HomeMy WebLinkAboutPermit Building 1996-3-25 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olllce: 726.3759
..
SPRINGFIELD
.
JOB NUMBER ~:"'74/? A
225 Filth Street
Springfield, Oregon 97477
LOC;ATlON OF PROPOSED WORK' 5'" /?/ ~--5;>o/~..4- ~'.
ASSESSORS MAP: -.tB V>~ .~ 9' - 2/ TAX LOT:
OWNER: fA/. 7: ~71~€~ r0-
ADDRESS' '''t" /7/ ~~.a9
:??~1- -, '
DESCRIBE WORK' 6.J1.A.?C;.... rf--dJ/71&0 At(
LOT:
CITY'
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl' I'U ~.,. J,~
PLUMBING:
MECHANICAl'
ELECTRICAl'
\~UAD ~.~EA'
. OF BLDGS;
OCCY GROUP'
. OF'STORIES:
WATER HEATER'
BLOCK'
STATE: .
&P:<.
r6~
SUBDIVISION:
PHONF'
"") ""8~?"5""?
4/
DEMOLISH
OTHER
ZIP: '9?c,/~
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES - PHONE
o Rou9h Mechanical....:. Prior to
cove~ .
D Site Inspection - To be made D"Rough Electrical - Prior to _
after excavation, but prior to cover.
setting forms. ~
o Under.lab Plumbing/ Eleclrlca" ~eP..aJ~.,{.ICe -~.!:~
Mechanical - Prior to cover. ~ a~~~d..!.o..Obt~l~pt
(/ elect,lcal po9(~?}?-1
o Footing - After trenches are ~~) ,IV'r'
excavated. ~F-r1;Pm~ce - Prior to facing
(o~aterlaIS and framing Insp.
o Masonry - Steel locatlo'1" "ct,N
.beams. grouting. 0 Framing - Prior to cover.
o Foundation. - After forms are
. erected but prior to concrete
placement.
- OFFiCe USE -
LAND USF'
. OF UNIT'"
CONSTR. TYPE:
HEAT SOURCE:.
RANG~'
o Wall/C.elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approvlIl
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - Alter
excavation Is complete: forms
and sub.base material In place.
o Fen~e - \Nhen completed.
o Street Trees - When all required
trees are planted. - . ~
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS'
,SECONDARY HEAT:
SQUJI.RE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons requested before 7:00 a.m. will be
made the same working day, Inspections requested alter 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
..
o Fln.1 Plumbing - When all
plumbing wc;>rk Is complet.c.
o Final Electrical - When all
electrical work is complete.
U Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
OOthur
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 ~;ervlce panel..
o Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
]
o Temporary Electric
o Underground Plumbing - Prior
to filling trench. .
o Underfloor Plumbing/Mechanical
_ Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulatlon or decking.
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.' .
o Water Llne'- Prlo"r to filling
trench. ~ .
o Rough Plumbl.ng ~ pr'lor 10
cover.
~'-
Lot faces
L~I ~yp.
'.
\.Lot SQ. ftg.
Interior
lot coverage
Corner
Topography
Total height
Panhandle
Cul:de.sac
"
-:":
...~! '"l .. "
,"""
PL.
" '. I ' .
;"l'":'"l;"'~':I: ::~!~'\{~t'
, IS THE PROPOSED WORK IN THE.
. ".HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Ihls application must be signed
'and approved by the Historical
Coordinator prior tot permit Issuance.
Setbacks .
HSE GAR ACC'!
N
S
W I I
'.--LL~
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT. c VALUE
Main F.
Garage
Carport -.~ "
'frAi ~) 3~
Tolal Value 1'-=-=
PJ,
Building Permit Fee 1<to?O -IM,,}U
State Surcharge I,Sor!.Of;
Tolal Fee
(A)
"
/9 .5 ]'f:>
/91'7'&
~.60
'- -z:ser,
3B,S/3
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING F!ERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S~wer
Water
FT.
. FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnaco
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. ft
Curbcut II
9!~/T Sac.. ~/f7iJ
1_.1
1-s;g Ii>
State Surcharge
did/. :11.1"",) ""alia,.)
9%3:J
,Ftr:= ,-i4,OJ~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
,
FEE
_f"o,,: ." '.'
2-'7.30
'2VJ .3 2
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thaI the said
construction shall, in all resp.ects, conform to the Ordinance
adopted by the City 01 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.
Plan Check Fee'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within tile City limits which are being Improved.
ADDITIONAL COMMENTS
r ~ "7,) 1,/ .~7) (> -
)4r I.J/?/L ,7b..-'(~ /~X~-rl.
By signature, I state and agree, that I have carelully examined
the compleied application and do hereby certify. that all
Information hereon Is true and correct, and I further certify
that any and all work perlormed shall be done In accordance
with the Ordinances 01 the City of Springfield, and the Laws
of the State 0'- 9regon pertaining to the work described
,herein, and thai 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 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 property, and the approved set of plans will remain
on the site at all times during construction.
Slg~tur~. '77,~d<z.G.J:7
Date 3'- ../-5-- 9{ - (r ~
VALIDATION;
RECEtPT NUMBER
2.Oe/3
:? /2-pC
/ .3.i
'2./:) ,
/M'~-
DATE PAl"
AMOUNT RECEIVEn
RECEIVED BY _