HomeMy WebLinkAboutPermit Building 1994-6-3
RESIDENTIAL"-
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT' .
=-
. BLOCK'
J!73'
STAT'" .
075'.
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JOB NUMBER
9<1 ()fJ'J'/
I
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TAX LOT" tfJ2.c{():)
SUBDIVISION: 7f'",..~ A~!"'":-,.
v ~"l,-:---F I
PHONE: 6~~ ~S y~
ZIP'
43?7"~<.
DESCRIBE WORK: /1/..~/~ <:. ?~;:I}"~- ?;'!~/T~~ _~:/ ~~-r' Z-b ~ ~
NEW REMODEL ADDITION" DEMOLISH OTHER~ ~c ':7'"":)
CONST.
CONTRACTOR'S NAME ADDRESS' CONTRACTOR # EXPIRES PHONE
GENERA' .
PLUMBIN'"
MECHANICAl'
ELECTRICA' .
- OFFICE USE -
QUAD AREA" LAND USE: FLOOD PLAIN'
. OF BLDGS' # OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
· OF STORIES: HEAT SOURC'" SECONDARY HEAT:
WATER HEATER: RANGF' SQUARE FO,OTAGE:
To request an Inspecllon, you must call 726-3769. This Is e24 hour recording, Alllnspecllons requested before 7:00 a.m. will be
made Ihe seme working day, Inspecllons requested efter 7:00 a.m. will be mede the following work day.
REQUIRED INSPECTIONS
D Temporery Electric
O Site Inspecllon - To be made
after excavation, but prior to
setting forms.
D Undersleb Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.' .
D Masonry - Steellocellon, bond
beams, grouting.
D Foundation - After forms are
erected' but- prior to' concrete
placement.
D Underground Plumbing - Prior
10 IIIl1ng trench.
D Underlloor Plumblng/Mechenlcel
- Prior to Insuletlon or decking,
O Post and Beam - Prior to floor
Insulellon or decking.
D Floor Insulellon - Prior 10
decking.
ri/l Senltery Sewer - Prior to filling
!4-l trench.
r71 Storm Sewer - Prior to f1t1lng
~ trench. .
r.7I Weier Lint' - Prior to filling
L+-J trench.
D Rough Plumbing - Prior to
cover.
D Rough Mech~nlcal ...; Prior to
cover. .
o Roug"h'-Electrlcal ~ Prior-to
. cover. ".
o Electrical Service - Musl be
approved to obtain .permanent
electrical power. :r ""}:..~
D Flreplece - prior 10 feclng
malerlals and framing Insp.
D Fremlng - Prior 10 cover.
D Wail/Ceiling Insulellon - Prior to
cove~' .
D Drywell .,.. prl.or 10 taping.
D Wood Stove - After histallatlon,
D Insert - After f1replece epproval
and Installation of unit.
D 'Curbcut & Approech - After
forms are erected but prior to
placement of concret.e.
D Sldewelk & Driveway - Alter
excavation Is completo, forms
and 'sub-base' material In place.
o F~n~e. - When cO~Pleted.
o ,Street Trees - When all required
trees are planted.
D Final Plumbing - When ell
.plumblng W9rk Is complet.e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanlcel - When all
mechanical work Is complete.
D Flnsl Building - When all
required Inspections have been
approved end building Is
completed.
D'Olher
MOBILE HOME INSPECTIONS
D Blocking end Sel.Up - When all
blocking Is complete. '
.
D Plumbing Connections - When
home has been connected to
water and sewer. '
D Eleclrlcel Connection - When
blocking, set-up, end plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
r
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'.. ,
Lot TYpe
lot faces
lot sq. flg.
Interior
lol coverage
Corner
Topogrephy
Tolal height
Panhandle
Cul.de.sac
. "('i< \.<:i ':" ~ 'I'I';";::"'~ ~:/ ':j}~'~e1.;"~:~
.,
,
.S THE PROPOSED WORK IN THE.
....HISTORICAl DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and epproved by the Historical
Coordlnetor prior to permit Issuence.
Setbecks .
HSE GAR ACC
1'p.L.
IN
Is'
Iw
IE
. BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. = VALUE
Main' '
.
Garage
Carport
"
"
Total Value
,
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT. J;:?'=3
Water FT, ~~
Storm Sewer FT. ~"3
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnserllFlreplece Unit
Dryer Vent
Mechanlcel Permit
Issuance
State Surcharge
Totel Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
Sidewalk fl
Curbcul fl
Demolition
Slate Surcharge
Totel Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
"
-,~
.
APPROVED: '
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, regulatlng'the conslructlon and use of
buildings. and may be suspended or revoked at any time
upon vlolallon of any provisions 'of s~ld ordinances.
Plan Check Fee'
Date Paid:
Receipt Number:
Received By: '
PlensRevlewed By
Date
Systems Development Charge Is due on all undeveloped
properlies within the City limits which are being improved.
:' ADDITIONAL COMMENTS
FEE
</e::>
t/tP
~t7
12 o. ""0
6.~
..,. -"'~
... -
/2 9. tt:o
"
By signature, I stale end agree, that I have carefully examined
the completed appllcellon and do hereby certify thel ell
InformatIon hereon Is true and correct, and I further certify
that any end all work performed shall be done In accordenc9
with the OrdJnanc~s of the City of Sprlngfleid, end Ihe Laws
of the State of Oregon perlelnlng to the work described
herein, and Ihat NO OCCUPANCY will be made of any
structure without permission of the Building Sefety Division,
I further cerUfy Ihat only contractors and employees who
ere In compliance with ORS 701.055 will be used on Ihls
project.
I further ~gree to ensure that all required Inspections are
requesled at the proper lime; thai each eddress Is readable
from the street, Ihal the permit card Is loceled atlhe front
of the prop~ and the approved set of plans will remain
~[pi;fL 'ru"'~
-'
VALIDATION:
RECEIPT NUMBER
J.</8~
6,/r/#.
/? <}' ({.O
A/.:l;::;~
DATE PAl"
AMOUNT RECEIVED
RECEIVED BY
,