HomeMy WebLinkAboutPermit Miscellaneous 1995-6-9
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP' /71!:l3>
LOT:
.
BLOCK'
L/ e:;~
.'-
JOB NUMBER
7' 51") 9_ -? f
225 Fifll' Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
n,5' 7 cJ 0
PHONE' 7~7- ~ 7/5
OWNER: -.1.1/ /1'/ Q~ M#Z'e'4
ADDRESS d0941 ///.2:n!
5?h/V'&,hR.-n
CITY:
-, '_u,_.._ STATE:
ZIP: Jl~17
DESCRIBE WORK E;(T~O ':::#<5 L.:-Vi;; ~.:$;rA/..L- &-"9.5 ~~ear
NEW
REMODEL
EXPIRES
CONTRACTOR'S NAME
GENERA' '
i
ELECTRICAL'
ADDITION
DEMOLISH
OTHER
ADDRESS
CON ST.
CONTRACTOR'
PHONE
/SH~,f6
PLUMBING:
MECHANICAl ,#m&i2P##~.5 A?.J?41HCtfF ..5;..iZLX'&~/g4H?.I~ ';a,.j5:/. >>Ro
7'76 z/ /O--P5""
QUAD AREA:
DoS
. OF B~DGS:
OCCY GROUP:
. OF STORI ES:
WATER HEATER:
- OFFICE USE _
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE'
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
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 (orms.
o Underslitb Plumbing/Electricall
Mechanical - Prior to cover.
o Footing - After 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 decl~lng.
o Floor Insulation - PrIor to
decking,
o Sanitary Sewer - Prior to rflling
trench.
o Storm Sewer - Prior to tilling
trench.
o .Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electr~cal - Prior to
cover. .'
o Electrical Service - Must be
approved to obtain permanent
electrlcaf power.
o Fireplace - Prior to facing
materials and framing Insp.
o Fram.lng - Prior to COver.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
F::71lnsert - After fireplace approval
~ and Installation of unit. 4'AS
o Curbcut & Approach":" Alter
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.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing w9rk is complet.e.
o Final Electrical - 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.
~Oth.r..L;;~ /~
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 - After all required
Inspecllons are approved and
porches, skirting, decks, and
venting have been Installed.
\:.' l;eTHE PROPOSED WORK IN THE
'Lol Type. ,
Lot faces Satbacks
Lot sq. Itg. Interior I P.L HSEIGAR ACC I HISTORICAL DISTRICT, OR ON
IN I I THE HISTORICAL REGISTER?
Lot coverage Corner II yes, this application must be signed
Topography Panhandle Is I I and approved by the Historical
Iw I I Coordinator prior to permit issuance.
Total height Cul-de-sac
IE I I APPROVED:
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
Slale Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
FT.
FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
u/ff'L"'JF : NfT /AlftiJ'2(
/1.? /..u
/'1.I'D
,
/~.6o
/. .20
'7 /.: ..1...0
Mechanical Permit
Issuance
State Surcharge . ') r -r ,.~.F
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demoltllon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
? /. 2-0
- U" r-
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 the Cily of Springfield, including the
Development Code, regulating the cOr)slruction 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:
Recei pt 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
c:;'A< /-f.%l3t?;-
F/A'.bt1hC!../E.
AtJ ,n?A-c;bll{P~
,
. By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certHy 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 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
prolect.
I further agree to ensuro that all required Inspections are
requested at lhe proper time, that oach 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~es :u';t';P rnstructlon,
Sl9nature~ ~~
/_ /?/5'r
-", ~
Datp
VALIDATION:
17& 7J
DATE PAID /yV9T
AMOUNT RECEIVED __ 2 ~ ,2..'"
4h:M_
'. -
RECEIPT NUMBER
RECEIVED BY