HomeMy WebLinkAboutPermit Building 1994-9-12
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RESIDENTIAL
PERMIT APPLICATION
JOB NUMBER 9~ /fO S"
Inspections: 726.3769
Office: 726.3759
225 Fi fth Street
Springfield, Oregon 97477
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LOCATION OF PROPOSED WORK:
ASSESSORS MAP: .I '1 LJ ~
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TAX LOT:
SUBDIVISION:
LOT:
BLOCK:
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OWNER: ,e... v r I)
ADDRESS~ .< fr9 ~
CITY: _E 'J _~,
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PHONE:
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STATE:
ZIP:
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DESCRIBE WORK:
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NEW
REMODEL t.--"-
ADDITION
, DEMOLISH
OTHER
CONST. '
ADDRESS' ,CONTRACTOR #
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CONTRACTOR'S NAME
GENERAL:E A/..,.. y '"
EXPIRES
PHONE
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PLUMBING:
MECHANICAL:
ELECTRICAL:
CrOW
VtLl/-cy
- OFFICE USE -
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
LAND USE:
FLOOD PLAIN:
ZONING CODE:
# OF BDRMS:
# OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
SECONDARY HEAT:
SQUARE FOOTAGE:_
WATER HEATER:
RANG E:
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, Inspect/ons req'uested after 7:00 a.m, will be made the following work day,
REQUIRED INSPECTIONS
o Temporary Electric
o Rough Mechanical -.:. Prior to
cover.
o Final Plumbing - When all
plumbing w()rk ,Is complete.
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Rough'Electrical - Prior to
cover.
o Final Electrical - \ll.l.hen all
electrical work is complete, ~
o Underslab Plumbing/ ElectrlcalJ
Mechanical - Prior to cover.
o Final Mechanical - When all
mechanical work /s complete.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Footing - After trenches are
excavated.
...
o Final Building - When all
required Inspections have been
approved and building is
completed,
o Fireplace - Prior to faCing
materials and framing Insp.
0: Masonry - Steel location, bond
beams, grouting,
O Foundation - After forms are
erected but prior to 'concrete
placement.
o Framing - Prior, to cover.
D Other
o Wail/Ceiling Insulation - Prior to
cover. '
D Underground Plumbing - Prior
to filling trench.
~ Drywall- Prior to taping,
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o Wood Stove - After Installation.
MOBILE HOME INSPECfIONS
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam - Prior to floor
Insulation or decking.
o Blocking and Set.Up - Whep all
blocking Is complete. '
D Insert - After fireplace approval
and Installation of unit.
o Floor Insulation - Prior to
decking.
o Plumbing Connections - When
home has been connected to '
water and sewer,
o 'Curbcut & Approach - After
. forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set-up. and plu~bing
inspections have been approved
and the home Is connected to
the service panel.
o Sidewalk & Driveway - After
excavation is complete. forms
and'sub-base material in place.
o Storm Sewer - Prior to filling
trench., "
o ~:~~~,L1ne,,:.-: ~~~,~,t: ~~~"ng
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o Rough Plumbing -- Prior to
cover, _''; :
o Fence - When completed.
D Final - After all required,
inspections are approved and
porches, skirting, decks, and
venting have been Installed,
o Street Trees - When all required
trees are planted. '. "
Lot faces
Lot Type
Lot sq, ftg.
Interior
Lot coverage
Corner
Topography
Total l"J.eight ,
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Panhandle
Cul-de-sac
BUIL~eI'NG PERMIT
ITEM
SQ, FT.
X $/SQ, FT.
fv1ai n
Gatage
Carport "
Total Value
B,uUding Permit Fee
M/;(.:l~
State Surcharge
, Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
,
Residenllal 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 Stovellnsert/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, B, C, D, and E Combined)
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,.:; THEPROPOSED WORK.tNTHE -
HISTORICAL DISTRICT, OR ON
THE HISTORICAL. REGISTER?
If yes, this application must be signed
and approved by the Historical
, Coordinator prior to permit Issuance.
Setbacks '
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VALUE
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FEE
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APPROVED:
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, an9 may be suspended or revoked at any time
upon violatfon of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
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SYSTEMS DEVELOPMENT CHARGE (SDC)
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.
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VALIDATION:
RECEIPT NUMBER
/f!~ '51
~;/;z/91
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY