HomeMy WebLinkAboutPermit Building 1993-10-12
, ' RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
L701
ASSESSORS MAP:
LOT:
7)BL,
q~n~
?)~
OWNER:
ADDRESS: -----2.e;"'J/,
~!4C;
rt'A?5
f
CITY:
DESCRIBE WORK:
NEW
REMODEL
, ADDITION
'.>
SPRlNGFIELD
BLOCK:
~
STATE:
~
-, .....
~;+e:; e;
A?.6k/A7/f
DEMOLISH
- OT..H E R
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JOB NUMBER
9_1/5~CL
225 Fifth Street
Springfield, Oregon 97477
#4
I
TAX LOT:
...J ,A,..r\? .
~J
SUBDIVISION:
PHONE:
.3 7'2 -~7?3
ZIP:
Y 74rJ /
,
CONTRACTOR'S NAME ADDRESS
.. ~
GENERAL: -k.--! ~S Cv~-r(L.Jc...-rc o.J rvz,.
CONST.
CONTRACTOR II
If- ?> '2-' ,
PHONE
G~q, (,/77
PLUMBING:
MECHANICAL:
ELECTRICAL:
QUAD AREA:
II OF BLDGS:
OCCY GROUP:
II OF STORIES:
WATER HEATER:
- OFFICE USE ~
LAND USE:
. "
II OF UNITS:
CONSTR, TYPE:
HEAT SOURCE'
RANG E:
EXPIRES;
IJ //~ /?'4.
.If r I '
1.
FLOOD PLAIN:
ZONING CODE:
II 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
o
Site Inspection - To be made
after excavation, but prior to
setting forms,
o
Uriderslab Plumbing! Electrical!
Mechanical - Prior to cover.,
o
Footing - After trenches are
excavated,
o
Masonry - Steel location, bond
beams, grouting,
o Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench,
o
UnderfJoor Plumbing! Mechanical
- Prior to insulation or decking,
o
Post and Beam - Prior to floor
insulation or decking, '_
._---~.' '.. ~~ ~ ~
I '
o
Floor Insulation - Prior to
decki ng,
o
Sanitary Sewer ,- Prior to filling
trench,
o
Storm Sewer - Prior to filling
trench.
o Water Line - Prior tofilling
trench, I " '
o
Rough Plumbing - Prior to
cover,
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
'1S<l Rough Electrical - Prior to
/' Gover,
o
Electrical Service - Must be
approved to obtai n permanent
electrical power,
o
FireplaCe - Prior to facing
materials and framing Insp,
~Framing - Prior to cover,
'b.c::-1'~aII/Ceiling Insulation -
~er,
~YWall - Prior to taping,
Prior to
o Wood Stove - After installation.
o
Insert - After fireplace approval
and installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
o Sidewalk & Driveway - After
excavation is complete, forms
arid sub-base material in place,
o
Fence - When completed,
o
Street Trees - When all required
trees are planted,
o Final Plumbing - When all
plumbing work is complete.
'C7f'Final Electrical - When all
~ectrical work is complete,
o Final Mechanical - When all
mechanical work is complete,
I ,
, IXYinal Building - When all
~ J'e.quired inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o
, '
Blocking and Set-Up - Wilen all
blocl<ing is complete,
o
Plumbing Connections - When
home has been connected to
water and sewer,
o Electrical Connection - When
blocking, set-up, and plumbing
inspections Ilave 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,
Topography
Total height
Panhandle
I P.L,
IN
Is
I'w,
IE
Setbacl<s
HSE GAR Accl
I
,I:::, .,-HEPROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
'THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
Lot faces
Lot Type
, \
Lot sq~ ftg.
Interior
Lot coverage
Corner
Cui-de-sac
I
APPROVED:
ITEM
BUILDING PERMIT
SQ, FT.
" )
X $/SQ, FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
" ... '...
This permit is grant~d_on the express con,dition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield',-,including the
De~elopnlenl CocJE~, regulating the cons"truction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances,
AlA
/
Plan Check Fee:
Main
Garage
'-
Carport
Building Permit Fee
-~..
}5~
?r
,/~ 7.1S"
I
SYSTEMS DEVELOPMENT CHARGE (SDC)
Date Paid:
Total Value
Receipt Number'
Received By:
State Surcharge
" '
Total Fee
(A)
Plans Reviewed By
Date
(B)
Systems Development Charge is due 'on all undeveloped
properties within the City limits which are being improved,
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Residential Bath(s)
NO
...c;' ALJAA?~ 'p/ r -r 4?",;;;.A.-. -' T
.......-r..~-- lot "'"""""~ , -~' ,
/ ,C:; ~~!:/~~
Fixtures
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
NO
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 ).hat NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division,
I further certify 1I1at only contractors and employees who
are in compliance with ORS 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 ag"ree 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 properly, and the approved set of plans will remain
on the site a~" tim()u~~
~ignature ~./
/
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft'
Date
Curbcut
ft
Demolition
VALIDATION:
State Su rcharge
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
J <;.?S"'
,
RECEIPT NUMBER / L.? ~rD
DATE PAID /~/~2-/J' 7
AMOUNT RECEIVED J 5, ;u-
y4~
RECEIVED BY
Total Miscellaneous Permits (E)
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