HomeMy WebLinkAboutPermit Building 1995-8-29
OWNER' r:- \(,\-\1'\tL ~ ~\.\\.o..RCec..; b '\LB="<;tN,
ADDRESS' 9l S ~I L(>,~ 'n!w-,;;
CITY: c,p1Z-\ ,'x;, C'\ 8M, ('f.. '1l4-l'iS' STATE: n l2-
DESCRIBE WORK /9'~~~ r~<lI"?'/-/-'r~~,YI~~~ ~~.::=:s9"~
NEW REMODEL ~ ADDITION DEMOLISH OTHER
T J.:,
;"'RESIDENTlAL .
PERMIT APPLICATION
Inspections: 726.3769
Iffice: 726.3759
LOCATION OF PROPOSED WORK:
/ CoD 2.
ASSESSORS MAP'
LOT:
.
SPRINGFIELD I ,I.
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JOB NUMBER
225 Flllh Street
Springfield, Oregon 97477
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TAX LOT:
SUBDIVISION'
6-D2..e:, /
BLOCK'
PHONE:..:l..Y 1- DIrLJ.5
ZIP:
"71l.J-"') 'i'
CONTRACTOR'S NAME
GENERAl' O/L.!..,nk
PLUMBING:
MECHANICAL:
ELECTRICAL:
f
rl'Q 1ft J i;>-y,
........ . - -
ADDRESS
CONST,
CONTFjACTOR .
EXPIRES
PHONE
QUAD AREA: .-51<5 C-
. OF BLDGS:
OCCY GROUP'
. OF STORIES: _.
WATER HEATER:
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you musl call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the sanlc working day. Inspections requested aftor 7:00 a.m. will be made tho following work day.
o Tomporary Eloctrlc
D Silo Inspection - To be mado
after excavallon, but prior to
setting forms.
o Underslab Plumbing/ Electrica"
Mechanical - Prior to cover.
D Fooling - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - Afler forms are
erected but prIor to concrete
placemont.
o Underground Plumbing - Prior
to fllllnQ trench,
o
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D
Post and Bea~ - Prior to tloor
Insulation or deckIng. .
D Floor Insulation - Prior to
decking. .
D Sanitary Sower - Prior 10 filling
trench.
o Storm Sewer - Prior 10 filling
trench.
o
Water Line - Prior 10 filling
trench.
D
Rough Plumblng- - Prior 10
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Eloclrl.cal - Prior to
cover. .
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Fram.lng - Prior to cover.
.0 Wail/Ceiling Insulation - Prior to
cover. .
o Drywall - Prior to laplng,
o Wood Stovo - Aller Installation.
o Insert - After fireplace approv41
and Installation of unit.
o Curbcut & Approach - After
forms are erected bUI prior to
placemont of concrele.
D Sidewalk & Driveway - Afler
excavation Is compietc, forms
and sub.base material In place.
o Fence - When com~leted.
D Street Trees ~ When all required
trees are planted. .
CKJ Final Plumbing - When all
plumbing werll Is complete,
rJ7l Final Electrical - When all
lAJ electrical work Is complete.
rY'I Final Mechanical - When all
~ mechanical work Is complete.
I.Df Final Building - When all
~ required Inspections have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Set,Up - When all
blocking Is complete.
D Plumbing Connoctlons - When
homc has been connected to
water and sewer.
o
Electrical Connoclion - When
blocking, set.up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - Aller all required
Inspections are approved and
. porches, skIrting, decks, and
venting hove been Installed.
,; .
Lot TYPO. Setbacks
Interior I PL. HSE GAR ACC I
IN I
Corner
Is I
Panhandle
Iw I
Cul.de.sac
IE .. I
LOI faces
Lot sq. ltg,
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. ~ VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee ~# /?- -
Slale Surcharge p; -:?t-
Tolal Foe (A) -L'6-2~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
I PLUMBING PERMIT
ITEM FEE
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit #/#, /5'.-
;{ './:>"
State Surcharge ,y~
Total Charge (C) /.h_~
:2- MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
~IY ~5',-
/;. ..-
t?- '.~
::? t:; ..:2-
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits IE)
TOTAL AMOUNT DUE (excluding olectrlcal)
(A, B, C, 0, and E Combined)
.5$~
..n
.
'"
\
.S THE PROPOSED WORK IN THE
'. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this applicatlon must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
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 thc City of Springfield. Including the
Development Code, regulating the cOl)itructlon and use of
buildIngs, and may be suspended or revoked at any time
upon vIolation of any provisions of said ordinances.
Plan Check Fee:
Dato Paid:
Receipt Numbcl:___
Received By:
Plans ROvie-wcd-ij-y--'n-------
Date
Systoms Development Charge Is duo on all undevelopod
properties within tho City limits which are being Improved.
ADDITIONAL C'pMMS.t~TS
~E:;4?zr#93? '5/~
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By sIgnature, I state and agree, that I have carefully examined
the completed application and do hereby certl(y 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 tho City of Sprlngfiold, and Ihe Laws
of the Stato of Oregon pertaining to Iho wo,k described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certJry that only contractors and employees who
are In compllanco wilh ORS 701.055 will be used on this
prolect.
I further agree to ensuro that all required lnspecUons 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 slte,at all~lm/ ~r1n~n~~~lion.
Signature ~#t/ !!f!uf.lt.
/ .
Date r, P'1'J ~
VALIDATION:
!-.t:?~ ("
DATE PAID .$ -:::?~. '9.$"
AMOUNT RECEIVED _7-r: $~
~-
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RECEIPT NUMBER
RECEIVED BY