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HomeMy WebLinkAboutPermit Demolition 1994-9-20 RESIDENTIAL PERMIT APPLICATION -. SPRINGFIELD Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: %'B<tCY':(T7e b=;,,-n}?rl r ASSESSORS MAP' ,'1"7 o~ ria A ...J LOT' BLOCK' . 94/43n JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 ~\:-i"7Gql"'l('l. (1('". TAX L~ .101 SUBDIVISION: - OWNER: Sy>r..\l. n n:'),....f' ADDRESS" ~~ ~lcll/\J~l"'L..")Lm(t"'. CITY: s'~~;i7Q~~ejd STATE:D( \ '\ DESCRIBE WORK:de.~bl;t{").1 ot \COo",eJt. s),<o\e. ~"...d~ fi"'.<:.~<k\1C~ a, I ~ / NEW REMODEL __ ADDITION DEMOLISH Y f CONTRACTOR'S NAME GENERAL: Y~Cl ~( Drf PLUMBING: \ ;_ .~J~ MECHANICAl' \ ,/c.. ELECTRIC~' \ ~ \~S\JtL ') QUAD AREA: . OF BLDGS' , OCCY GROUP: . OF STORIES: WATER HEATER: OTHER PHONE: _/...::tc:... - F3~ ZIP:~ , O-:l\r,\ic- S-e.wef \ ADDRESS ~ T\rJ~ t JLt'J.:J ~ \-ya CONST. CONTRACTOR' '7'@(...,.1q PHONE '7't(., -R'111 - OFFICE USE - \\\ \ LAND USE: . OF UNITS: CONSTR. TYPE: HEAT SOURCE: _ RANG"' EXPIRES ~S 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. o Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumblng/Electrlcell Mechanical - Prior to cover. o Footing - After trenches are excavated. o Masonry - Steel location, bond beams, groutIng. o Foundation - After (orms are erected but prior to concrete placement. o Underground Plumbing - Prior to IIlllng trench. o Underlloor Plumbing/Mechanical - Prior to Insulation or decking. o Post and Beam - Prior to floor Insulation or dec.klng. . REQUIRED INSPECTIONS o Rough 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. o Framing - Prior to cover. o Well/e.olllng Insulallon - Prior to cover. o Drywell - Prior to taping. o Wood Stovo - A"fter Installation. o Insert - After fireplace approval and Installation of unit. O Floor Insulation - Prior to .. decking. . 0 Curbcut & Approech - After . . forms are erected but prior to ~ - .., , 'placement of concrete. "'.......g.y~"~...2- - , nor .... .,,,,,,g "- 2:U..X\'~(Idln . I _'_. ..' ~.-D. Sidewalk & Driveway - Aller D~torm Sewer'- Prlo'-totllll~g'-' exc~vatlon Is completc, forms trench. and sub.base material In place. i . ~ I , . o Waler L1no - p,rlor to IIl,llng trench. . .1 , , , o Rough Plumbln'g - Prlo"r to cover. . ' / \ o Fence - When completed. , o 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. C o Final Mechanical - When all mechanical work Is complete. o Final Building - When all required Inspections have been approved and building Is ~:~:I~tv!.cALL 'I ~~t1J~ ~ MOBILE HOME INSPECTIONS o Blocking and Set.Up - Whep all blocking Is complete. o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set.up, and plurt,lblng 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 faces Lot Type . Lot sq. ftg. Interior I PL. I Lot coverage Corner IN Is Topography Panhandle Iw Total ilelght Cul-dc.sac IE BUILDING PERMIT ITEM SQ. FT. X $/SQ. FT. ~ Main Ga<age Carport TOlal Value Building Permit Fee State Surcharge Tolal Fce (A) VALUE " SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM Flxl,ures Residential Bath(s) Sanitary Sewer Water N' FT. FT, Storm Sewer FT. Mobile Home Se-ww (' o....c> Plumbing Permit S~te Surcharge ?F{O "t/tfWl,", H. e- Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuahce State Surcharge Total Permit (0) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut It Demolition State Surcharge 3~ a.d."",,,, +-eQ... Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) FEE \S'.CV I l'SOD '15 ,4<; ---!.(",?n l '( ,oD '07) 1':)"1 1t1~L} 35,~f '. :~~:i~.\1;'Y; ( ~THE PROPOSED WORK tN THE. "HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? Setbacks 'HSE GAR'ACcl I I I I If yes, this appltcation must be signed and approved by the Historical coordlnato~r prior to,permlt Is,:-uance. APPROVED., ~)~ BUILDING VALUE, PLAN C ECK 10 . AND BUILDING PERMIT This permit Is granted on the express condition that the said construction shall, In all respects, conlorm to the Ordinance adopted by the Clty.ol 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: 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 k~77If AP~ /A.././Y .~..DA:/~ J By signature, I state and agree, that I have carelully 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 Ordlnanc~s 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 fro of the property, and the approved set of pi on the site at all t~ during co r- ......-;, -"1-. - Slgn~/- -_-----F- :.-:-#- I " i. .~ , , . 'f ,'\ VALIDATION: ~ /\ RECEIPT NUMBfEl, I,J f")u DATEPAlf'I y.p.J.). <t AMOUNT REC'EjD 35. t o.q RECEIVED BvC'-1) /.f'()....J