HomeMy WebLinkAboutPermit Building 1994-3-25
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JOB NUMBER --3-.4' () 3 9 (':l
225 Fifth Street
Springfield, Oregon 97477
.
SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORt<.
~
?..5
17/J":l.,
&. G. o--n
I
TAX LOT'
SUBDIVISION'
ASSESSORS MAP'
BLOCK'
LOT:
OWNER:~-
ADDRESS: ~ 7' 7
CITY' ~Ff,
DESCRIBE WORK: ~)(l"k .<:::' I"';
NEW REMODEL L ADDITION
721":, - ~.?9"-
,}'h? -" m-
,F//f!1Jt A-P6
PHONE: .
ZIP' 97~77
STATE: _I'Y
~~
( /,I')~ c..,f'~ J
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DEMOLISH
OTHER
CONST.
CONTRACTOR'
ADDRESS
EXPIRES
PHONE
CONTRACTOR'S NAME
GENERAl' /)(/'/ l~
PLUMBING'
MECHANICAl'
ELECTRICAl'
~t~
- OFFICE USE -
LAND USE:
FLOOD PLAIN:
ZONING CODE:
QUAD AREA:
. OF UNITS'
CONSTR. TYP'"
. OF BLDGS'
. OF BDRMS:
OCCY GROUP'
. OF STORIES:
WATER HEATER:
HEAT SOURCE:
SECONDARY HEAT:
SQUARE FOOTAGE:
RANG'"
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.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Final Plumbing - When all
plumbing work Is complete.
o Tempor~ry Electr~c
- -~. ~ \
0" Site Inspection - To be made
after excavation, but prior to .
settlng forms.
o Rough Electrical - Prior to
cover.
D Final Electrical -. When all
electrical work is complete.
D Final Mechanical - When all
mechanical work Is complete.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
'r'\7( Footing - After trenches are
~excavated.
K/l"'Flnaf Building - When all
..JY-J required Inspections have been
approved and building Is
completed.
o Fireplace - Prior to facing'
materials and framing Insp.
o Masonry - Steel location, bond
beams, groutlng.
(
o Other
~ Framing - Prior to cover.
~ Foundation - After forms are
~erected but- prior to concrete
placeme~t.
o Wail/Ceiling Insulation - Prior to
cover.
D Underground Plumbing - Prior
to IIlIlng trench.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Underfloor Plumbing/Mechanical
-.Prlor to Insulation or decking.
~ Wood Stove - After I~sta"atlon.
o Blocking and Set.Up - When all
blocking Is complete.
o Post and Beam - Prior to floor
InsulatIon or decking.
D Insert - After fireplace approval
and Installation of unit.
o Plumbing Connections - When
home has been connected to
water lilnd sewer. .
o Floor Insulation - Prior to
decking.
o Curbcut & Approach - After
forms are erected but prIor to
placement of concrete.
.
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set-up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Sidewalk & Driveway - After
. excavation Is complete, forms
and 5:ub-base material In place.
o Storm Sewer - Prior to filling
trench. .
o Fence - Whe.n completed.
o Water Line - Prior to filling
trench. .
o Final - After all required
Inspections are approved and
porches, skirting, decks; and
venting have been Installed.
o Street Trees - When 'all required
trees are planted.
D Rough Plumbing - Prior to
cover.
Lot faces Lot Type ,e Setbacks I (~THE PROPOSED WORK IN THE
Lot sq. Itg. Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner Is I If yes, this application must be signed
and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total height ~ Cul-de-sac
IE I APPROVED:
BUILDING PERMIT:
ITEM SQ. FT.
Main 2.. 510
VALUE
~775"~
X $/SQ. FT. =
}}/O
-'"I
Garage
Carport
Total Value
~ f2,:o
/:'1'3
(. '() ,1-3
SYSTEMS DEVELOPMENT CHARGE (SDC)
}.//A
Building Permit Fee
State Surcharge
,Total Fee
'(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
/'
/'
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
(wOOd'SiO~~Hre!f.a~"
, Dryer ven\.: '4-CO, 00 .
---
MechanIcal Permit
) ,c:;, "'<::f
Issuance
/,').00
.75
..:;:?.c;. 7.s-
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
/__/__/~
TOTAL AMOUNT DUE (excluding electrical) ...JPE-.
(A, B, C, 0, and E Combined)
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
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.
2~.o3
Plan Check Fee' :::>
:i/~4'/94
1 i'
Receipt Number' /?- () '5 <I
Recelved~ ' V~A/1
R~~-:~ .'
Pla",l. Reviewed By'"
Date Paid:
J:~5'/~
Y ~t7 "';
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon 15 true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances of the'Clty 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 the Building Safety Division.
) further certify that only contractors and employees who
are In compliance wIth CRS 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
on the site ~ all times during consW'ctlon~ / ,tl
X-onaturer\~~ ~ ~/A;:t:.
Date,,"2-5" M"i2rd '1''1-
VALIDATION:
RECEIPT NUMBER /"207C
-<:: -25'"-"l~
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DATE PAin
AMOUNT RECEIVEn
RECEIVED BY
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