HomeMy WebLinkAboutPermit Demolition 1991-12-18
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769 ..~
Office: 726-3759 5' 2 5C( ~t>tP ..$; ~!'
LOCATION OF PROPOS'ED' WORK' .j? / /1{' e /P1 ePM
ASSESSORS MAP' /~ ~ '2 ..a y- "2/
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LOT:
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OWNER'
P/')h~.pr
CITY:
NEW;,I.
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JOB NUMBER
qp Y'7b
225 Fifth Street
Springfield, Oregon 97477
of ~6/kd~
BLOCK:
TA1< LOT: ~ '? S'<::'",o
SUBDIVISION'
PHONF'
7~~~!?'2..-
/?' t'JG..>=-e...u
ADDRESS ,5';?,t!:; t;/ r072 ~/19
:s.oRI'IU';~~ STATf'~PCmU ZIP' c:lJ7V"YR
f/ ' -. - ~
DESCRIBE WORK:j).pU(13IIc;..It~ hRe1lB#~e.A#:"~~;41A(.
- ''/ -
REMODEL ADDITION DEMOLISH X OTHERpY"/j?~ /J.cNR:'
CONTRACTOR'S NAME ~9JRESS
GENERAL' J('.p /V j ,,9//A./,;<)1!ilT .
V
CONST.
CONTRACTOR'
6'5' 720
EXPIRES PHONE
E -/696 7ft7M)
PLUMBING'
MECHANICAL: 1--...
ELECTRICAl' - ~clf'
QUAD AREA:
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER:
2:=h/
'- OFFICE USE -
LAND US'"
. OF UNITS'
CONSTR, TYP'"
HEAT SOURCE:
RANGE:
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
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.
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D Temporary Electric
D Site InspJbtlon - To be made
after exec ~ation, but prior to
setting to !ms.
1
D Underslat 1 Plumbing/Electrical I .
Mechanic t ~ Prior to cover.
o Footing.!. After trenches are
excavatec I
D Mas~nry 1;.- Steel location, bond
beams, grouting.
ct;I Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underfloor Plumbing/Mechanical
. - Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking,
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D' Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. .
D Water Line - Prior to filling
trench.
D Rough Plumbing ~ Prior to
cover.
,.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
o Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
.0 Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required inspections have been
approved and building is
completed,
DOther
D Wall/Ceiling Insulation - Prior to ........
cover.
D Drywall - Prior to taping,
o Wood Stove - After Installati00.
D Insert - After fireplace approval
and InstallatIon of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub.base material In place.
D Fence ---: When'con:'lpleted~
D Street Trees - When all required
trees are planted.- . ..
Ij' .
MOBILE HOME INSPECTIONS
m Blocking and Set-Up - When all
blocking is complete.
rJl Plumbing Connections - When
LA,-J home has been connected to
water and sewer.
ru. Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
rYl Final - After all required
LLf-J Inspections are approved and'
. porches, skirting, decks, and
venting have been Installed.
.,
Lot faces ~ot Type. Setbacks . THE PROPOSED WORK IN THE '.
Lot sq, ftg, .': Interior I P,L, HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Topography Panhandle Is I 'and approved by. the Historical
iw I Coordinator prior to permit issuance.
Total height Cul-de-sac IE I
,APPROVED:
BUILDING PERMIT
ITEM SQ, FT,
X $/SQ, FT,
VALUE
Main
Garage
Carport
r~7'~C;
..,
"
15'~I1?-, -
"
Total Value
Building Permit Fee
-:;> "'>:- oc:>
I. 2,-"-
"2~ _ '2-5'"
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT,
FT.
Water
Storm Sewer
Mobile Home
/~ .->!>
PlumbIng Permit
State Surcharge
~s: .-
. ?5'
/~ :;:-s-
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
/PS:-=>
~.~e>
State Issuance
State Surcharge
<<:..,,,":~
Sidewalk
ft
Curbcut
ft
Demolition
I~-
.~e:>
State Surcharge
Total Miscellaneous Permits (E)
/~O. ~5
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
,!-;f],.--~
;::?cO? yo
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, i~ 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 provisions of said ordinances.
Plan Check Fee: _/6- 2:S-
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.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed 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 certl 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 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.
Signature JIH /J ~.A" ~ /? tJ/
~- ./r'
Date /;;2..- /:?~ 9/
VALIDATION:
RECEIPT NUMBER ---n SI~
DATE PAIr> / .:z. -/&-"'7/
AMOUNT RECEIVEr> 7~7_)b_
RECEIVED BY ~-~;:;- l-~7--?
/f}- ( -
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RESIDENTIAL .
PERMIT APPLICATION
Inspections: 726.3769 . ' ..~
Office: 726.3759 5- 2 ~7C(;:::tJ;P ?; ~!I
LOCATION OF PROPOSED WORK:P / /lc e /f1 ~k.J
ASSESSORS MAP' /.tC ~2 .4!:) <,/- 2/
~(
LOT'
NEW'"
REMODEL
ADDITION
.
9b' Y'76
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
of Pd6/k~~A'
BLOCK'
TAX LOT' ~"2 5~o
SUBDIVISION'
PHONF'
7~~~..'?z..-
OWNER' P/')h.-p.r /?I'JG.>=-e"',u
ADDRESS' . ,5d,~ ~ FOR ~/J4
CITY: ;:; .0 R I' IU<:-F~....eP' STATE:(M2<"""CO;IC.) ZIP' q J7 V7R
(/" . -
DESCRIBE WORK: j)P/t/t3I/<;-h~ hReJJH4A0e~.A#~/I1//.
''/ ,/)
DEMOLISH _X. OTHER /#0"'/ ?~ a..,c/l' K
CONTRACTOR'S NAME ~JRESS
GENERAl' ~ P /1,) J. ,,5/;k,,u19lT
V
CONST,
CONTRACTOR .
5'7'720
EXPIRES PHONE
Z-I6'96 71tmn)
PLUMBING'
MECHANICAL' -;...,
/ifck'
ELECTRICAl'
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
~k>...r..,
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPF'
HEAT SOURCE:
RANGE:
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT'
I '
SQUARE FOOTAGE:
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.
"
D Temporary Electric
D Site InspJctlon - To be made
after exeC' {at/on, but prior to
setting fo 1m3.
i
D Underslal i Plumbing/Electrical I
Mechanic f' - Prior to cover,
o Footing a ~ After trenches are
excavatec ,~
D Mesonry It... Steel IDeation, bond
beams, 'droUlIng.
o Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to flllin9 trench,
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Posl and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
deckl ng,
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water line - Prior to filling
trench.
D Rough Plumbing:"" Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power,
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Slave - After Installation,
D Insert - After fireplace approval
and Installation of unll.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Fence ~ When. completed.
D Slreet Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing work Is complete,
D Final Electrical - When all
electrical work Is complete.
'D Final Mechanicai - Wheo all
mechanical work'ls complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
m Blocking and Set.Up - When all
blocking Is complete,
r:Jl Plumbing Connections - When
LA:J home has been connected to
water and sewer.
rn. Electrical Connection - When
blocking, set.up, ,and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
rY1 Final - After all required
lLt-llnspectlons are approved and
porches, skirting, decks, and
venting have been Installed,
~
Lot faces Lot Type . Setbacks .HE PROPOSED WORK IN THE '.
Lot sq, ltg, Interior p.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
I THE HISTORICAL REGISTER?
Lot coverage Corner N If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total height Cul-de-sac IE I
APPROVED:
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
VALUE
Main
Garage
Carport
..,.E~7'/~<;
15~""~ -
Total Val ue
Building Permit Fee
'::> .;: 00-
j.2r~
"2~. '2-,~
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Resldeotlal Bath(s)
NO
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT,
Mobile Home
/ -!;: .--,p
Plumbing Permit
~5'- .-.
. ?5'
I~?.-<?' ,
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Ho~d
Vent Fan
',NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
MechanIcal Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
/P5:'"=
~..e.
""'''';~
State Issuance
State Surcharge
Sidewalk
It
Cu rbcut
It
Demolition
I?:? ..-
,~
State Surcharge
Total Miscellaneous Permits
j";?o_ ~5
(E)
TOTAL AMOUNT DUE (excluding electrical) _"1:';:::= .$>
(A, B, C, D, and E Combined) ;:?.cs?, yo
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, 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: _/6--::zS--
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.
ADDITIONAL COMMENTS
By slgn~t~re, I state and agree, that I have carefully examined
the completed 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, aod 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 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.
Signature ~-t ,~A/I t?/
Date /9.. - /::?' 9/
VALIDATION:
,RECEIPT NUMBER --n'lB
DATE PAID 1<' -/8- ~ /'
AMOUNT RECEIVEf' ::?~7.- yz:;> __
RECEIVED BY~~~~~~
,
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DATE RECIEVED I-;;>./<a-,/, JOB No, "'7//<1 'J:!Z..
2'.?NE L.7/;qhv-<? OcCUPA~ ".:... G~O.:'P A'J~Y'''','
UNITe I OccUPM -:,y LOAD
STORIES I TYPE CC-l.eT. ~ .
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L-ItGAC DESCRIPTION ~ ~'2...,?'7 'Z / -&:>?-:5 ""C>
ADDR<~ 4?'2 5'7 F~/ ''''::>~#/ r
,OWNER p/57j67?r-~~~~~/ '-
THE CONTENTS MERE OF HAV' BEEN REvn;;WED. WITH
ALTERATIONS INDICATED IN CO O~ED PENCIL. CHANGES
......... ,,'-......JUT't'H..t.9. MADE AFlER OAT;;;: BELOW ".t:tAL~ BE
API"ROVEO s'y TH! t:;IUI L.UIIIIJ- ~&L
CIIY OF;;R:N~, OREGONS ;:'e~~"':
I APPROVED B~/~ A~--? w_'</:"'~.:./ ~/-1'F
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19.9~ ;unskul1-
Jeff IUD
NC If:JIf'2~ 7'35t.
COM Pf'O.r
W01J-c( > 1;h;Uy
C{JV ~/l-CTcJ?e
J( e.vru y S Ti ~~8lf'
Ale ;1./0 6"572.0
EXrf/pe~ -Z-/?-72-