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HomeMy WebLinkAboutPermit Building 5-8-11 (2) RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 SPRINGFIELD LOCATION OF PROPOSED WORK: ~ hi ASSESSORS MAP: /7~_~ -~-::z/ ,,- , :-~--: ./~C&- /' LOT: BLOCK: JOB NUMBER 9~~7'9':3 225 Fifth Street Springfield, Oregon 97477 TAXLOT:~~~~ SUBDIVISION' OWNER:M~Fu:?/E Pf'l~4AL~&F.?"?e~~P//.#.&:. PHONE: ?~-~o/"5:::> ADDRESS: /~~ 6 ~. CITY: ~~~. - - / STATE: ~.. ,. ZIP: ~7V./? DESCRIBE WORK:~~?:,~'ve=7I~.~~cA ,~~;? ~~ ~/ NEW Y REMODEL ADDITION DEMOLISH OTHER CONST. CONTRACTOR'S NAME ~.cB.~/~X?' CONTRACTOR /I EXPIRES .:. PHONE GENERAL:~M'/A/~:"~ ~~~-N'~':~~.q_ ~_-:;J~ ~ /7i:~~_ dS$3"~? PLUMBING: MECHANICAL: ELECTRICAL: QUAD AREA: -2~#'W' '" /' OCCY GROUP: .75--3 I /I OF BLDGS: /I OF STORIES: WATER HEATER: - OFFICE USE - LAND USE: //// I FLOOD PLAIN: ZONING CODE: L.rj1q /I OF BDRMS: ~ SECONDARY HEAT: SQUARE FOOTAGE: '??$"'2.. 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. o Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing I Electricall Mechanical - Prior to cover. [t[J Footing - After trenches are excavated. D Masonry - Steel location, bond beams, grouting. [!] Foundation - After forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. m Underlloor Plumbing I Mechanical - Prior to Insulation or decking. [l] Post and Be'am - Prior to floor Insulation or decking. [2] Floor Insula'tion - Prior to decking. rn Sanitary Sewer - Prior to filling; trench. ~ [2] Storm Sewer - Prior to filling trench. [Aj W~ter Line - Prior to filling trench. r7i1l Rough Plumbing - Prior ~o ~ cover. .. /I OF UNITS: CONSTR. TYPE:. ~ :s~/-{' . ", HEAT SOURCE: ~~J::.r ~J ~ RANGE: REQUIRED INSPECTIONS [A] Rough Mechanical - Prior to cover. r7l Rough Electrical - Prior to LflU cover. r:i7l Electrical Service - Must be ~ approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. [i(J Framing - Prior to cover. ~ Wall/Ceiling Insulation - Prior to cover. '. ~ Drywall - Prior to t.aPlng. D Wood Stovo - After Installation. D Insert, After fireplace approv!ll and Installation of unit. ~ Curbcut & Approach - After forms are t)rected 'but prior to placement of concrete. . ~ Sidewalk & Driveway - After l.LlJ excavation Is complete, forms and sub.base material In place. ~ Fence - When completed. rvI Street Trees - When all required ~ trees are planted. ., [2] Final Plumbing - When all plumbing W9rl{ Is complete. rn Final Electrical - When all electrical work is complete. [l] Final, Mechanical - When all mechanical work is complete. r-:vl Final' Building - When all L,.4.J required Inspections have been approved and building is completed. Cll Oth~r J(~,,? r P ~~~~~~ MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking is complete. D 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 service panel. o Final - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed. .~' . . Lot Ty~ Interior I P.L. ~ Corner IN Is Panhandle Iw Cul-de-sac IE Lot faces Lot sq. ftg. Lot coverage Topography Total height BUILDING PERMIT ?7~~.......P' , ''- ", .,9.~~ -41'~ . ~ ~~.zg I~. 'Y'f SYSTEMS DEVELOPMENT CHARGE (SDC) ~o/JI. ~ ITEM sa. FT. X $/SO. FT. Mai n ?39Y2 Garage Carport ~Q/ ~~ ~t;I - Total Value Building Permit Fee State Surcharge Total Fee PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO Sanitary Sewer FT. Water FT. ~ Storm Sewer FT. -92 Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace -;:J Exhaust Hood ""::? Vent Fan NO 5" Wood Stove/lnsert/Flreplace Unit Dryer Vent "" A~ ~ . -g' ~ ~d./~ Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ~r'~ ft Curbcut 9LJ ft .c.- --: "~/",~6I'c F( ~/.:?6a ) $~='~~~) Total Miscellaneous Permits (E) " TOTAL AMOUNT DUE (excluding elecirical) (A, B, C, D, and E Combined) VALUE ~c;-.&-~ t~' -r " (A) (B) FEE /92.~ ~~. ~ t:> ~ ... "'" ~ -< -,~ -//.€3 . ~.~ -:::z. 57 . / / --.L$. .-c:o "'7, _0 /?~ 6.,e> ~.-- ~,~i!> /~ 6-b ~~ '1~ 21. ~S .//.~ ~~$&' .r::;-:~ 2$1'2- ~ ~~,2~ / "'" "3~_ ~r' ;, 'i\ ~ ,.'1:" ~\' ,}", Setbacks HSE GAR ACC' \ 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. . APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This p~rmit 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: ~.4!J} ~$7. Date Paid: Receipt Number: Received By: __." ~~. S/-- ::>-~.5' Date Systems Development Charge Is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS (r-.~S) ~o.??#~/ ~~-<2>L~~/LL ~.A'~ ~3~.fg-/2~ ~.,.. ~ (S'?d/1"#-) (~~~~) (~:...J-:- /1t?(rt'9~&e::~ . ~.~~~~~)~. ~ ~~'i!~/~~' ~~ 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 Ordinances0'f 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 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 .remaln on<the site ~t ~ limes \dU',' ng c\l1stru,tion. ~:atu,"="_~ ~ ~ ~. - VALIDATION: rh RECEIPT NUMB?r" R \t.r...\o~ DATE PAID t') ./1 q~ AMOUNT RE(;f~D -.B2~?. ~ RECEIVED B~~