HomeMy WebLinkAboutPermit Building 1991-7-22
RESIDENTIAL'
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK: \Lo 70
ASSESSORS MAP: .17{7~' 3(... 2/
LOT:
SPRINGFIELD
,JOB NUMBER
q'(0752-
225 Fifth Street
Springfield, Oregon 97477
S~~~aJ 0 \~ '
"' .. _ " TA?< LOT: , ~~? CJ?)
SUBDIVISION:
OWNER: ,7Yic,E='\l"" ~. ~C--'~ \JfC(q,lr.? PHONE:/20- 39'79
ADDRES~' I c:, 7 fJ. f-)
CIT~~lv,(y~\e\d 'STATEQR- ZIP:Cf74-77
DESCRIBE WORK: S~O ()
r
NEW Y REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME
GENERAL: '- hC;:Q\, \\
PL.,UMBII)Jr-:.
MECHANICAL:
BLOCK:
ADDRESS
"-\- \\r...C"' Cot\rdG (
\..
lto 70
CONST.
CONTRACTOR #
1+ "5d'c-l. G- ~
~ '
ELECTRICAl'
QUAD AREA: ,!). 'Q \\ ') \.0
# OF BLDGS: \
OCCY GROUP: \\1\
# OF STORIES: \
WATER HEATER:
- OFFICE USF -
LAND USF' \ \ \ \ .
\ .
CONSTR. TYPE: V AJ
# OF UNITS:
HEAT SOURCE:
RANGE:
EXPIRES
PHONE
FLOOD PLAIN:
( A)(J
ZONING CODE:
# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: -q~{ 12-
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/Electrical/
. Mechanical - Prior to cover.
.....1'XIFooting - After trenches are
, ~excavated.
(
-
o Masonry - Steel location, bond
beams, grouting. '
~ Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench. .
o Uriderfloor Plumbing/ Mechanical
- Prior to insulation or decking.
o
Post and Beam -. Prior to floor
insulation or decking,
o Floor Insulation - Prior to
decki ng.
o Sanitary Sewer - Prior to filling
trench.
~ Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench. ,
o Rough Plumbing - Prior to
cover.
o
REQUIRED INSPECTIONS
o Bough Mechanical - Prior to
cover.
o Rough Electrical- Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace -'" Prior to facing
materials and framing Insp.
~Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
. cover.
o Drywall - Prior to taping.
,- ',,'.' .
o Wood St(Jve - After installation.
O. Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
andsub.base material in place.
o Fence - When completed.
D Street Trees - When all required
trees are planted..
o
Final Plumbing - When all
plumbing work is complete.
o Final Electrical - When 'all
electrical work is complete.
o Final Mechanical - When all
mechanical work is complete.
l':71 Final Building -. When all
~required inspections have been
approved and building is
completed.
'0 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.
o Electrical Connection - When
blocking, set.up, and p.lumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
. " . inspections are approved and
porches,ski rti ng, decks, and
. venting have been installed. .
Lot faces Lot Type Setbacks THE PROPOSED WORK IN THE
Lot sq. ftg. Interior P.L. HSE GAR Accl HISTORICAL DISTRICT, OR ON
lOr THE HISTORICAL REGISTER?
Lot coverage Corner N If yes, this application must be signed
S and approved by the Histo'rical
Topography Panhandle Sl Coordinator prior to permit issuance.
Total height Cul-de-sac W
IE Z.Z/ I APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. VALUE
Main
Garage
Carport
~c q~~ /~/O - /~/9 7
j , J, 11:X'6c
. ...."
/(J)&,. ~o
,
c;-, ~ S
. -
/01.73
SYSTEMS DEVELOPMENT C~AR~~ (SDC)
(B) \Cb"1-- ~~IA
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Cu rbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
~ r:J. ~3
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: ??7,7'3
..::&J - CO
Receipt Number' Z-D66 \
Rece~~
Plans Reviewed By'"
Date Paid:
-7 ~ 7h'/
'/ bate -
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 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.
X Signature ~~L9 Yv-L r ~ O.~
Date '7 - 2 Z - er /
VALIDATION:
RECEIPT NUMBER 2t2 7~ ~
r
DATE PAID 7 - 2.2- - 'tl
~ , '!i';J'
AMOUNT RECEIVED ?~ '.
RECEIVED BY -<~ v ~ _ J
~