HomeMy WebLinkAboutPermit Miscellaneous 1996-4-22
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
..
SPRINGFIELD
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP'
LOT'
OWNER' 51.1.JIIP_
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BLOCK'
G'rlf'+llA 11 MAr K
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Conrad
ADDRESS'
CITY'
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STATC,
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JOB NUMBER ~.:::::> ~
225 Fifth Street
Springfield.. Oregon 97477
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TAX LOT' ~< <.0/
SUBDIVISION:
PHONC'
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ZIP'
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OESCRIBE WORK:/n-,?7-4/~
NEW REMODEL
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ADDITION DEMOLISH OTHER
CONTRACTOR'~E
GENERAl' ..- Ko Th s
CONST.
C ADDRES~ ~~e:;-8~~NT~ACTOR .
6-YJ. CT-?/"ow "7?V'::>~ . 1)53 cl.. I
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PHONE
,4 <f-218'f
PLUMBING'
MECHANICAl'
ELECTRICAl'
EXPIRES -.
Y -2X'- Ciro
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BORMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER' HEATER: RANGF' SQUARE FOOTAGE: _
To request ~n InspectIon, you must call 726-3769. This Is a 24 hour recording. Alllnspecllons requested before 7:00 a.m. will be
made the same working day. Inspections rCQue~ted after 7:00 a.m. will be made tho followIng work day.
REQUIRED INSPECTIONS
o Temporary ElectrIc
O Site Inspection - To be made
after excavation, but prior to
settln,g forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
[Z] Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor PlumbIng/Mechanical
- Prior to Insulation or decking.
o Post and 8eam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decKing. .
"
o Sanitary Sower - Prlof 10 filling
trench.
o Storm Sewer - Prior to filling
trench.
O Water Line - Pflor to filling
trench.
D Rough PlumbIng, - Prior to
cover.
o Rough MechanIcal - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to laplng.
o Wood Stovo - After Installation.
D 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 - "Vhen completed.
D Stroot Troos - When all required
trees are planted.
o Final Plumbing - When all
plumbing worl< Is complete.
. .
D Final Eleclrlcal - When all
electrical work ,IS complete,
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When ell
blocking Is complete.
o Plumbing Connections - Wilen
home Ilas been connected 10
waler and sower.
o Electrical Connection - When
blocKing. sel.up. and plumbing
Inspections have been approved
and the home Is connected to
the servIce panel.
o Final - After all fequlred
. Inspections are approved and
porches, sklrllng, decks, and
venting have been Installed.
'~
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SO. FT.
. Main
Garage
Carport
"
,
TOlal Value
Building Permi I Fee
State Surcharge
Total Fcc
Lol ~YP.
Interior
Corner
Panhandle
Cul.de.sac
,
X $/SQ. FT. =
,-_.-
."! " ::. ,-' \;;:: ;~(H :~~~.
.IS THE PROPOSED WORK iN THE.
....HISTOJ:lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcallon must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
I P.L.
IN
Is
\W
-I E
Setbacks
HSE GAR'ACcl
I
I
.1
I' "
VALUE
"
/l ~",
d~~~
.,..~ . .d'_
~'9: '9'''3
(B)
TOTAL AMOUNT DUE (excluding electrical)
(A. B. C. D. and E Combined)
N'
FT.
FT.
FT.
(e)
Dryer Vent
Wood StovellnserllFlreplace Unit
N'
Vent Fan
Mechanical PermIt
Issuance
State Surcharge
Totaf Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Balh(s) ..
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
Slato Surcharge
Tolal Charge
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Curbcul
It
Oemolillon
Slate Surcharge
Total Miscellaneous Permits (E)
~
FEE
APPROVED:
. ,.).:; of
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permltl.s granted on the express condltlo~ thai the said
construcllon shall, In all respects, confofm to the Ordinance
adopted by the Clty.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 any ~r~~lsions of said ordInances.
P-Ian-Check F.ee:
. ", .' -
"
Date Paid:
Recelpl Number:
Received By:
"
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stato and agree, that I have carefully examined
the completed appllcallon and do hefeby 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 peftalnlng to the work described
herein, and thai 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
pro/ecl.
I further agree to ensure that all required Inspectlons 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 sel of plans will remain
on the site at all t es during .c~n(s:;72 ' #
Signature ./, v ~
. (j
LJ--d.,~ -90
Date
VALIDATION:
RECEIPT NUMBER :2/2'2 ;;-
l./_ :?-:?_~
AMOUNT RECEIVED q;s:. Cf':3
/7.. -~'I'
DATE PAID
RECEIVED .BY
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