HomeMy WebLinkAboutPermit Building 1999-11-17
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SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
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JOB NUMBER
Inspections: 726.3769
Office: 726.3759
225 Fillh Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK' ;;'"51 F 10M --"50
ASSESSORS MAP' 17 6 322. Lf L
(}6 26 l>
TAX LOT'
LOT:
BLOCK:
SUBDIVISION:
FC'r,..J) L;~
ADORE"'" 5" 3 IF} C. 011/1 ,'1\ c n
CITY: -<;pJ...iJ1S.( " -elr f ..) -'~J ~
GrIJMb)~J
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~'-IJ-72tJ- 7<13;5(
OWNER:
PHONE: _
nt1..
ZIP: tJ;7L/ 7 7
STAT':'
DESCRIBE WORK:
REMODEL
NEW
ADDITION
DEMOLISH
OTHER
CON ST.
CONTRACTOR'
CONTRACTOR'S NAME
I.-U;!rl,.. r
ADDRESS
fC-1I11 irOfl m"r1lf~
EXPIRES '," PHONE
p.o. &J/1!670
o (l CJ.,L'in <j
6'0'1,11"
1355'7S/,,/ol../~/ bl5'tJ4Lh7
NOTICE:
'fl iiC :-::-!..~~-':~ ~^'_'_ O=VPIO~ I~TI-l~WnRK
- OFFICE USAutHORIZEDUNDERTHISPERMlTISNOT
LAND USE: :::OMMENCEDORIS~aNGlilfOR
· OF UNITS: .~v1Qnr'\~PERIOOONING CODE:
ECHANICAI'
ELECTRICAl'
QUAD AREA:
. OF BLDGS'
OCCY GROUP:
CONSTR. TYPE:
. OF BDRMS:
A"T'TENTIOI'..r '''C'I''I,-,r, ,.J,"l., ., II nrB& you tt.
'" I SECONOARY HEAT: _ '
follow rules adopted by me uregufI UIIIIlY
';, -""""at' Ion C,SQUARE(!FOOTAGE:"'" "M tnrtt.
I~VUII'" 1,;.;, "-'" \.. ...-
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To request an Inspection, you must call 726.3769. This Is a 24 hour recordlng0'!iI.!J!n,SRec,tl,oJ'S)'n;queste:(flbelo;,;17:00)~~';;.tvJill be
made the same working day, Inspections requested aller 7:00 a.m. wlfl be mae~lm~ll.'?'Lo~J!\g;",~r~(day:the lele~ho~e
, REQUIRED INSPECTIONS~berforthe Oregon UlIlliY Notification
, ., "" 33' ,.,n44)
CAnj:.~:';3 >nL.,r ~.~..;) .
o Final Plumbing - When all
plumbing w9rl< Is camplet.e.
~Inal Electrical - When all
ITlectrlcal work Is complete.
~Inal Mechanical - When all
l/eChanlCaJ work Is complete.
o Final BUilding - When all
required Inspections have been
approved and building is
completed.
. OF STORIES:
HEAT SOURCE:
WATER HEATER:
RANGE:
o Rough Mechanical - Prior to
cover.
o Temporary Electric
D Site Inspection - To be made
after excavaUon, but prior to
setting forms.
D RoughElectrlcnl - Prior to
cover.
o Underslab PlumbIng/Electrlcall
Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o FootIng - After trenches are
excavated. .
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
o Framing - Prior to cover.
o Other
o Foundation - After forms are
erected but prior to concrete
placement.
o Wail/Ceiling Insulation - Prior to
cover.
o Underground PIl.fmblng - Prior
to filling trench.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Undernoor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stovo - After Installation.
o Blocking and Set-Up - When all
blocking Is complete.
o Post and Beam - Prior to floor
Insulation or decking.
o Insert - After fireplace approval
and Installation of unit.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Floor Insula lion - Prior to
decking. '
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
D 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'sub.base material In place.
D Storm Sewer - Prior to filling
trench.
o Fence. - \Nhen corl'pleted.
O Water Line - Prior to filling
trench.
o Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
o Rough PlumbIng - Prior to
cover.
D Street Trees 0;- When all required
trees are planted.
..
Lot faces
Lot sq. Itg.
Lot coverage
Topography
Total height
BUILDING PERMIT'
ITEM SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fec
Lot ~p_
Interior
Corner
;
Panhandle
Cul-de-sa~
i
X $/SQ. FT. ~
(A)
';.1.,
, I; I.' I~C
;:'.,....'. "l)';~:~.'; .~t
" ',,',' ".. .j....,'.
. "",.,,:),.:1
Setbacks.
HSE I GAR ACC'!
'IS THEPRO~OSED:ORK.tN THE.
'-"HISTOI;lICAL DISTRICT, OR ON
, THE HISTORICAL REGISTER?
If yes, this appliCation must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
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I'P.L.
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S
Iw
IE
VALUE
I, APPRovcn.
BUILDING V):I.Ll1E, 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.
I
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FIxtures
Residential Bath(s) N'
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
FT.
FT.
FT.
(C)
Wood StovellnsertlFlreplace Unit
N'
Dryer Vent
(./.wI fJufl.-ll
I (
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
Systems Development Charge Is due on all undeveloped
properties within the Clly limits which are being Improved.
FEE
ADDITIONAL COMMENT~
/J ~ _ ilc-qJ
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If/I' __ f
,
fo-00
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Jo. ~v
By signature, I state 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 Clly of Sprlngflcld, 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.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I' ",
2.C.{J
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from tho 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 all times during construction.
Slgnaturp ~A'# 7l!/~'
1!j17/11
Date
VALIDATION:
03{,ZA 0 Cj
/1/11/17'
iCSVIJ
d tJtrf/
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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