HomeMy WebLinkAboutPermit Building 1998-11-13
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RESIOENTIAL
PERMIT APPLICATION
9 j /'1/7
JOB NUMBER
Inspections: 726.3769
Office: 726.3759
225 Filth Street
Sprln9l1eid. Oregon 97477
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ASSESSORS MAP'
LOT'
TAX LOT'
SUBDIVISION:
BLOCK:
Je>s 5 ,4 . Ifot...,.-
7t 7 St:-I/J ~/.o.,
~/J{t(i Cr~/"'/ ,
OWNER'
PHONF'
.!J,e
ADDRE"'"
Q7-Y77
",1/
CITY'
STATE:
ZIP'
f/uLu,J
A'}(lU
DESCRIBE WORI<"
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR'
CONTRACTOR'S NAME
ADDRESS
EX~RES ~ PHONE
6W,v..l1'l-
/
/
GENERA' .
PLUMBING'
MECHANICAl'
ELECTRICAl.
__ I~\AI reaUlreS yuu.:.~ .
- OFFICE USE -ATfEN1IU'''do'~;d by the Oregon ~~Ii~rth
follow rules a :\,l;l.ose rules are s
QUAD AR~O"j'I~~. LAND USE: ~center''1b'tli\Bu~R952-001-
~'lUOAR 952, _001-001 . n.<t.o.fffihe rules oy
. OF BLDGs!1~ PI=RMIT C:"'AII I=l(PIRE IF THE<:\llORltTS: In ob~1WIlII13''t,,'UD . -hAro
0090. YoLl may dNote: the I"l'''~;
OCCY GR0i!JFi:HnRI7l=n I JNnl=R T"'I~ PERMffd>,&1;'f)t TYPE: ,,3Ilffig.1he centl;r F~/m'i\\iW:\\ln\ilicatlon
. OF STORlES!Mi=:Nr.EO OR IS ABANDONEDHifilT SOURCE: numberforthe.O~~'lm?~1.T:
'Genterts,< .
WATER HE'it+~~r(\ nAy PFRlnl". RANGE: _ 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, Inspectlons requested 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 w9rl< Is complet.c.
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Rough Electrical - Prior to
CQver.
D Final Electrical - When all
electrical work is complete.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~~otlng - After trenches are
@~~cavated.
o Final Mechanical - When all
mechanical work Is complete.
c3u FI).I Building - When all
required Inspections have been
approved and building is
completed.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facIng
materials and framing Insp.
eramlng - Prior to cover.
o Masonry - Steel location, bond
beams, grouting.
OOthor
O Foundation - After forms are
erected but prior to concrete
placement.
o Wail/Ceiling Insulation - Prior to
cover.
O Underground Plumbing - Prior
. to filling trench.
o Drywall - PrIor to taping.
MOBILE HOME INSPECTIONS
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stovo - After Installation.
o Blocking end Set.Up - When all
blocking is complete.
o Post and Beam - Prior to floor
Insulation or decking.
o Insert - After fireplace approvel
and installation of unit.
O Floor Insulation - Prior to
decking.
o Plumbing Connections - When
home has been connected to
water and sewer.
D Curbcut & Approach - After
forms are erected but prIor to
placement Qf concrete.
o Sanitary Sewer - PrIor to filling
trench.
o ElectrIcal Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Sldewall< & Driveway - After
excavation Is complete. forms
and sub.base material In place.
o Storm Sewer - Prior to filling
trench. ~
D Fence - When COfllpreted.
O Weter Line - Prior to filling
trench.
o Final - After all required
Inspections are approved and
porches, sklrllng. decks, and
venting have been Installed.
o Rough Plumbing - Prior to
cover.
o Street Trees - When all'requlred
trees are planted. .
Lot faces
Lot sq. flg:
Lot coverage
Topography
Total height
,j
BUILDING PERMIT
ITEM
sa. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
L~t ~ype.
Inlerlor
Corner
Panhandle
Cul.de.sac
'.
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_S THE PROPOSED WORK iN 'T~E-.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, thl. application muat be algned
and approved by the Historical
Coordinator prior to permit Issuance.
X $/sa. FT. =
(A)
I P.L.
IN
Setbacks
'HSEIGAR'ACcl
..'--1
S
I
~-l-
VALUE
"
;l., r;oo
3;l..~o
i, tq(J
"s:f()
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
(B)
N'
FT.
FT.
FT.
(C)
Dryer Vent
Wood Stove/lnsert/Flreplace Unit
N'
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
State Surc~arge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
. 56.),3
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 Springlleld, including the
Development Code, regulating the construction and use of
oulldlngs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
:2.1, 13
Plan Check Fee'
Dale Paid:
"/'J!9 8'
Receipt Number'
~
dW~
Received By:
d0lJ
Plans Reviewed By
"It lhr;-
Date
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 thaI 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 lo 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.
Signature dHP1y ~ ;.l ALr
Date /)/~~/rY
VALIDATION:
RECEIPT NUMBER 6 ~ "2.." Lf J
DATE PAIP /f/(~ / 1 f
AMOUNT RECEIVED J f:J2-Y //
RECEiVED BY d l ~
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