HomeMy WebLinkAboutPermit Building 1999-4-30
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RESiDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ortlce: 726.3759
ASSESSORS MAP'
LOT'
SPRINGFIELD
,
BLOCK'
STATE: ~P...
-
JOB NUMBER Cjt:! ()S"8-7
225 Fifth Street
Springfield, Oregon 97477
TAX LOT' 007..0()
SUBDIVISION'
PHONE:
'7%- 091-S-
ZIP: Q?L/'7R
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES '.~ PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL: thA~U,~ 4/10 D/~mpi~~q?'f1X' 1f":J5?9()
- OFFICE USE -
ATTENTION'O're "
f.oJJoW rules !Icl~~ g~law re9uires vnw"
Notitication CIi!~er~J.~he ,?regon Utility
'1/ UflH 952-Q01-QQ.l n th;:;'- ';J,v"" a... ..t:I1 ronh
11090,. You maycc,SHT.R' TY~!i~ OAR ll'i?-001
calling the llffitU~~S ot the rules by
numoer tor the 0 '. !.o """,,"une
. C tJ'l~ v,w.son Utlilly NotificRtiM
en 6r~j.'g0ll-332'2344\ .
ELECTRICA' .
QUAD AREA:
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER'
~~~'7~~'
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SOUARE FOOTAGE:
To request an Inspection, you must call 726-3769. ThIs Is a 24 hour recording. All Inspections requested before 7;00 3.m. will be
made the same working day. Inspections requested after 7:00 a.m. will be made the following work day.
REQUiRED INSPECTIONS
o Temporary Electric
D Site Inspoctlon - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
/
o Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected-but prior to concrete
placemont.
o Underground Plumbing - Prior
to filling 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
deckl ng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
~. ugh Plumbing - Prior to
o~~ri.:
.jot'.:. ..;. ". . ~ .' . ~
,
r/-.'"
"
o Rough Mechanical - Prior to
cover. " '
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
(0 --;;Ja' Plumbing - When all
~mblng wt;>rk Is complet.e.
D Final Electrical - When all
electrical work Is complete.
r~a' Mechanical - When all
~echanlcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Framing - Prior to cover. @t rf:~'..'
O her 'I cl 1')"""",/
/ I
o Wail/Ceiling Insulation -,Prior to
cover.
o Fireplace - Prior to facing
materials and framing Insp.
o Drywall - Prior to t~plng.
. '"
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installallon of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement ot concrete.
o Sidewalk & Driveway - After
excavation Is completo, forms
and sub-base material In place.
c;::J Fence - "'..,hen cOiy'pleted.
D Street Trees - When all required
trees are planted.
MOBILE HOME INSPECTIONS
o Blocking and Set. Up - When all
blocking Is complete.
o PlumbIng Connoctlons - '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 .
Interior
I PL.
IN
Lot SQ. flg.
. '
Lot coverage
Corner
Topography
Total height
,.
Panhandle
S
Cul.de.sac
W
IE
.;
BUILDING PERMIT
ITEM SQ. FT.
'f
.,
X S/SQ. FT. -
VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Ir
Fixtures
Residential Beth(s)
/'..
Spnltary S~wer
Water
N'
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
I) ~
'rr' f 7J
It, hi
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven I Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
64-( ~/
I.
Mechanical. Permit
I f',o...>
Issuance
lih ();>
<61'"'" 7)'
:2-C;.LA
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcul
fl
Demollllon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
:,,- '...: :."~,;I~ \'
. \.\
I~E PROPOSED WORK trl THc:'~,
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'
I
I
"I
I'
APPROVED'
. . , 'I
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, Including the
Development Code, regulallng the construcllon and use of
buildings, and may be suspended or revoked at any lime
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
. Date
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
I
Va. \U e'_
t I ~ 66.00
By signature, I state and agree, that I have carefully examined
the completed appllcallon and do hereby cerllfy 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 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.al'lhe'prope,,'lIme/that9ach-address.ls readable
from ttie street. that the permit card Is located at the front
of the properly, and the approved set of plans will remain
on the site at all times during construction.
Signature ~l-~() ~PPt40/l N-
Date Ld..,c; fOUl
I~ .
VALIDATION:
RECEIPT NUMBEf (J 3 ~ 7 (.,. (
DATE PAir, '-I / ~4 7'7
AMOUNT RECEIVED '-{2 ~ l( () /
RECEIVE~ BY tJ/ tJ~