLISH
OTHER
JOB NUMBER
qlQ~~
225 Fi fth Street
Springfield, Oregon 97477
TAX LOT () m \L\. ,
SUBDIVISION: .J.!- m b - LI S
PHON E: --=t:t7 ~ ~7 OJ
C{747R
ZIP:
. CONST.
ADDRESS CONTRACTOR It EX!I~1S
4 T'l S- )I;'(!. .3 2- 9 '/7 (O{UJ/V\\ 7 V 7 'Y 7 & r'
.' .' 4\o\d~ 81\P~q2-Q1~7s-9?:f
"
, & \2>S \ 4 (l.;JJf( 3 t/.3 IL?S-3
PHONE
- OFFICE USE -
QUAD AREA: \~RS.~ LAND USE: \ \ \. \ FLOOD PLAIN'
It OF BLDGS' \ It OF UNITS: . ( ~ONING CODE: CD \2-
OCCY GROUP' \R~-\-\'J\ . CONSTR. TYPE: V'f\} It OF BDRMS' ~
It OF STORIES:' \ HEAT SOURCE: W\-\ SECONDARY HEAT: '"
WATER HEATER: L/ RANG~' 'F~ SQUARE FOOTAGE: \ l~o \ t12J
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.
~e~porary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
M Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting.
~ ,
~ Foundation - After forms are
~erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
~Underfloor Plumbing/Mechanical
AJ - Prior to insulation or decking.
~ Post and Beam - Prior to floor
JaJ insulation or decking.
~Floor Insulation - Pr.ior to
~decklng.
~san~tary Sewer - Prior to filling
~ trench.
1"Vr'Storm Sewer - Prior to filling
~ trench.
~ Water Line - Prior to filling
~ trench.
~ Rough Plumbing - Prior to
~ cover.
REQUIRED INSPECTIONS
~. Rough Mechanic'a!' -: Prior to
~ cover. ,
~ Rough Electrical -' Prior to
~ cover.
,
~ Electrical Service"":: Must be
~approved to obtainp,ermanent
electrical power.' ,
o Fireplace - Prior to facing
materials and framing Insp.
~'Framing - Prior to cover.
~ .'(
l"'oo.A' Wall/Ceiling Insul~ti~n -;- Prior 'to
~cover.
",
~ Drywall - Prior, t~. ta~'n.g'.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
~ Curbcut & Approach"""" 'After
forms are erected but prior .to
placement of concr.ete. ·
P<[' ,
Sidewalk & Driveway - After
...excavation is complete, forms
and sub-base material in place.
o Fence'- When completed.
~Street Trees - When ~,; r:qUired.'
V1trees are planted. '. . ~ '
f';2( Final Plumbing - When all
JL-:> plumbing work is complete.
~ Final Electrical - When all
~ electrical work is complete.
~ Final Mechanical - When all
~ mechanical work is complete.
I~ 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.
D Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbillg
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 Ty Setbacks IS THE PROPOSED WORK IN THE
Jlnterior I P.L. HSE GAR ACC I HISTORICAL OISTRI01', OF! ON
Lot sq. ftg. IN I THE HISTORIOAL R~GI~T~A?_ .__
Lot cO'I(~rage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height Cul-de-sac IE I
APPROVED:
BUILDING PERMIT
so. FT.
\\rJlo
M'D
ITEM
X $/SO. FT.
2Y\ .1)
\4 . \()
- VALUE
4lollo~f}
~
Main
Garage
Carport
Total Value
I
Building Permit Fee
~12ffi t
292 ~
, -I. ,c
;3t>& .~o
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) m. '7
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 City of Springfield, includin~J the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at an:r time
upon violation of any provisions of said ordinances.
( 9-P\ . tp.{)
~
Plan Check Fee:
Date Paid:
~
"
Receipt Number'
Rece~~
p~~~?~
~-/9-f/
Date
Systems Developm~nt Charge is due on a(.l undeveloped
properties within tre City limits which are being improved.
PLUMBING PERMIT ADDITIONAL \~OMMENTS
ITEM FEE
Fixtures
Residential Bath(s) NO 2- /~O.fXJ
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge J?O
Total Ch2,rge (C) /6$ .fN'
MECHANICAL PERMIT
Furnace
Exhaust Hood
4- 5"'1)
?,6.
:J .Q
Vent Fan
NO
?-
Wood Stove/Insert/Fireplace Ur'it
Dryer Vent
Mechanical Permit'
ht/IO,
/5/JO
//) (J D
+; 7. 1"
u; ,2-r
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance,
State Surcharge
Sidewalk 6? '2- ft
Curbcut' 2Irf ft
Demolition
), ~D
l?'.~{)
Sta~:charge (\
\ V \(f)J\ , ,,~~
Total Miscellaneous permlD ~ (E)
~CJ.ro
.... - . ~ -
io J tQ.t]Q.
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
.'-...' -
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 .:my
structure without permission of the Building Safety Divi~;ion,
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 inspectio,ns 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 ~:~ dU~ construction.
Signature ~/i,../-t"
Date ~ tty/ ~/71
j/
VALIDATION: ".:) A
RECEIPT NUMBER ( , ~.;;:Jj
DATE PAID 4 . L..?) .0\ .
AMOUNT RECEIV~~ J ' ~ '& \ . ~
RECEIVED BY r;r\ {~~) ,