HomeMy WebLinkAboutPermit Building 1999-6-28
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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LOCATION OF PROPO~D ~~~'4 I
)( ASSESSORS MAP' / 6 '(
)l'LOT' BLOCK:
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REMODEL ADDITION DEMOLISH
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OWNER:
ADORES'"
CITY:
,
DESCRIBE WORK'
NEW
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STATr::' ,I) /c.....
.
JOB NUMBER 7f tJf{6 f
I
225 Filth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
()fC.OD
PHON'"
726 .jZ3JW)
9&g-..9'oU ~~
ZIP'
97~ 77 -.?l? f7z..
Z,<~,-;L.hhJ
OTHER
EXPIRES ':':' PHONE
Sbz/t/J1.
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tit) 'J --><J ~7
I.x9-7YzJ -
9/1/~o ?W-",~
QUAD AREA: "n""'ii"nlf'l1::. . LAND USE:
, U~~. 1=\1=THEWORK
. OF BLDGS: .......,c::P1=RMITSHAlLEXel~l= ul'olif>>'-
.,.' IZEDUNDER1l:IISPERMIII::iI\lV'
OCCY GROUp:--.AIITHOR CORD~
. OF STORIES: COMMENCEDORISAB~AT SOURCE:
ANY 180 DAY PI::RIOD.
WATER HEATER: RANG'"
- OFFICE USE -
ATTENTION:Oregonlaw reqUires YOU.~L,
. 'I 'Jle< ado"'L<DO,lil'llill:AiNreaon Ulllily
'Vlvnl .:) po--. .
Nol'lf',cation Cenl"" Tho"e rules a..e set fortn
ZONING CODE:, ~,~_~ ~n<
in OAR 952-001-0U1IJ tnrOuYlI Un, 'w_ - - '
uJ90. You may OO(gfflBDf.lM"....t the rules by
I. h enlMINnlA" The telephone
calmQ I e c .. :>ECON'DAR'I: HEAT:f~
numberfortheOregon Ullllry ow," 'vw,"""
Center i!3~uABE?l:'06T')(6'E,
, CONST
CONTRACTOR'S NAME " ADDRESS r~ CONTRA9:0R .
GENERAL: ,\f~~ AJO,rs ' ~..s O-br./e......,.;) ,
PLUMBING' A ~ c.. DIlAt/l) .E~ ~ o".e J, g J/(/) ~ /
rfe1,~~. rl-{S .a,~ t?~ 6z.';3(,(a~)
ELECTRICAl' C ~ S ~d tJlZ. .36>4 CJ(cc.lJ)
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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
'settlng forms.
o Underslab PlumblngtElecTrlcall
Mechanical - Prior to cover.
D Footing - Alter trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
~P'.w"c1.Uon - Aft.' fgrma ar.
~e'eClted but .,'10' to concrete
pfacement.
o UndorgfOUnd Plumbing - Prior
to IIfllng trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
, . "~
. ~\.
o Floor Insulation - ~rlor to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sower ~ Prior to filling
trench.
D Water Line - Prior to IIfllng
trench.
D Rough Plumbing - Prior. to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical -~rlor to
cover. .
M Rough Electrical - PrIor to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing,
materials and framing Inap.
o Framing - Prior \0 oover,
, D WalllCelllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
D Wood Stovo - After l~stal~atlOn.
D Insert - After fireplace approval
and Installation of unit,
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Drlvew3V - Alter
excavation Is complete, forms
and sub.base material In place.
D Fence - V~hen cor.,pleted.
D Street Troes - When all required
trees are planted.
D Final Plumbing - When all
plumbing wor!< Is complet.e.
I5<:f Final Eloctrlcal - When .all
, ...lectrlcal work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
'K71' Final Building - When all
~ required Inspections have been
approved and buildIng Is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Conneclion - When
blocking, set-up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel. .
D Final - Alter all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
r
l
Lot sq, flg.
Interior
,', '" '.. 'ii""{"I'~'~"
~, , t '1~' , "_t'\., '1,".1i- 'ft;j1ll.! ,., .
,,~. \ "". ' . . ,!:\ ,;":.1:1';."",
.... Setba'cks .
I' p.L. 'HSE' GAR' ACe"
IN
Topography
Total height
,.
Panhandle .
S
'IS THE PROPOSED WORK iN THE.
".HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcallon must be signed
and approved by the Historical
Coordinator priOr to permit Issuance.
Lot faces
L~t ~ype.
. Lot coverage
Corner
Cul-de.sac
_"Y.._
E
APPROVED:
BUILDING PERMIT "I
ITEM SQ, FT,
X $/SQ, FT,
VALUE
BUILDING VAL~E, PLAN CHECK
AND BUILDING PERMIT
11
'~
Building Permit Fee
State Surcharge 4?3 -I- ;z. 12.
f1:J6 . 7~
--.fr, _ ~s
~.'5"
ThIs permit Is granted on the express condition that the said
construction shall. In all respects. conform to the OrdlncYnce
adopted by the City of Sprlngfl~ld. Including trle
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.
~ .J.., ?, 1
Plan Check Fee' . ~
c, /1.<1/17
Receipt Number: tfl'345 '1 r /J
$W~
Date Paid:
Main
Garage
'.
P::t
t/ti. ()()O
Total Value
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Total Charge
(C)
:')'~~ l=:'U:rr ,~QM'/H/r'I,~
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4-1~&t7Z /hRJ??/T ItS ,f~k~
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/'~L.lI'{lJdl"J)IJA J /l/MJ~ yt/4tfi ~1
A-T ~ i/TC ~1Ib-<A /IJo/I~'
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature. I state and agree. that I have carofully 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 perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the'Sulldlng Safety DIvision.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permll
(D)
I further agree to ensure that all required inspections are
requested at the proper time, that each address Is readable
from the street, th,at the permit card Is located at the front
of the property, and the approved set of plans will remain
In the W all tlr:e".,t)'lt c~str~tI~'~J
1'-'711Jrp ~-C/).::::/ ~/
~J 6-~i- 99 ,
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcu l
It
Demolition
.,
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C. D, and E Combined)
~.7'S
VALIDATION:
RECEIPT NUMBER O~ 'It:> 'I I
DATE PAID (;1zf/rr"
AMOUNT RECEIVED fSt. '1)" /7
RECEIVED BY "11::- t.),.,f/
State Surcharge
Total Miscellaneous Permits (E)