HomeMy WebLinkAboutPermit Building 1991-4-23 (2)
:::yf~O:;~~DE~'::A/~~ITIONS ,
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726,3759
ASSESSORS MAP:
1:2-
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LOT'
OWNER'
ADDRESS:
CITY'
.
SPRINGFIELD
-, ~
.JOB NUMBd~::'~ t.{)~eJ,
~. .. .
225 Fifth Street ".
Sprlngfleld,Or.;g.on'97477
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TAX LOT: n~q (Y::)
SUBDIVI~ION: a Pn.b - / d
PHON~'
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BLOCK:
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/lI - (C '
STATE: -I2t.-U ~
/
~,D,
DEMOLISH
OTHER
ZIP'
~,.-:. . ,~.."rGdNST.
CONTRACTOR'S NAME ADDRESS.,,, >, . 'CONTRACTOR #
. "J '/l '; . f'''''' l.> \
GENE'RAI~\\' fA/1€-~', ",ljr9-rlY. C- :":j7_Q4/7
P~~~;~;: \" 5~' ~.""">,- "//"'7im';Hc'''''~('o(() fA
///U'Lti . . /; ?'tr/YrC ~, '. .-
-&/1-,- If/' 24 1<.-6I0-};' ,~:,0;1~s \
MECHANICAl'
. ELECTRICAL:
QUAD AREA:
p,p cz::.,O J
- \ .
t<~~
\
L
# OF BLDGS'
OCCY GROUP:
# OF STORIES:
WATER HEATER:
-'OFFICE US\-
LAND USF' \ ~ \.
\ ,..,~ . .
'1.,. ,
Vf\J'
# OF UNITS'
CONSTR. TYPE:
HEAT SOURCE: ~
RANGE: ~
!XPIRES PHONE
(Q. (o/Cf J 7 q7 ? 711l.(
'OM jaz.- . N.3IU3)
4 !~I ?t.(7SfTrL
FLOOD PLAIN:
ll)h
:5
SECONDARY HEAT: ~.\J
SQUARE FOOTAGE: It o~
,.ZQ~ING CODE:
# OF BDRMS'
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.
10 Temporary Electric
O"site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o . Footing - After trenches are
excavated.
D Masonry - Steel locatton, bond
beams, grouting.
~Found-ation - After forms are
~ erected but prior to concrete
placement.
D Underground Plumbing - Prior.
to filling trench,
1C71" Underflo~/Mechanicall
~ - Prior to InSUlation or decking.
"C7f Post and Beam - Prior to floor
~Insulation or decking.
I
~Floor'lnsulation - PrIor to
~ecklng,
~ Sanltary Sewer - Prior to filling
~trench.
'f;7l' Storm Sewer - Prior to filling
~trench. " .
1S7I' Water Line - Prior to filling
~ trench.
, , ,
,
~ Rough Plumbing - PrIor to
~cover. . .
REQUIRED INSPECTIONS
~ Rough Mechanical .!.;IPrIO[ to
cover. , t..~~ ,~_ . .
. ..: I", \
" ..~,
~ Rough Electrical - Prior to .
~ cover.
~ .... \
Electrical Service - Mus,t 'be
approved to obtain permanent"
electr!cal power. '"~""'. '. ;;
~~) ,.>-)\
o Fireplace - Prior to facing' "
materials and framlng,~nsp.
. ~ L..
~ Final Plumbing - When all
~plumblng work Is complete,
~ Final Electrical - Whe(l all
~electrlcal work Is compfete.
~ Final Mechanical - When all
~mechanlcal work Is complete.
\,
~ Final Building - When all
~ required InspectIons have been
approved and building is
completed.
~ Framing - Prior to cover.
......:i:'~~ .l..\'l...... , . .:D .Othe~
. ',-t._''''.;':~... .. '. .\
'f;;7l' Wail/Ceiling Insulati,!n~- .P.,rl,or to
~cover. ," .) I
L. Q ,
~rYWall - Prior to tapl~g~ \
t,":., ':j\-:,. MOBILE HOME INSPECTIONS.
:~-;:i Wooq_Stove - After Installation.
.-
"-,~ '
;.!;
o Insert - After fireplace approval
and Installation of unit
1"21'Curbcut & Approach'-':'.After
~forms are erected but p'rio"r.to
placement of concrete. ::: . 1.
. .. ~ .
.. .',
TV1" Sidewalk & Driveway - After
~excavatJon Is complete, forms
and sub-base material in place.
. ,.~ .'~, '._.~...: (
o Fence - When com~l~ted.,t ~.
. '....:.: ~." ,
." ., \ io
~treet Trees - Wh'ea '~II req~lred' '
lJrees are planted. . -.,.. ,,:. \
o Blocking and Set,Up - When all '0-
blocking Is complete.
o Plumbing COnnec!Tons -:- When
home has been cOl')nected to '\
. water and sewer.~'''''.':'. :' .'
*' ...,
o ectrical Connection - When
bl eking, set-up, and plumbing
. --.." In ectlons have been approved
\ an the home is connected to
ttle ervlc~~~?~el~. 't' "Jl;~', '~.
o Final - After all required "
. inspections are approved and
porches, skirtIng, decks,-and
venting have been Installed.
BUILDING PERMIT
SQ, FT,
.~~
ITEM
Main
Garage
Carp.ort
Total Value
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
X $/so, FT. = VALUE
2fDJ. 4~A lip'
\4:10 ~
(A)
(B)
Fixtures
Residential Bath(s) N' .~
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
SIl. \ <(A .
~'2-!O
;f-U1
~ !!!!
SYSTEMS DEVELOPMENT CHARGE (SDC)
'1jJ~, ~h
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
I
Exhaust Hood
Vent Fan
~
(C)
N'
r
2-
Wood Stove/ Insertl Fireplace Unit
Dryer Vent
Mechanical Permit
IssuanCE:
State Surcharge
Total Permit
/#/,0
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
I
State' Surcharge
Sidewalk 1b9~ ft
Curbcut' 2. "2- ft
Demolition
State Surcharge
PiAvD' ~'1:;
. ,
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. D, and E Combined)
I further agree to ensure that all required inspections are
requested at the proper time, that each address is rea<jable
.~ . - . .
~, I: \,~fr~~.~~~t:C)treet. that the permit card Is located at the front
~. of tHe property. and the approved set of plans Will remain
on the site at,al tlm~ construction, .
Signature ___ ~.~y/ ,':'
Date I<i:-
FEE
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19, 3.0
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BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
constructi.on 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 prOViSjOnS.Of~aid rdlnances.
. H
Plan Check Fee:..;..wt!!~ _
.~#
#~L..
/ Dpe . .
Date Paid:
Receipt Number'
"
Systems pevelopment Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
.J..{) mo . AS ~mo
~C~\-k~ \rL..- .
,
By signature; I.state and agree. that I havecarefuily examined' r
II
the complet'ed '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 the Building Safety Division:
I further certi!y .that only contractors and employees who
are In compliance with ORS 701,055 will be used on this
project
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VALIDATION:
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RECEIPT NUMBE~
DATE PAIl' '1'
AMOUNT RECEIVEI' \',...j~ ,
RECEIVED BY ~,ro. ' ,.
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