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HomeMy WebLinkAboutPermit Building 1999-11-23 .....: :';."-----.--i.-..;, RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: ~ 17()~ 2t;/1 1 OWNER: ~ }eAkIAI) fJ.O JI(~IKJ ADDRESS: .~~ ~ 2- 2. 2- - <::'A{2tc! I DESCRIBE WORK: ~M.s A (I/tuv( tJ~ .' ' '.., Q # NEW REMODEL ADDITION DEMOLISH, ASSESSORS MAP: LOT: CITY' CONTRACTOR'S NAME t? (rI A/-t:7t.--- . ~ ..'" GENERAl. PLUMBING' MECHANICAL: ELECTRICAl' BLOCK: i., JOB NUMBER 180/111 -". 225 Fifth Street Springfield, Oregon 97477 TAX LOT: t3 / / C:l 0 SUBDIVISION: IZ.. 5-rtt<J- PHONF' 7J.Pf-S~:;L /~6- (/06S ~e ZIP: Cf?-'t77 STATE: -, 'OTHER ADDRESS' CON ST. CONTRACTOR # EXPIRES;~ PHONE - OFFICE USE - QUAD AREA' LAND USE: FLOOD PLAIN: # OF BLDGS' # OF UNITS: ZONING CODE: OCCY GROUP: CONSTR. TYPE: /I OF BDRMS' # OF STORIES' HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RANGF' SQUARE FOOTAGE: To request an Inspection, you must call 726-3769. This Is a24 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 Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing/Electrical/ Mechanical - PrIor to cover. o Footing - After trenches are excavated. . . D Masonry - Steel location, bond beams, groutIng. D Foundation - After forms are erected but prIor to concrete placement. D Underground Ph~mblng - Prior to filling trench. D Underlloor Plumbing/Mechanical - Prior to Insulation or decking. D Post and Beam ~ Prior to floor Insulation or decking. D FloorlnsulatJon - Prior to decking. ' J D Sanit~ry Sewer - Prior to filling . trencli. . D Storm Sewer - Prior to mllng trench. " , .,. ,. " ....., "j ". -j : D Water Line - Prlo,r tl? f~"lng trench. . iI, ." ", . " D Rough Plumbl.n; -prior to cover. : '., '. REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. D Rough Electrical -,. Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing 7). terlals and framing Insp. ~ramlng - Prior to cover. o Wail/Ceiling Insulation - Prior to cover. . D Drywall - Prior to taping. o Wood Stovo - After Installation. o Insert - After fireplace approval .. and Installation of unit. r- - ~. ,_ 0 Curbcllt & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub-base material In place. o Fence. - When completed. o Street Trees - Wh~n ~1I,requlred trees are plal)ted. . f D Final Plumbing - When all . plumbing w9rl< Is complete. D Final Electrical - When all electrical work Is complete. o Final Mechanical - When all .u;;2meChanlcal work is complete. nal Building - When all required Inspections have been approved and building is completed. D 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 plumbing Inspections have been approved and the home Is connected to the service panel. D Final - After all required Inspections are approved and porchos, skirting, decks, and venting have been Installed, Lot faces Lot Type' Leot sq. ftg. Interior Lot coverage Corner Topography Total height .. panhandle .. Cul-de-sac BUILDING PERMIT 'I " r:l ., '("..:~." :\ .~' ~.. , ;. '.. I, t; . f ;".J \,-.l(., , 'r,'J" -, ,O't . >.' 'tf1' ~ :". .oft \' . . ... .::' ">:.,;:-;;".~:i~:.i\' Setbacks ' HSE GAR ACC' . ,- . ",.. ..... IS THE PROPOSED WORK tN"ft.fi:;'. . "HISTORICAL qlSTRICT, OR ON , THE HISTORICAL REGISTER? . '. ".;, :~ I' P'L; IN Is If yes, .this aPlplleatlon must be signed and approved by the Historical Coordinator prior to permit Issuance. '1 I I BUILDING \ni.tCiE,PLAN 'CHECK AND BUILDING PERMIT w E APPROVED: ITEM SO, FT. X $/SO, FT. VALUE Main Garage " ',,'r Carport Total Value Building Permit Fee State Surcharge Total Fee (A) ~ ~.Sb ,- l.t.) This permit Is granted on the express condition that the said construction shall, Inali respects, conforn'1'to the Ordinance adopted by the City. of Springfield, Including the Development Code, regulating the constru,ction and use of oulldlngs, and may be suspe'nded or revoked at any time upon violation of any provlslons.of said ordinances. Plan Check Fee: 'Lt: 0 ~ Date Paid: ," I.z.l'/' ',7 -, . Receipt Number' Received By: . 'A dU~ Plans Reviewed By II /1!.~/77 Date SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) N' Sanitary S~wer Water FT. FT. FT. Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stove/lnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, S, C, D, and E Combined) Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMENTS FEE 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 cohect, and I further certify that any and ali 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, an e approved s~t of tans will remain on the site at time during c~n~t c:,o) 0 Slgnaturp ~~ ~ WU ~ \ ",,---..--' . Date / I-~ ~ 3 - t?t.CJ VALIDATION: RECEIPT NUMBER DATE PAID ()3'7-72- 1,/l.J!f, I /7 Jf f ~ tJJ ,7,3~ AMOUNT RECEIVED RECEIVED BY . ~~'~'1f' \. If c, r 0 g-q t.j (j?r1r . . ,: W\~ ~+11 ATTENTION:Oregon law requires. you to follow rules adopted by the Oregon Utility Notification Center. Those mlesare set forth in OAR 952-00'1-001 0 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note:.t~~e tel?~ho~e number for the Oregon Utllny NOllflcatlOn' Centsr is 1-800-332-2344). 1 ,:;" If:;) \~ ~) I ~ //,' ~~ (/ f~ . ~ ~ . ,. CJ(j. ,\.0 / ~', <<t -~. r;Y_t8,';-i,f"'I' .... . .._-V0<3~ - . , ' , \ I)" ~I'<k- ,,~ -Ff eM fto. '^ \woJ v.-'- \~1 \\ Y ~ \ NOTICE: --.. THIS PERMIT SHALL EXPIRE IFTHEWORK AUTHOR'LtuUNDERTHIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. ,,-- ;--~+ '- - ~ 1;~"'2J,Ju. ~ ;}- J--J-."'L R Sl-r-€Qt t-J.lst\\l'') ~\IJ<J.-' L-.. 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