HomeMy WebLinkAboutPermit Curb Cut 1993-10-29
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726-3759
.
SPRINGFIELD ,"
. It-'
JOB NUMBER~3/mg
TAX LOT:
(IY2{J()
LOT: BLOC\<' SUBDIVISION'
,
OWNER:~OJ\~ ~ - - - PHONE: ffiS-13f3'd-J
ADDRESr- . ;<.,41 D1 J ( , Q OL:>JLrm U Q ~ k>C\l{;\ I: ~ 1 / / J ""
CITY" \ '\ ). Q J\Hc-uJ2~ j STATE: 'XJJ) f' {( JI'-...J ZIP: Cj rf,J..ltI
DESCRIBE WORK: J ~ LAN J..~
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CONTRACT~X Nt}j~ ^.f'n . rtPr:l~s~
GENE~CJ r 1 J~f/ ) a ('j (QLll JLlk
PLUMBING:- (\
CON ST.
C(P~Cff~ c/-XCJ2t.
PHONE
MECHANICA' .
ELECTRICA' .
QUAD ARE^:
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
- OFFICE USE -
L^ND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SOUARE 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
Sito Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/Electricall
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
Underfloor Plumbing/Mechanical
_ Prior to Insulation or decking.
o Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water line - Prior to filling
trenctl.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prior to facing
materlals and framing Insp.
o
Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to laping.
D
Wood Stove - After installation.
o Inserl - After fireplace approval
am] installation of unit.
~curbcut & Approach - Alter
fQllns are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complele, forms
and 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.
D
Final Electrical - When all
electrical work Is complete.
o
.1
Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel-up. and plumbing
inspections have been approved
and the home Is connected to
the service panel.
I
1
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
.
Lot faces
Lot Type
Lot sq, ftg.
Inlerior
Lot coverage
Corner
Topography
Total height
Panhandle
CuI-dc-sac
BUILDING PERMIT
ITEM sa. FT. x $/SO, FT.
Main
Garage
Carport
I
Total Value
Building Permit Fee
State Surcharge
Total Fec
(A)
'THE PROPOSED WORK IN THE
HISTORICAL DISTRtCT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I P.L. I HSE GAR ACC
IN
S
W
IE
\
VALUE
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sower FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
,
Total Charge
(C)
MECHANLCAL PERMIT
Furnace
Exhaust Hood
Ven t Fan
N'
Wood Stoveflnscrt/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk (I
Curbcut ~i (t
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E c'omblned)
FEE
j(j.W
/..;:) _ LvU
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, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
"
Plan Clleck Fcc:
Date Paid:
Receipt Number'
Received By:
Plans Reyrcwed By
Date
Systems Development Charge is due 'on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon 15 true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinancus of the City of Springfield, and the Laws
of tile State of Oregon pertaining to the work described
herein, and IIlat NO OCCUPANCY will be made of any
structure without permission of the Building Safely 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 stre that the permIt card is located at the front
of t the approved set of plans will remain
on the site at a tl s during constructlGn. /:J
~
,
Signatur....
Dale 1/- ~ 9-
93
VALIDATION: ID t7 3 /) ,
RECEIPT NUMBER / c;:;I--/
DATE PAID /(')-/29. .C(o -
AMOUNT REC~"':! /0, CoO
RECEIVED Bf.- /\ I,m ,
'- --( - -
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