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'
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94/43n
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX L~ .101
SUBDIVISION:
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OWNER: Sy>r..\l. n n:'),....f'
ADDRESS" ~~ ~lcll/\J~l"'L..")Lm(t"'.
CITY: s'~~;i7Q~~ejd STATE:D(
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DESCRIBE WORK:de.~bl;t{").1 ot \COo",eJt. s),<o\e. ~"...d~ fi"'.<:.~<k\1C~ a,
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NEW REMODEL __ ADDITION DEMOLISH Y
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CONTRACTOR'S NAME
GENERAL: Y~Cl ~( Drf
PLUMBING: \ ;_ .~J~
MECHANICAl' \ ,/c..
ELECTRIC~' \ ~
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QUAD AREA:
. OF BLDGS'
, OCCY GROUP:
. OF STORIES:
WATER HEATER:
OTHER
PHONE: _/...::tc:... - F3~
ZIP:~
,
O-:l\r,\ic- S-e.wef
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ADDRESS
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CONST.
CONTRACTOR'
'7'@(...,.1q
PHONE
'7't(., -R'111
- OFFICE USE -
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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. . '
/
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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
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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:/~
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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
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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