HomeMy WebLinkAboutPermit Building 1991-5-2
RESIDENTIAL
PERMIT APPLICATION
.
SPRINGFIELD
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPllSED WORK: r0a 5~
ASSESSORS MAP' \ f\ () C\~t() \ \
LOT'
,
BLOCK.
.
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
_ TAX LOT:
SUBDIVISION:
OWNER: \'\\'(4; ffi ~~. 3\0 , ~ ) ro ~ \? f}f\\ \ e... PHONE: '\ 41 fl' S40n
ADDR~S".,..Q8S~-.x()se..~OS~\ '(\ V' . - -
CITY' ~~\r:t - STATE: Lw, t~ ZIP: C\1:EO
DESCRIBE WORK: \. ).-.( Il.b\d 0 (l",nCl \l - I.~ 1 bnn. /~(lX1l;U_/ ~
NEW REMODEL ADDITION DEMOLISH OTHE;'; . 1 \ 6' -
lJ
, CONST
CONTRACT&.,.R!. N~~ ~ ADDRESS (\ CON~~CT01# EXPI::;y.., \ J~ PHONE
GENERAL:i\\J\ \ ""T~~ <~kl.n? \''''~Moo.J.ll{. 6\?'L2_QjZlM~ _
PLUMBING' '\\ 1(''\ - \j - - . - . 114-1_S2A-1
MECHANICAl. ~- m _......1
ELECTRICAL' \_t"'_"\ Q:J.(l n ~
QUAD AREA:.A.~~\0 J
# OF BLDGS' - \
OCCY GROUP: ~ ~
\
# OF STORIES:
WATER HEATER:
- OFFICE USE -
\ \ \ \
# OF UNITS' \
CONSTR. TYPE: -.-J../ 1\\
LAND USE:
HEAT SOURCF'
RANGF.
FLOOD PLAIN'
ZONING CODE:
L\)~
# OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
r!)l()
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
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
lVf Foundation - After forms are
r erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
~ Post and Beam - Prior to floor
~nsulation or decking.
"rvf Floor Insulation - Prior to
~ecklng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
1::71' Rough Mechanical - Prior to
~ cover.
KA"'RoU9h Electrical - Prior to.
~~over.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material In place.
D Fence - When completed.
D Street Trees - Whe-Ii ~all requ'ired
trees are planted.
o
Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
~ Final Mechanical - When all
mechanical work is complete.
"fV'f' Final Building - When all
~quired 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, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - After all required
inspections are approved and
..... porches, skirting, decks, and
venting have. been installed.
Lot faces Lot Type. Setbacks
Lot sq. fig. :i Interior I PL. HSE GAR ACC
IN
Lot coverage Corner
Is
Topography Panhandle
Total height la' Cul.de.sac Iw
IE
BUILDING PERMIT
ITEM SO. FT.
c!)J0
X $/SO. FT
( qq. 16
VALUE
R,~~7
I
Main
Garage
Carport
~}~?'{I.:o
71.S0
S,73
18.2.3
SYSTEMS DEVELOPMENT CHARGE (SDC)
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
I
I
I
/
Sanitary Sewer
FT
Water
FT
Storm Sewer
FT
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
I
MI,y,
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Mt',u.
1'5 "0
/0 CD
1'2..~
2~.4.S"
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Cu rbcut
fI
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
11}4 , o?tJ
. THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON t\ <"""'-
THE HISTORICAL REGISTER?---l..l.A..-/
If 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 01} 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 Jr<~~li~ of said ordinances.
Plan Check Fee: ~ -J ~
Date Paid: 4. 18 ~ L
Receipt Numbe~Yl.!:13
Received By: J ~ ./
h7/.h:/~ - --,../AD~aZ;t~h.!.
Ff(~; ~~d' Sy '- 77 ~ ,.
Systems Development Charge is due on all undeveloped
properties withln 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 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 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.
Date t...
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VALIDATION: q~s /l
RECEIPT NUMBER ~ c:;;I-,
DATE PAin ;<; .C;A' ] .
AMOUNT RECEIV~'" ('J {(114b
RECEiVED BY (7J'~