HomeMy WebLinkAboutPermit Miscellaneous 1994-6-3
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RESIDENTIAL
PERMIT APPLICATION
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Inspecllons: 726.3769
Office: 726.3759
LOT'
SPRINGFIELD
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JOB NUMBER
9.;/CJSa
225 Fifth Street
Springfield, Oregon 97477
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SUBDIVISION: 7r "'f~ A4c;, .,-;
v ',' J - -- .....
BLOCI"
CITY'
, ,;:73'
STAT~' '
oR.
PHONE: 6~~ -s Y5""9
,ZIP'
<53?'7-'c=:><.
DESCRIBE WORK: /"rfi=,77'?CC --:;;'-"?1~ ~/7"A~ ......t-/ ~~ 7~
/1/" , r / -1'';'/,'/' /,,'. l~' I:~.-
NEW REMODEL ADDITION" DEMOLISH OTHERrqr7~~.c '/ ..;>
CONST.
CONTRACTOR'S NAME ADDRESS' CONTRACTOR . EXPIRES PHONE
GENERA' .
PLUMBIN(>'
MECHANICAl'
ELECTRICAl'
.::.. 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' RANGF' SQUARE FOOTAGE:
To reQuesl an Inspection, you must call 726.3769. This Is a24' hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested aHer 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o R~ugh M.ach~nl~al .::.. Prior to
cover. .
o Temporary Elec~~lc
D Site Inspecllon - To be made
after excavation, but prior to
sottlng forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Footing - After trenches Bre
excavated. '
o Masonry - Steel location, bond
,beams, grouting.
O Foundation - After forms are
' erected but- prior to ~ concrete
placement.
o Underground Plumbing - Prior
to IlIIlng trench.
O Undarlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post anc;l Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
ri/I Sanitary Sewer - Prior to filling
\A-l trench.
r71 Storm Sewer - Prior to tiMing
1,4.J trench. . ".
r.7I Water LIne - Prior to filling
~ trench.
o Rough Plumbing - Prior to
cover.
o Roug'h 'Electrical ::- Prior-to
cover. .'.
o Electrlcal ServIce - Must be
approved to oblaln.permanent
electrical power. :,- "'y::.._
.-
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - prl,or to taping.
o Wood Stove - Aller Install all on.
o Inaert - Aller IIreplace apprOval
and Installallon 01 unit. '
Ocurbcut & Approach - Aller
forms are erected but prior to
placement of concrat.e,
o Sidewalk & Driveway - Alter
excavation Is completo, forms
and'sub-base'niaterlal In place.
,0 F~n~e, - When completed.
D ,Slreet Trees - Wh,m all required
trees are planted.
o Final Plumbing - When all
.plumblng wprk Is complel,e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
requIred Inspections have been
approved and building Is
compleled.
o Olher
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 - Alter all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
.: ,., ...~: ~'.,f '.':. ,'i,';i: .'~:.
Setbacks '
HSE GAR Accl
.'h
,\' '.,' ,
. . . ~':..., ,~
Lot faces Lot 'TYpe
,Lot sq. fig. Intarlor IP.L.
IN
Lot coverage Corner Is
Topography Panhandle Iw
Total height Cui-de-sac IE
.,
BUILDING PERMIT
ITEM ' SO. FT. X SISO. FT. - VALUE
MaIn
,
Garage
Carporl
"
Total Value
Building Permll Fee
Slale 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. ~7
Mobile Home
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(_ THE PROPOSED WORK IN THE. '
'''''''fiISTOl;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, thIs application must be signed
and approved by the HistorIcal
, Coordinator prior to permit Issuance.
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condlllon that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, of Springfield, Including the
Development Code, regulallng the ,construcllon 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:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Developmenl Charge Is due on all undeveloped
properties within Ihe City limits which are being Improved.
~ ADDITIONAL COMMENTS
FEE
,-/p
7'~
~O
Plumbing Permit
State Surcharge
120. "'0
6.~
..... '...
.; -
/2 9, B::>
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
Sidewalk fI
Curbcut fI
, .. Demolition
',State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
By signature, I state and agree, that I,have carefully examlnad
the completed appllcallon and do hereby certify that all
Information hereon Is true and correct, and J lurther certlly
that any and all work performed shall be done In accordance
with the.ordlnances 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 Ihe Building Safety Division.
I further certify thai only contractors and employees who
are In compliance with ORS 701.055 will be used on thla
project.
J 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 pro~ty, and the approved set of plans will remain
on the site ~ all times durin c structlon.
~na~~ ~--'
DiJ/5/9f
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VALIDATION:
RECEIPT NUMBER
/ '2, /8.r
0;1'.~
/2{7~ & 0
A#~
DATE PAin,
AMOUNT RECEIVED
RECEIVED BY
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