HomeMy WebLinkAboutPermit Building 1991-4-23 (2)
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
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SPRINGFIELD
· JOB NUMBEREJ()~ VI'
225 Fifth Street.
Springfield, Oregon 97477
LOCATION OF PROPOSEp),ii!,ORK' .5'05/ hp.f!..u fh M A..
ASSESSORt ,MAP. { ~();;) ()4 (/) / TAX LOT: O.~ GIJ j;
LOT. ~ BLOCK. SUBDIVISION: () Ir1 h -. / 5
,
OWNER' I~ '?, i.1 -- IV / R I:i
ADDRESS' /. y q S- AI, le'
CITY. ~--,jI STATE:
/ I
DESCRIBE WORK. /1/eJ S, F/ D.
NEW REMODEL ADDITION DEMOLISH
CONTRACTOR'S ~
GENERA" I #-rYt/
PLUMBING:
MECHANIC^' .
ELECTRICAL:
QUAD AREA: <.'2J( ~C-
. OF BLDGS. I
OCCY GROUP: J~ ~~ lY\
\
~
· OF STORIES.
WATER HEATER.
PHONE:
I t./7 'T7 tJ t/
/'
I
I
fl) 1-0. M.-'
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REQUIRED INSPECTIONS
~ Rough Mechanical ~.Prior to
~cover. \ +.
"~f\' .~ ...., \.
~ Rough Electrical -=. P'r16~ t'o
~cover.
1':A" Electrical Service - Must be
~ approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
8. Framing - Prior to cover.
~ Wail/Ceiling Insulation -,Prior to
~ cover. .' "
~ Drywall - Prior to t~Plng: , '
_ " , l ~
D Wood Stove - After installation.
o Insert - After fireplace approval
and Installation of unit.
c.:7f Curbcut & Appro8_ch,- After
~ forms are erected 'but ftrlor to
placement of concrete. '. \
... t". .. \
~Sidewalk & Driveway - ~fter
)6J.. excavation is complete, forms
and sub-base material In place.
o Fen~e'- Whe,n co~rrlPI~'t~'d!\
'geet Trees -, W~~~' a;;:r::~lred'
~es are plantr~: \
ZIP:_tf71/7 j-
....,', .'. :.CONST.
....: ..', {'CONTRACTOR · E1PIRfS PHONE
';' , . ,~2 ~ l/ 7. laIlDI4{? ~7%'7;' t/
.. -. :' ','~4tddo4 3H~Jqz...'$ '/7 S1 79
1/ ~ / J....r3-
AD)/RESS
W, ;"13
--
s- ~
fj,) /rh
. ..-- . -~'/. ... -
.e 1/.9
OTHER
.....' -J\\4<:..\
......,. :..:....:"~"CX.. JLJ
- OFFICE USE -
LAND USE: _, l \ I
· OF UNITS. . \..,., - .
CONSTR. TYPE: V .A/ ~
HEAT SOURCE: ~ ~
RANGE:
FLOOD PLAIN.
..'.?ONING CODE:
· OF BDRMS.
Ll)~
~
SECONDARY HEAT:
SQUARE FOOTAGE: I V) J la
To r~qLiest 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.
o Temporary Electric
OI~Site Inspection - To be made
I after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrlcall
Mechanical - Prior to cover.
o "Footing - After trenches are
excavated.
D ~asonry -- Steel location, bond
._ beams, grouting.
C"'7f Foundation - After forms are
IAJ erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
~Underflool"PJumblnbJ Mechanical
~ - Prior tcfT?r......'.....:.l.'. or decking.
oQf ~O$t and Beam - Prior to floor
~nsulatlon or decking.
~ Floor Insulation - Prior to
~ecklng.
g San~tary Sewer - Prior to filling
trench.
~ Storm Sewer - Prior to filling
~rench.
-c7I Water Line - Prior to filling
~tren9h.
~ Rough Plumbing - Prior to
~cover. "
~ Final Plumbing - When all
jAJ. plumbing work is complete.
'"
,
~Final Electrical - When all
~electrlcal work Is complete.
~Final Mechanical - When all
~mechanlcal work Is complete.
"
~Flnal Building - When all
~requlred inspections have been
approved and building is '
completed.
o Other
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. :.
'.J~...
o Electrical Connection - Wh"an
blocking, set-up, and plumbing
Inspections have been approved
and the home is connected to
Sh~ .s~rvlc~. parte!.' "
":'.~.~"\ '..;.~;j': ."~ .~..... " ~.!'.... .~.~
o Final - After all required "
_ Inspections are approved and
. porches, skirting, decks, and
venting have been Installed.
A'.
Lot faces
LotTe
t Interior
Corner
I P.L.
IN
Is
Iw
IE
Lot sQ. ftg.
Lot coverage
f.
Topography
Total height
Cul-de-sac
Panhandle
b'
BUILDING PERMIT
ITEM SQ. FT.
J.8~
4-( 0 L...
X $/SQ. FT. ~ VALUE
_,~fl flD 4'1 'l8S
(4 .~IJ f..p ~\4
Main
Garage
Carport
r .
j-.\
:iPJ ~9'7
~
3/9.2.0
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8) atf. 4&.
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)I
,
PLUMBING PERMIT
ITEM FEE
Flxtu res
Resldentiai Bath(s) N' "2- / ~I? IH}
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit .
'./ ".u
State Su rcharge "
Total Charge (C) / Ib~. Of)
MECHANICAL PERMIT.
Furnace
Exhaus~ Hood
4'.~
-LocO
Vent Fan
N'
.-
Wood StcoVellnsert/Flreplace Unli "
Dryer Vent
,~.cO
Mechanical Permit
~
I~.CO
7{).UJ
(,AC:;
nJ(p.().5
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ~ 2. ft"
Curbcut. 2 (i. ft
li.'~
-.! ~ , r'~
DemolltlCH1
State Surcharge
~ At'vliW ~
J.j!7. ~O
~.SO
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE <excluding etectrlcal,.1 ~~.11
. ft>,:- C, 0, and E Combined)
Setbacks
HSE GARIACCI
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I I
I I
I I
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n'~
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVEi"'.
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 Qrdinance
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 ordinance~.
\ C\Yl. lot)
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved. t
ADDITIONAL COMMENTS I,
"
By signature, I state and agree, that I have carefully examined
the com"Plet~d 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 ?f Oregon pertaIning to the work described
herein, ~nd t)1at NO OCCUPANCY will be made of any
structure without permission of the Building Safety Divisi.on.
J further c~rtl fy that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspectiom. are
requested at the proper time, that each address is re€lde>.qle
.from the street, that the permit card Is located at the :ront
of the property, and the approved sef of plans will remain
on the site at al~es!'1ng construcHon.
Signature .:.../1AX
;; l;-/q /
/ /
Date
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::~~::~:MB5r \ q0~ \
DATE PAID ~ . 2.. ~ . ~ \ _ _'
AMOUNT RECEIVE~' \~:-! .0ft - .....
RECEIVED BY ~ ~