HomeMy WebLinkAboutPermit Building 1998-1-20
OWNER: _~ U C1 C ~.AJ(,,),"71';:=-,v,;::/'\
ADDRESS' Z/?? </?:€,~.5:;~ C"--r
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
LOT'
17 0'2..
CITY:
.
2/ 77 ~A"&'S",..~~.
2- c;- ;) 1 0 7 7a--t)
BLOCK'
STAT'"
(!)~
DESCRIBE WORK:
B1~ /?~<IO~
REMODEL '.............--ADDITION
NEW
DEMOLISH
OTHER
.
JOB NUMB~R S$,/')() 7 J
.
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
PHONE:
7Q(p - 4-77'-1
ZIP' <7'7'1"77
CON ST.
..- CONTRACTOR' EXPIRES,..., PHONE
..e~~"....,......- -&Uo ~ ___ ..-~'L 0
.-~ c. ~37...s CA!';./8 7~$ib' ~
4/ ,l'if/-7<1l/.' )
CONTRACTOR'S NAME ADDRESS
GENERAL: _/~I\J"" ~.c:-L ~ ",,-CO
PLUMBING' ~ c" cy..j,t:;'- ,.pdu....- ~,,,.J
MECHANICAl'
ELECTRICAl'
LAND USF'
. OF UNI}$~:
, ~ "'2
CONST!.. i'\lk.F.: ~\~
CJ' '-?J~~ .
l-feA:P~O E~,:,"
'Vj.. -r.-_ ~"'or
RANTiE~~ O}.
.~" <<,,, ~,"1V(
"Y -0. 'u. '0',
To request an Inspection, you must call 726,3769. Thl~~a'2)t)1~re";sl5dlng. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested art~:olP-tm~lI~ made the fOllowing work day.
REQUIRE?r I~~~S ,../
o Rough Mechanlcal~.A'~t!}'~ ~ ~~~~I Plumbing - When all
cover. ,~ 'IS> V~ plumbing wprk Is complet,e.
1>. 'h'q-
D Rough Electrical - Prlol~o V~
cover.
QUAD AREA:
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER'
o Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underalab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - Arter trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
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
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer -Prior to filling
trench.
o Water Line - Prior to rilllng
trench.
~OU9h Plumbing - Prior to
cover.
- OFFICE USE -
o Electrical Service - Must be
approved to obtaI n permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
~elllng Insulation - Prior to
cover.
~ryWall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - Alter fireplace approval
and Installation of unit.
o Curbcut & AI>proach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When completed.
D.Street Trees - When all requlred-
trees are planted.
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SOUARE FOOTAGE:
D Final Electrical - When all
electrical work Is complete.
~I Mechanical - When all
mechanical work Is complete.
~
Lk1 ~Inal Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set,Up - When all
blocking Is complete.
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.
o Final - Alter all required
Inspections are approved and
porches. skirting, decks, and
venting have been Installed..
Lot faces
~t~pe.
Lot sq. ftg.
Lot coverage
Corner
Topography
Total height
Cul-de.sac
BUILDING PERMIT ''1
ITEM sa. FT.
'f, 'f
X $/sa. FT. ~
VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
+-.o.037~
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(e)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding clcctrlcal>
(A, B, C, D, and E Comblncd)
Interior
"
Panhandle '
(A)
(B)
,'..,
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".'1..' I .~ .s ! :. : ),.~ Ii: ';.. t .
.... ....._.HL.\
':,..
I P.L.
IN
Is
I
W----J___
E I I
"
FEE
1/6,"'-:"""
./7[;,t cf1
4:..;,' ~
,~.
;'.
$~.-
:J 1(). -
,7t;; -t- . lfS'
$~.~
Setbacks,
HSEIGAR
I
._ THE PROPOSED WORK IN THE.
HISTOI;1ICAL DISTRICT, OR ON
THE HtSTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
/pC{" <:;'0
'3. If). +-';;'.D~~
1-73 ,ql-
SYSTEMS DEVELOPMENT CHARGE (SDe)
ACe' I
I
APPROVED:
'- .'.... " '!
BUILDING "ALOE, 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, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number"
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties wilhln the City limits which are being improved.
ADDITIONAL COMMENTS
'.
,
")
By signature, I state and agree, that I have carefully examined
the completed appllcallon and do hereby certify that all
information hereon Is true and correct, and I further certlfy
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 Orcgon 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 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 appro se of plans will remain
on the site at all times d fig 7~'
klgnature ~ y~::
'Iv _".
Date /- ;?(!) ~
~
VALIDATION:
DATE PAID
.).<bS.;;l.1
\- :JO-t1~
M
RECEIPT NUMBER
AMOUNT RECEIVEr>
RECEIVED BY