HomeMy WebLinkAboutPermit Building 1994-12-9 (2)
SPRINGFIELD
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LOCATI~N OF PROP9A,E~WORK: < ~QBt 0 1)>\ n\rt D \)x1~
ASSESSORhMJt \ 'C:O'd" a~cC'r) .. \. \ TAX LOT:\llo f'I'fJ..CX')
LOT' ..:. ""'t\ BLOCI". SUBDIVISION\ J::~\"'l.. 1(\5> f'\ G~:
OWNE~' cJ\'C\ Cl.~of\ t 1\.1:0 (\\~Q J) ~~(\~HONE: t \'-\4i . \d-1l()lo
ADDRE~: BJY ~?~t) -,\3,() fYi \ '- f)ho 0 ,t-,
CITY:U\\)\ ~ r\ l ~. (j (V - STATE: :~.) 0 rz~f\
DESCRIBE WORK: ~ f\~^ Q., ~() N\lV L, \_~O t\\cl Q~
NEW Y REMODEL ~ADDITION.. DEM~ISH
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Olllce: 726.3759 .
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OTHER
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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ZIP:
01" ,7')
CONTRACT~'~ NAM~ C J' ADDRESS.
GENERAI.I..)'l'D J.( \ 01\ C I\t\.. ..
PLUMBIN; ~}[(\ Q rt. \ b ~ ~O 0 \
MECHANIr-!,.fuL.\C'\Of\ rN-l. .
ELECTRICA;\' cA\ \ 0 A Y ~ oM~ (' J
CON ST.
CONTRACTOR *
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QUAD.!,-REA: ~s.,~ /
* OF BLDGS' \
OCCY GROUP', ~ ~ -\ lv\
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9 -"
. OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE: \ \ \ \
* OF UNITS: \. ,
CONSTR. TYPE:-4L.JV
HEAT SOURCE: \ ~
f_
RANGE:
EXPIRES
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q. \.C\,
tj:\Q..
Q4
FLOOD PLAIN'
ZONING CODE: J.1:)\2-.,
. OF BDRMS: ~
SECONDARY HEAT:
SQUARE FOOTAGE: ~
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requesled belore 7:00 a.m. will be
made the sama working day. Inspactlons requasted after 7:00 a.m. will be made the following work day.
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REQUIRED INSPECTIONS
r'i7'I R~ugh M.echanlcal ~ Prior to
1...0.4. cover.
D Temporary Electric
D Site Inspoctlon - To be made
alter excavation, but prior to
setting forms.
D Undorslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
r<VI Footing - After lrenches ara
~ excavated.
D Masonry - Steel 'location, bond
.beams. grouting.
~Foundatlon - After forms are
erected. but, prior to'concrete
placement.
D Underground PlumbIng - Prior
to filling trench.
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~ Underfloor Plumbing/Mechanical
- Prior to Insulation or deckIng.
rD Post and Beam - Prior to floor
~ Insulation or dacklng.
(gJ Floor Insulation - Prior to
dacklng.
fV1 Sanllary Sewer - Prior 10 filling
L..O.l trench. .
~ Storm Sewer - Prior to filling
trench.
~ Water Line - Prior to filling
L..Cl..trench.
~ Rough Plumbing - Prior to
CJ cover.
~ Roug.ti .Elaclrlcal - Prior to
~ cover.
C2l Elaclrlcal Servlca - Must ba
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
. ~ Wall/C'elllng Insulation - Prior to
cover.
rzLDryWall - Prior to taping.
D Wood Stove - After Installation.
D Insert - After lIra place approval
and Inslallatlon of unit.
IL9 Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
gj, Sidewalk & Driveway - Arter
excavation Is complete, forms
and sub-basa material In place.
D Fence - When completed.
D Street Trooo - When all required
trees Bre planted.
~Flnal Plumbing - When all
- plumbing Work Is complet.a.
~ Final Electrical - When all
. electrical work Is complete.
@'Flnal Mechanical - When all
mechanical work Is complete.
r.::t1 Flnsl Building - Whan all
l..2:"1'"-requlred Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocKing Is com pi eta.
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 the home Is connected to
the service panel.
D FInal - After all required
Inspections are approved and
porches, skirting. decks, and
venting have been Installed.
....
Lot faces
Lot sq. Itg.
Lot covaraga
Topogrephy
Tolal height
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BUILDING PERMIT
l1~T:
~lcO
ITEM
Main
Garage
Carport
Total Valua
Building Parmll Fee
State Surcharga
Total Fee
.,
,~;,!, \'j,'
". ~".:.I
Lol Type .
X Interior
,.~'
I'P.L.
:' IN
Is
Corner
Panhandle
Cul-deoOsac
W
E
X $/SQ~
&.OJ
/4.f0
:~
~?;~
10:41+ ~
(A) ~{)lo.q'J.- '
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) $.1.~f"8, '7/
PLUMBING PERMIT
ITEM
Flxluras
Rasldanllal Bath(s)
Sanitary Sawer
Water
Slorm Sawer
Mobile Home
Plumbing Parmlt
Stata Surcharge
Total Charge
FEE
~
flpQ.CD
FT.
FT.
FT.
0/\ /(oo.OO
4.ClU f- P; .CD
(C) /7 Z. 'i?c)
MECHANICAL PERMIT
Furnace
Exhaual Hood. 4.ro
Vent Fan N' ~ ~.CC>
.
Wood Stove/lnsert/Flreplaca Unit
Dryar Vant .r':2,.OO
Mechanical Parmlt / (0 ,SU
Issuance /0.00
State Surcharge ,50\ .f3~
Total Permit (D) 8.2S3
MISCELLANEOUS PERMITS
Mobile Home
Stata issuanca
I Stale Surcharga
Sldewelk ~ It ~()$B
Curbcut It 13. I
;':::"~~~ - \':) ,0:>
,H\ t\. ~l)qJ.
Totel Mlscellanaous Permits (E)
TOTAL AMOUNT DUE (excluding alectrlca~':2,C). '8 0
(A, B, C, D, and E Combined) .
"f' ..:":;:"'~;\~:~I
Sat becks . ....
HSE GAR Acc:1
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'(.THEPROPOSED WORK.IN THE. .
....HISTOIOlICAL DISTRICT, OR ON
THE HISlORICAL REGISTER?
If yas, this application musl be signed
and approvad by the Historical
Coordinator prior to permit Issuance.
APPROVFn. .
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
, This parmltls granted on the exprass condition that the said
construction shail,ln all respects, conform to the Ordinance
adopted by tha City .of Sprlngflald, Including tha
Devalopment Code, regulating lha construction and use of
buildings, and may be suspended or revokad at any time
, upon violation of any provisions of said ordinances.
Plan Chack Fea: '\~\t-\ J ./
Data Paid: oJ ~
Recalpl Numberu Y
Racelved BY:~'
~s:\\~'~,Lili
f). \~.<#
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Date
Systems Davalopment Charga Is due on all undevaloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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By signature, I stale and agrae, that I have carefully examined
lhe complated appllcallon 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 accordanca
with lhe Ordlnancus of the City of Springfield, and the Laws
of the State of Oregon pertaining to lha work dascrlbed
hareln, and that NO OCCUPANCY will ba made of any
struclura without permiSSion of tha Building Salaly Division.
I further cartify thal'only conlractors and employaes who
are In compliance with ORS 701.055 will ba used on this
project.
I further agree to ensure that all required Inspections are
raquasted at the proper time; thai each address Is readable
from the straat, that the perrrill card Is locatad attha' fr~nt
I
of lha proparty. and the approved set of I ns will remain
Eo"'""", '~1;j '"n.' """
ature J' ~f '
ale
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VALIDATION: i
RECEIPT NUMBER . 15'71 - .
',1'1 ~
DATE PAID l-1.. .q. .
AMOUNT RECEI\lE~d . blp
RECEIVED BY ( @Jltl_ )
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