HomeMy WebLinkAboutPermit Demolition 1991-10-1
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK' ~ 3lfS-
17-03 -:2.7-00-(C)tJOl!:J)
ASSESSORS MAP'
LOT:
OWNER'
ADDRES'"
12..'1 ~
1/37., .5v^"","~
I
{;~;...."-
CITY:
BLOCK:
7>rr,
STAT'"
O....""'bO'J
NEW
REMODEL
ADDITION
rr"7>n. 1:>0<'V'1V }.I,.,u,<<-
OTHER
DESCRIBE WORK'
CONTRACTOR'S NAME
GENERAl' ~ A-wI.c&oN
PLUMBING'
MECHANICAl'
ELECTRICAl'
QUAD AREA: DR~l)
. OF BLDGS'
OCCY GROUP'
. OF STORIES'
WATER HEATER:
DEMOLISH X
.
JOB NUMBER
"7///57
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
01000
PHON'"
f.. 88-"7?~
ZIP' Q7y-oq
CONST,
ADDRESS CONTRACTOR'
O.D. ~::l./~1 G....., "n'102- t.b,~ '"
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stove - After Jnstall~tion.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - Afler
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub.base material in place.
D Fence - When ,completed.
D Street Trees - When' alr"requlred-'
trees are planted.. .
EXPIRES
$"-/ p,..q ,
PHONE
(,8 j- :U. 7 9.
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspectlon, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the follo~lng wo.rk day.
- OFFICE USE -
LAND USE:
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
D
Final Plumbing - When all
plumbing work is complete.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
settlng forms.
D Underslab Plumbing/Electrlcall
Mech,anical - Prior to cover.
D Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D
Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
D
Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to.fIIlJng
trench. '
o Rough Plumbing - Prior to
cover.
o Final Electrical - When all
elec~rical work is complete.
D Final Mechanical - When all
mechanical work is complete.
D Final Building - When all
required inspections have been
approved and building is
completed.
!Xl Other I?N'~L ~.?
~ ?t$PT/L ~~/:;~
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When ali
blocking is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D 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.
porches, skirting, decks, and
venting have been Installed.
,... Lot Type. ,es THE PROPOSED WORK IN THE
Lot faces / Setbacks
Lot sq, ltg, :;0 .,r~ -4 Interior I PL. I HSE I GAR ACC I HISTORICAL DISTRICT, OR ON jl./
IN I I THE HISTORICAL REGISTER? I':)
Lot coverage 1,;J.ooJ'f, PI": _ Corner If yes, this application must be signed
F.I2L Is I I and approved by the Historical
Topography Panhandle Iw I I Coordinator prior to permit issuance.
Total height I~, J:r. Cul-de-sac
IE I I APPROVED:
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
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, regulati ng the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Garage
Carport
Plan Check Fee:
Date Paid:
Total Value
Receipt Number:
Building Permit Fee
Received By:
State Surcharge
Total Fee
(Al
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT,
FT.
Water
Storm Sewer
Mobile Home
hl.,? '5EPT/<:' ~-'r
/..,-; --
/ ;5,":-t?
Plumbing Permit
Total Charge
(C)
-75
/'5: /. ~
State Surcharge
MECHANICAL PERMIT
Furnace
Vent Fan
N'
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 Ordinanct;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 OAS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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 plans will remain
0",", ~~ ,""0", 0" '00.
Signature ..) ,/?~ - .
c..o' 17<'7 n
Date /.6~ /
( '("If
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
/-J!? .-
State Surcharge
.~
VALIDATION:
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
70/.~
-;;?/7"7?
/&>-/-"7 /
AMOUNT RECEIVED ?! <Y. .s::: "::>-
~~":> .4. ~
DATE PAID
RECEIPT NUMBER
Total Miscellaneous Permits (E)
RECEIVED BY