HomeMy WebLinkAboutPermit Building 1999-2-23
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT-
/7n~
- -
OWNER' iAHr{)(:::C , 1BR.a.\
ADDRESS:' 20'14 h IUTt
CITY' S~"-lbr-;V1 '"
DESCRIBE WORK' !too
NEW REMODEL
.
SPRINGFIELD
Sr
BLOCK:
~
hQ.J~'2lL
:<,>,
STAT'"
&.e-
R~ INiNDI"\...J
ADDITION .......-
DEMOLISH
OTHER
.
JOB NUMBER 2..2nz ,rC-.
225 Fifth Street
Springfield, Oregon 97477
_ TAX LO-{)S"1DO
SUBDIVISION:
PHONE:
7f'7-~7/S
ZIP:
CONTRACTOR'S NAME ADDRESS
GENERAL: ~e.dCA:::' ~Q.b.i.C G."'Y'JS~Q..It"\l').~
CONST,
CONTRACTO,I3 .
9.2A '2,7.0
." PHONE
~bl- '10'15
PLUMBING:
MECHANICA' '
ELECTRICA' '
L'lI \c I.::lRLt'/'LH'.
EXPIRES
td5
- OFFICE USE -
QUAD AREA' LAND USE: __ FLOOD PLAIN:
. OF BLDGS: · OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE:_ 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
D Site Inspection - To be made
after excavatlon, but prior to
setting forms.
D Underslab PlumbIng/Electrical I
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams. grouting.
~ Foundation - After forms are
~ erected but prior to concrete
placement.
o Undarground Ph,mblng - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
yxlFloor Insulation - Prior to
decking.
, .
D Sanitary Sewer - prio; to filling
trench.
D Storm Sewer - Prior to HlUng
trench.
o Water Line - Prior to filling
trench.
o Rough PlumbJ~g ..:... Prior to
cover. . ~
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
~ Rough Eleclrlcal - PrIor to
~ cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp.
~ramlng - Prior to cover.
'f:::::::1 Wail/Ceiling Insulation - Prior to
~over.
'i>21 Drywall - Prior to taping,
, ,
o Wood Stovo - After Installation.
D Insert - After fireplace approvel
and Installation of unit
o Curbcut & Approach - After
forms are emcted but prIor to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub-base materIal In place.
o Fence - When cOinpleted.
D Street Trees - Whel"! all required
trees are planted. I
o FInal Plumbing - When all
plumbing w9rk Is complet.e.
J9( Final Electrical - When all
~Iectrlcal work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
~Inal Building - When all
qui red Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECfIONS
o Blocking and Sat.Up - When all
blocking Is complete.
D 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 p~nel.
o Final - Atter all required
Inspections are approved and
porches, skirting, decks, and
venting haye been Installed.
Lot faces
L~t ~y.
Interior
" :~: ,. hj ~~..~: \~ i
. ',I,.')
.
Setbacks
PL HSE I GAR Acc'l
li.__.."___
S
Lot sq, flg..
Lot coverage
Corner
Topography
Total height
;'
Panhandle
I
~l-
Cul.de-sac
BUILDING PERMIT '1 'i; '1
ITEM SQ, FT, X $/SQ, FT,
Main
Garage "
Carport
~ (()/Il2J~Jl.., 1
Total Val ue
Building Permit Fee
State Surcharge :2- ":!-'+ p.f.
Total Fec (A)
VALUE
4/")0l),~
~o
~,S7
4-~P7.'
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
, Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flrcplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
fJ~ ~W/Q,)
2.'~fJ
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding clcctrlcal)
lA, B, C, 0, and E Combined)
-77r~
IS THE PROPOSED WORK iN THE,
"..HiSTORiCAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVEf"
, .~,'" , .j .,
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 City of Springfield, including the
Dovelopment 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.
22>.'73
Plan Check Fee:
Datc Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge is duc on all undeveloped
properties withIn tho City limits which are being improved,
ADDITIONAL COMMENTS
~~ eUr:r ,~~~/,r
/<; >>~///_q)
,. -- 1 -
By signature, I stato 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 Ihe 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
;; the site at ~rlng construction,
Signatun~ ~
(
/_/2-?/P I
I !.
Date
VALIDATION:
RECEIPT NUMBER
DATE PAID
7'2. , Fe:;
2,/23/9 J
{ 7-i#O
~
AMOUNT RECEIVED
RECEIVED BY