HomeMy WebLinkAboutPermit Building 1995-9-13
flo U S/N& A()T1IMITY
700 /J)EST FA-/R./Jlcw
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
/7
LOT:
OWNER:
ADDRE~<:'
CITY:
NEW
J!;MOIJE7.c..
REMODEL X
DESCRIBE WORK:
.
SPRINGFIELD
23'3'2...
t'J '30 2..,
BLOCK'
~F L~Ct!),
STATE:
Of<....
.-
JOB NUMBER
95'~S/
225 Fifth Street
Springfield, Oregon 97477
I SfJFD.
/
TAX LOT'
SUBDIVISION:
PHONF'
&tJ7-10'f6
ZIP:
'77177
F'f.l &716
110M C ;
/
tvbWS J -pctJ.4..J ec.ez..7'; fW/~/i~ F"'~:rV/J.t 'S
Eft \ - I ,
OTHER
ADDITION
DEMOLISH
IItJ8llc.. ~'1>
OONTRACTOR'S NAME ADDRESS
GENERAL: 24 ~~. /Y!I /~r/L1e ..PtJ_ffUt:'.
PLUMB;NG' !:3./;r"?,,,,-= /)&/7-:"'_
".J- t4
MECHANICAl'
ELECTRICAl. ..../ ,f.,-// Afr~k,r_7J/A_('
OUAD AREA: Z ~ N tAJ
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
CON ST.
CONTRACTOR'
~"~"9
- OFFICE USE -
LAND USE: ---11 II
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
VN
EXPIRSS PHONE
~//;/~~'l- 3~~
FLOOD PLAIN:
ZONING CODE:
. OF BDRMS'
LOt2-
RANGE: _
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. Ttlls Is a 24 hour recording. A/llnspeclJons 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.
REQUIRED INSPECTlo'NS
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Fo'otlng - 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.
rn Underlloor Plumbing/Mechanical
~ - Prior to Insulatlon or decking.
o Post and Beam' - PrIor to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to fllling
trench.
o Water Line - Prior to fillIng
trench.
f';r Rough Plumbin.9 ~ P~iC;r to
T cover.
lXJ Rough Mechanical - Prior to
I " cover. . .
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtaIn permanent
electrical power.
D Fireplace - prior to facing
materials and framing Insp.
~ Framing - Prior to cov~r.
f\7tWall/Celllng Insulation - Prior to
[' cover. .
~ Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fIreplace approvel
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior 10
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base malerlal In place.
o Fence - When completed.
D Street Trees - Wh~n all~reQuired
trees are planted. . .
[YJ Final Plumbing - When all
r plumbing wc;>rk Is complet,e.
D Final Electrical - When all
electrical work is complete.
r\/1 Final Mechanical - When all
Lf-J mechanical work Is complete.
f\?l Final Building - When all
L,C:d requIred InspectIons have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking is complete.
o Plumbing Connections - When
home 118S been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
inspecllons have been approved
and the home Is connected to
the service panel..
o Final - Arter all required
inspections are approved and
porches, skirting, decks, and
venting. have been Installed.
'.....
,..... I~S THE PROPOSED WORK IN THE
'1'.
lot Type. I:
Lot faces Setbacks
lot sq. fig. Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner II yes, this application must be signed
Is I , and approved by lhe Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height Cul-de-sac IE I
APPROVED:
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT
VALUE
Main
Garage
"
Carport
~~~~
'10~O
Total Value
qo~,<;!:2..
enS!l
b. 'is.
0. 15.'
06.
Building Permit Fee
State Surcharge )..\.0"6+ :;\,'-\:)..
~
Total Fee (A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
-e--#3
(B)
PLUMBING PERMIT
ITEM
FEE
~r-. ~,
FIxtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
7
Storm Sewer FT.
Mobile Home
Plumbing Permit
to ~
SfoQ
1S. ~
State Surcharge
3:<:iQ ~ ~.~C
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t Fan
N'
I
~.~
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
I C;. CllJ.
( (').crQ
I~
A,.C;. ';)..0
Issuance
State Surcharge
.?5+."fS,
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
fI
Curbcul
fI
Demolition
Stale Surcharge
,PlA-v A' EI//6tJ
52 :~':i
Total MIscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrlcal)
lA, B, C, 0, and E Combined)
UI. de I
...
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
adopled by the Cily 01 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.
5:!- ~3
Plan Check Fee:
Dale Paid:
Receipt Number'
Received By:
~"":L.."
,.0-""..
Plan cviewcd By
.~r15
Ollie
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS 7J .
~ MCL S~/7r~
~b.;r:-r" ?~/.r"(~-:,,------ c:;-
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r-
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 Stato of Oregon pertaining to the work described
heroin, and thai NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further cerllfy that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensuro that all required Inspections are
requested at the proper time. that each address is readable
from the street, th..ft the permit card Is located at the front
of the property,/a',{d the approved et of plans will remain
on the Slt/D:~'{ Ii s during onstru~n.
XnalurU4 J:; . vrr
1/ ........,
, Dale / 1~ /. ') - t;lJ.s-
VALIDATION:
RECEIPT NUMBER
/'Jon ./
;;".-0r
q/~
-< -
DATE PAIf'
AMOUNT RECEiVED
RECEIVED BY