HomeMy WebLinkAboutPermit Building 1992-3-17
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
/7
ASSESSORS MAP'
LOT
.
SPRINGFIELD
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Ave-
BLOCK:
OWNER:
idOLA I At:' t/ "- 'D 1 AtvE- _ \...,.,.., EO c:.
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ADDRESS'
CITY'
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DESCRIBE WORK'
NEW ;(
1/ CC-f'S C; o./''7
REMODEL
ADDITION
STAT'"
011--
.
JOB NUMBER
'9'::?c> :-=3 s/R
1:J LOG-
DEMOLISH
OTHER
225 Flflh Slreet
Springlleld. Oregon 97477
TAX LOT
110')
SUBDIVISION:
PHONF'
7')."'. (, ($ 'l (.
ZIP:
'7711'77
CONTRACTOR'S NAME
GENEFJAI" !Yl A~v
PLUMBING:
. CONST.
ADDRESS CONTRACTOR #
6LovCiL ;}.(SO (=;2101"-'1(1-'1- &, 3.2:z..9'
C:u 6--tr-~ ,. 711-J)
EXPIRES
1-73
PHONE
(3 y~- ;Z "?~)
MECHANICAL'
ELECTRICAl'
OUAD AREA:\ \ RJ\ ']0
# 01' BLDGS: . \
OCCY GROUP: -- ~~
1/ OF ~nOnIES: _____ __\
WATER HEATER:
, ~ :
'....., ,
1....\.,.
FLOOD PLAIN:
ZONING CODE: -LD 9 ~
# OF BDRMS:
SECONDARY HEAT: --t- ----
SQUARE 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.
D Temporary Electric
o Sito Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D
Footing - After trenches are
excavated.
o Masonry - Steel location, bond
bCLllllS, {Jrouting.
k-~undalion - After forms arc
J2L ~~t.!ctell lJul prior 10 concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
~POSI and Beam - Prior to floor
~ insulation or decking,
o Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior 10 filling
trench.
o Storm Sewer - Prior to filling
trench.
o
Water Line - Prior to filling
trench.
D
Rough Plumbing - Prior to
cover,
- OFFICE fSE -
LAND USE: J. \ \ \.
# OF UNITS: )
CONSTR. TYPE:_V-f\.
HEAT SOURCE:
RANGF'
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover. I
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and (ramlng Insp.
~ Framing - p:rior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Pr'iar to taping.
D Wood Stove - After installation.
o Insert - After tlrep/ace approval
and Inslallalion of unit.
o Curbcut & Approach - After
torms are erected but prior to
placement of concreto.
,
o Sidewalk & Driveway - After
excavation Is. complete, forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - Whe..n.all-req~ired
trees are planted. .'.
o
Final Plumbing - When all
plumbing work is complete.
o Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical worl< is complete.
~Final Building - When all
~equired inspections have been
approved and building is
completed.
DO'her
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.
D 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
ventlng have been Installed.
J
_32. ?o
J.lP3
3-1. /3
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8) I/> 4-2 '.:! ~
Lot faces
':...... ....
Lot Type.
Interior
Lot sq~ rtg: "" .
..-
Lot coverage
Corner
Topography
Panhandle
Tolal height
Cul.de.sac
BUILDING PERMIT
ITEM
SO, FT.
X $/SO. FT.
Main
Garage
Carport
k<: .
/6t?
Total Value
Building Permit Fce
Slate Surcharge
TOIDI Fcc
(A)
PLUMBING PERMIT
ITEM
, Fixtures
Residential Bath{s) NO
Sanitary Sewer FT.
Water FT.
Slonn Sewer FT.
Mobile Homo
Plumbing Permit
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t Fan
NO
Wood StovellnsertlFlreplace Unit.
Dryer Vent
Mcctlanical Permit
Issuance
Stale Surcllargc
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile I'/ollle
Slate Issuance
Stale Surcharge
Sidewalk
It
Curbcut
II
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. 8. C. D. and E Combined)
Setb1cks
I HSE GAR I ACC I
I
I
I
I
I:L
Is
W
E
VALUE
""7~_CX>
FEE
~0.3~
. THE PROPOSED WORK IN THE
HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
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 urantcd on tllO express condiUon \11<1\ 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 Check Fee: r:2./_ IS
"3-~ ~ "2
Receipt Numucl ~~3,/
ReceiV~Y. /? ,.~~
~'-
~d_
PIa cVlcwcd ~
Date Paid:
_~p2
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 ttlal all
information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the OrdinancE;:s of tho City of Springfield, and the Laws
of the Stale of Orogon pertaining to the work described
herein, and 'that NO OCCUPANCY will be mado of any
structure without .permission of the Building Safely Division. .
I further certify Blat only contractors and employees who
are in compliance with ORS 701.055 will be used on this
projec 1.
I further agree to cn~llre that all required inspections arc
requested at tho proper time, that each address is readable
from the street, that the permit card is located at tllC fronl
of the propcrly, and tile approved sel of plan~; will H)flWill
::~~:;;:!)J~<lltn~OIl'
Date (\' (? - 17~ "i 2...
~:~~~~4ttl;
DATE PAID ,~~ . q~ -
AMOUNT RECEI~' -n 0; nCf....
RECEIVED BY \_7')( ~