HomeMy WebLinkAboutPermit Building 1994-2-22 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: :l..5 ~..,.
ASSESSORS MAP:-L'7-0.....- ~- 4 - 4-
LOT:
.
q~\\lo
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
0t.M A. c:::...
J
S'P~O .
TAX LOT:
I ~ "7'
BLOCK:
OWNER: O"'__~l
ADDRESS: ----2-#5 ~
CITY: S?FO.
L.. IU..~
Ot)~c:,
STAT~'
Oc:l
DESCRIBE WORK: r"'N<:"'~~J-r A.. N.~"'V ..,.. MIL-.....
NEW REMODEL v"'" ADDITION V' DEMOLISH
CONTRACTOR'S NAME
SUBDIVISION: ~Oa...-T\o(...""'^"'>t? 0:: ....~ '
PHONE: ~c.. - (,,:c.^O
ZIP: ct7 +7''''
~ 1'2"" ~Ql-no~ ..,...
1Z.~P\l..\.,... <:)~ ~... ~"\J!. _
OTHER
ADDRESS
CONST.
CONTRACTOR'
PHONE
,?,~-3~
EXPIRES
flO.
PLUMBING'
GENERAL: .9'f'11S'~ KtL1..&a. ~c:"T. ,--."X:> ~~,.( 9oEUr:-(:'"
,
MECHANICAl'
ELECTRICAl'
QUAD AREA:<}.t:SQJ\ )LU
. OF BLDGS' I
OCCY GROUP: f{ 3
I
. OF STORIES:
WATER HEATER'
- OFFICE USE -
LAND USE: _I I / I
. OF UNITS: I I
CONSTR. TYPE: 1I AI
HEAT SOURCE:
RANGF'
FLOOD PLAIN'
ZONING CODE:--.L&-
. OF BDRMS:
SECONDARY HEAT:
SQUtR~rn-f~ _/ (.0(')
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.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
l2S:t 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.
129. Underfloor Plumbingl Mechanical
- Prior to insulation or decking.
~ Post and Beam - Prior to floor
Insulation or decking.
~Floor Insulation - Prior to
lL:.( decking.
o Sanitary Sewer - Prior to fjlljng
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
~ Rough Plumbing - Prior to
t",L-J' cover.
REQUIRED INSPECTIONS
IVf Rough Mechanical - Prior to
~ cover.
f'::/1' Rough Electrical - Prior to
~ cover.
~ Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
l3 Framing - p;~ cover.
r')(T Wall I Ceiling Insulation -
7L->' cover. , .
~ Drywall - Prior to taping.
D Wood Stove - After installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place.
o Fence - When ~ompleted.
o Street Trees - When all required
trees are planted. .
rlor to
r"7I Final Plumbing - When all
l.L::i plumbing work Is complete.
~ Final Electrical - When all
electrical work Is complete.
I':A Final Mechanical - When all
I.,..C::I mechanical work is complete.
rV1 Final Building - When all
~ required Inspections have been
approved and building is
completed.
o Other
o Blocking an ~Up - When all
blocking Is compTE!'te. "
o Plumbing Connections - 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.
D Final - After all required
Inspections are approved and
" porches, skirting, de"cks, and
venting have been Installed.
Lot faces
Lot sq. ftg.
Lot coverage
Topography 171f-
Total height" 11- \
~31.o' . ).
BUILDING PERMIT
so. FT.
Jj JJn
ITEM
Main
Garage
Lot TY.
.J Interior
Corner
Panhandle
Cul-de.sac
. IS THE PROPOSED 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.
I P.L.
IN
Is
Iw
IE
Setb~cks
'HSE GAR'ACCI
I
I
I
I.
X $/SO. FT. ~ VALUE
"c:J/ 0 . 'db l?fHa.
Carport .
V Q 1Y\rr1P~ --L::O- &9,.10 -4A \ ~
1~{)'7
/ .'
J"I.{ ,~
S:. '203
/It)<t . 73
SYSTEMS DEVELOPMENT CHARGE (SDC)
....t:9-
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(A)
(B)
I
N'
FT.
FT.
FT.
(C)
Wood StovellnsertfFlreplace Unit
N'
Dryer Vent
-Due -r Ev.rg"Tl/>-N
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home .-
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
FEE
/5.DO
15.no
.71;
15,75
15.15'"
'5.~"
/d,OO
.7>
7,.5_ 75'
/51.2.'2,
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit.ls 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, regUlating the construction and use of
buildings, and may be suspended or revoked.at any time
upon violation of cry prMSiO~'., id ordinances.
Plan Check Fee:~t I J .
...::.-g
Date Paid: .' ,
Receipt NumbeT~'I,~
Re:;red By: ~ (/j( 1 ~ )
~ J m'lA rf/A.
. . Or--.D
prans Reviewea By /
'Z...-/o-"i Y
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 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 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 site at all times urlng consl~.ructlo ,
Signatur~ j , ~ ./
F"~.h. 'J.'A -~
Date
VALIDATION:
RECEIPT NUMBER ;/ /' ,? Y
Q -..:('2."'7 '7
/9/. :2;3
~~
'/
DATE PAin
AMOUNT RECEIVED
RECEIVED BY
...