HomeMy WebLinkAboutPermit Building 1995-3-22
. e SPRINGFIELD .
RESIDENTIAL ~,., 9:5"t!?::::c '/0
PERMIT APPLICATION JOB NUMBER
Inspections: 726.3769 225 Fifth Street
Office: 726.3759 Sprlnglleld, Oregon 97477
LOCATION OF PROPOSED WOR!" r;~o R II/C' tC "" I '- ~.J PI( ,
ASSESSORS MAP' J"/ CJ ? 'f'r I ] o ~ 900 TAX LOT:
LOT: BLOCK' SUBDIVISION'
OWNER'
P/Jr/It7
6~-o
R II/C'C
<I- T II ,'tC ..'7.-9
ADDRESS'
..I't(,-~,c'no
CITY'
DESCRIBE WORt<. I'/""fll
NEW REMODEL x:.
ADDITION
CONTRACTOR'S NAME
GENERAI'~/~
/ ~7,
PLUMBING'
MECHANICAl.
ELECTRICAl'
QUAD AREA: \ \<.. ro\0
. OF BLDGS' \
OCCY GROUP:?-' ~
?,;
. OF STORIES:
WATER HEATER.
t?{(,.l7"
HIL/...;
1M,
PHON~'
,.</0,( k
7YY- of"Yy
6.'i7-1/70 {j),q..~
ZIP' 97 Y:>J
STATF'
a-?
ADDRESS
CONST.
CONTRACTOR'
PHONE
REQUIRED INSPECTIONS
[=:II Rough Mechanical - Prior to
cover.
~ Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover,.
r'V'1 Wail/Ceiling Insulation - Prior to
L....FJ cover.
[3. Drywall - Prior to taping.
D Wood Stovo - After Installation.
o Insert - After fireplace approvll.r
and Installation of unit.
o Curbcut & Approach - After
forms are erected bllt prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is compiete, forms
and sub.base materIal In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
EXPIRES
'.1
FLOOD PLAIN: i2...-..
ZONING CODE:.Ll:)A
. OF BDRMS.
SECONDARY HEAT:
SQUARE FOOTAGE:
i](O;{
"p ,Tt9I-tJ
DEMOLISH
OTHER
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. AI/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 follo~lng work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover,
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
.beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench,
, 0 Underfloor Plumbing/Mechanical
. . '- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking,
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench.
rn Rough Plumbing - Prior to
cover.
- OFFICE USE -
LAND USE: \. \. , ,
. OF UNITS: \
CONSTR. TYPE: -V-~0
HEAT SOURCE:
RANG~'
L::I:l Final Plumbing - When all
plumbing work Is complete.
r'if Final Electrical - When all
., electrical work Is complete.
r'V1 Final Mechanical - When all
~ mechanical work Is complete.
I'JI Final Building - When all
, required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the servIce panel.
D Final - After all required
inspectlons are approved and
porches, skIrting, decks, and
venting have been Installed.
Lot faces
Lol Type
Interior
Lot sq. fig.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de'sac
: ~ - ,':'~ ..
Setbacks
i :L. i HSE I GAR I ACC .
I S I I I
Iw I I I
lLLLL
BUILDING PERMIT
ITEM SO. FT. X $/SO, FT, ~ VALUE
Main
Garage
Carport
/9#~~~'5~/C:::>
. ~ ~ ~ , .
Total Value
Building Permi I Fee
State Surcharge
1,(,:~"t' 3"8
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
3.
Residential Bath(s) NCI
Sanitary Sewer FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
\.Sc+~~
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t Fan
~
N'
Wood StovellnserllFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
Slate Surcharge
,1S + ~ ~
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fl
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D. and' E' Combined)
"
;7/ -5"~. s;e:: .
Y'
FEE
'3. 0, S<U-
~O.~
~ ,'iQ.
:6~, L:l.Q
co'~
IS,~
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ct
5'-\\.~1
., IS THE PROPOSED WORK IN THE,
'HtSTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prIor to permit Issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition thatlhe said
construction shall, In all respects, conform to the Ordinance
adopted by the City ,01 Springfield, Including the
Development Code, regulating the construct/on and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisIons of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
9'9./'=3
'~-.:? -9S
/h'::/8/
~~,
// '
Received By:
~ '
p~eVlewed By
~~
I
IS~,SQ
I .Q.. a.l
\ b~, 1.L
SYSTEMS DEVELOPMENT CHARGE (SDC)Jl2.
(B) ~?I'1~-'/'P
Systems Development Charge Is due on all undeveloped
properties wllhln the City limits which are being Improved,
ADDITIONAL COMMENTS
~,-~ . J>~,~~~.u.J
~ J... '-~ SU>.t. ...uAA..".D
'~' \) ,
By signature, I state and agree, that J 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 perlormed shall be done In accordance
with the Ordinances ollhe City 01 Springfield, and the Laws
of the Stale 01 Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
struclure without permission of the Building Safety Division,
I further cerll fy 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 re~ulred 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.
Slgnature~S:- ~
Oatp
f/Z'2./9T
VALIDATION:
RECEIPT NUMBER ~9<:;;
-;;'-:2 :::? --? "5--
- ,
AMOUNT RECEIVED ~ .fu7- -5'9 y: /"7'
~ ./~~- .
/7""-
DATE PAID
RECEIVED BY