HomeMy WebLinkAboutPermit Sidewalk 1984-6-12 (2)
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APPLICATION/PERMIT
225 North 5th Street
Springfield, Oregon 97477
Building Division
726-3753 '
Job l<Jcation: \ W~Q\O ~\ ~lf'\
ABceesoro Map # \ W W 2. 2- \ -\) -
SubdilJision:
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Tax -;"t # 0\ t-t(J
Pr.one:
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C\fY\. ~
Zip:
Describe frork:
t~; '~~\(Ji~, 30
Date of Application
Contractors
Genera l \~ \' '( ,
Plumbing ---.....J .
Electrical.
Mechanical.
Constroucticm Lender
It is the responoibility of ths permit holder to Bee that all inDpections are T:'lade at the proper timE;~ that eac:h .;ddreB8 is raadab~e
f1'Onl the street, and that th9 permit caPd is l.ocated at the front of the propert;y.
*!Jui!dirl{J Divi:::ior. approL'ed plan shall remain on th~ Bu-!.l.ding Sits at all times.
PROCEDURE FOR INSPECTION RE'.";lUEST:CALL 726-3769 (recorder) state your City designated job number, job ad.&css, type of in:;pectic,t
requested a~d when you will be ready for inspection, Contractors 01' Owne~s name end phone number. Requests received befcre 7:00 ~
t..'ill be made the 8cune day" requests made aft;;:r 7:00 am will be made the next :.JOrking day.
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.ql?n:!J7:"?~f( TrJ1mp~tir.n~
O SITE INSPECTION: To be made after
excavation" but prior to Set up of
forms.
O. UNTJERSD_4_'i_ PU'MBING, ELECTRrC4L &
. MECHANICAL: To be made before any
work is ~ovcred.
o
FOOTING & FOUND,iTION: To be m:zde
after trenches are excavated and
forms are eroeated" but proiaI' to
pouring ccncret~.
UNDERGROUND PLUMBING. SEWER. WATER"
DRAINAGE: To be rraie proioI' to fi~-
.lir.g trenches.
O UIIDERPWOR PWMBINr. & MFCH4NTCA&:
- . To be made--prior to installation of
floor insulation or decking.
O POST AND BEAM: To be made prior to
insta~lation of floor insulation or
, decking.
D ROUGH PLW1BIlIG. pr,ECTRICAT. & MECH___
ANICAL: No work is to be cotlered
:ur.ti~ these inspections have beer.
made and app1'Oved. .
O FIREPLACE: Pr>ior to placir.g facing
materiaZs and before framing inspec-
tior:.
o
O FRAJ!ING: Must be requested after
approvaZ of rough pZwrhing" eZect1'i-
.caZ & mechanicaZ. All. roOfing
" ,bracing d chimneys" et~. ~~st be
)'compZetcd. No work is to be CGn-
.....,.ceaZed until thifJ inspection has
~ be~n made and approved.
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Address .
\ \ 1 L\sQ\)J 1''l. Ilfl ,
,
Value
...
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Signed: diiroJ
Dote: '\JJS\Q \IL\ R~
Lise. #
Exvircs
Phone
fntl_ \\ X':='\ ~
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Your Ci ty' Desigr.ated Job Number Is:
O INSULATION/VAPOR BARRIER TlISPF:CTION:
To be made after aZl insuZation a."'.d
. . . required vapor barriers are in place
. . but before any lath" gypsum board or
waU covering is appUed" and beforoe
.. a1'!y insu'lation is conceaZed.
D DRYWALL INSPECTION: Tc be made
after all drywaZZ is in place"
. but prior to any taping. .
0' ~SONRY: SteeZ Zocation" bona
beams" grouting or verticals in
accordance lJith U.B. C. Section
2415.
D WOODSTOVE: After installation is
ccmpleted.
D CURB & APPROACH APRON: After> foms
a:re erected bu t prior to pouring
aonarete.
'~EWALK & DRIt'EWAY: For all ~on-
~ ~;~te paving within street right-
.of-way" to be made after an exca-
vating complete & form work & sub-
base materiaZ in place.
o
PENCE: Wher: compl~te -- Provide-
gates 01' movable sections through
P.U.E. '
lo/ll,,/P4
" I
Pf\c)4\Q
I DEUOLITION OR ;'.lOVED BUILDIj'!GS
~ Sanitary Se',.)e1' c:apped ~t p:...opi:r~:J. Zir:e
~ Septi:! tank p:'cl?cd and fiZZc~ with gra:.:,eZ
I Pinal - mten abcve items are acmpZetcd
~ ar~ when demoZitior. is compZete or stru~-
ture moved and pr~~3es cZeaned up.
Nobile Homes
::J BZocking and Set-up
::J PZumbing connections -- 8~e1' and Water !
::J Electrical Connection - Blocking, Bet-up I
and pZumbing conr:ections ~~st be approved
. before requesting eZectrical inspectio~
~ Acaes~oY"d Bui"Lding
--, Fina.Z - After porches" skirting" decks"
~ etc. are corrrpZetcd.
D
AZZ prooject conditions" such as the instaZZation of street trees, co~Zation of t~e
required Zandscepir:g" etc." must be satisfied before the BUILDING FINAL can be raquestad.
o FIliAL PWMBIJlG
o FINAL MECHANICAL
o FINAL ELECTRICAL
o
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FINAL BUILDING: The FinaZ BuUding Inspection must be requested eft-er the FinaZ Plwnbin:J
EZectricaZ" and Mechar.icaZ Inspections have been made and approved.
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>tAT.L MANHOLES AND CLEANOUTS HUST BE ACCESSIBLE" ADJUST!fEllT TO BE MADE /IT NO COST TO CITY Page 1 of 2
.JOB
NQ,84C4\9 N...'.
Occuvancl/ Group:
Zone:
l<Jt Sq. Ftg.
~ of lot Coverage
,/I of Stories
Total Height
Topography
I
lITEM
!-kzin
Ga:1'aae
Carvort
I Accessoru
Is.v.c.
lITEM
I Fixtures
SQ.FTG
TOTAL VAWE
(va(..uc)
1.5 ;r:
Bui lding Permi t
State Surcharge
Total Cha.....ges
Residential (1 bath)
Water
Sani tary Sewer
ITEM
Plumbing Pel"17:i t
State Surcr.a.rge
'1't'Jtal Cha:raes
Res. Sa. fta.
New/Extend Circuits
Temporary Service
ITEM
I Furnace PTU' S
lExhaust Hood
I Vent FCD1
I WOodstove
Ele~trical Pe~t
State Su:t'~ha1"de
Total Cha:rces
Permit Issuance
Me::hanical Permit
State Surcharac
Tot:n 1. r.harI'T(':m
NO. I FEE
NO,1 FEE
NO.
-- ENCROACHMENT --
ISe~~ritu Devosit
I Storage
I Maintena~e
I PaI"mit
I Total Charqes
I Curbcut
I sidewa Zk
I Fcn~e
Electrical Label
Mobile Home
I TOTAL AMOUNT DUE:'
'r
LOT TYPE
Interior
Corner
Panhandle
CUL-de-sac
x
Value
CHARGE
CHARGE
FEE
CllARCE
'T. 00
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-1ocJ
"
- ....
.
T;'pe/Cor.st:
Bedrooms:
I Enerqu Sources
III' Heat
Water' Yp-atp.l'
I I Range
I I Firevlace
I I Wood;; tove
II
TUrJe
I l<Jt Faces -
I Setbacks
I P. L. House I Carage
North
lEast i
South I
IWest I
I Access.
Fees
Building Value & Permit
This permit iD 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 Zoning Crdinanae, regulating the construation
and uae of buildings, and may be suspended 01' revoked at any time upon vio-
lation of any provisions of said Ordinances.
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Plan Check Fee:
Date Paid:
Rec8ipt #:
Signed:
Plumbing Permit
No person ahall construct, instal!, alter 01' change any r~w or e:isting
plumbing or drainage system in whole or in part, unless such person is the
legal possessor of a valid plumber's license, except that a pe~son may do
p1..ur..bing work to property which is owned, leased 01' operated by the appli-
cant.
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Electrical Permit
Where State LaJ.J requires t;..at the electrical work be done by an Elec:trical
Contractor, the electrical portion of this pel'17lit shall not be valid until
the label has been signed by the Electrical Contractor.
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Mechanical Permit
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Pl.an E:cam"Ltl8r
oo.e
I HAVE CAREFULLY EXAMINED th2 completed application for permit, and do
hereby certify that all info~tion hereon is true and correct, and 1
f-.nother certify that any ar.d all work perfor:ned shall be do'n.e in acc:or-
dance with the Ordinances of the City of Springfield, and th;; La-...;s of tho
State of Dreg"n p~rtaining to the work described herein, and that NO OCCU-
PANCY will be ~de of any structure without parmission of the Building Di-
vision. I fupther certify that o:1ly contractors and e:rrpl.Qyees who are in
compliance with ORS 701.055 will be used on this project
(... t br?Y
Date