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HomeMy WebLinkAboutPermit Building 1991-5-8 RESIBENTi')).L PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOT' . BLOCK' . JOB NUMBER q 1{)~7 225 Fifth Street Springfield, Oregon 97477 r'J.,.Y+or; SUBDIVISION' ~Q \I~C'QJ\T \ ,J.' PHONE: fq.~(n~ ADDRF"S: . _ ", \-_ V0 .l-\X\ Q)( ) \. '>D{~) ~ . CITY:~ l) STATE: (~ ZIP: C{l4il DESCRIBEW~RK~' ~(\+n \ dt1flLnC31t) NEW REMODEL ADDITION ~ DEMOLISH OTHER OWNER: CONTRACT~ NAME ~ GENERA' ,\..\J.LLJt\Q ~ ) PLUMBING: MECHANICAl" ~\101l Q If') ~\) \ 0\\ tiLT ELECTRICAl' QUAD AREA: t) ~ t\)V . OF BLDGS: '\ e..~ \ OCCY GROUP' . OF STORIES: WATER HEATER' ADDRESS CONST. CONTRACTOR' PHONE - OFFICE USE - LAND USE: \ \\ \ . OF UNITS' \ CONSTR. TYPE: ~^) HEAT SOURCE: RANGE: EXPIRES FLOOD PLAIN: ZONING CODE: 1 f~ \2- . OF BDRMS: SECONDARY HEAT: SQUARE FOOTAGE: J{ I) 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. o Temporary Electric o Si_te Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbingl Electricall Mechanical - Prior to cover. ~ Footing - After trenches are excavated. o Masonry - Steel location, bond beams, grouting. lLJ Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. ~ Underfloor Plumbing/Mechanical - Prior to insulation or decking. ~ Post and Beam - Prior to floor L..,L.J Insulation or decking. rVl Floor Insulation - Prior to l...,CJ decking. o Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling trench. o Water Line - Prior to fillln9 trench. [X] Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. IX! Rough Electrical - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. [E] Framing - Prior to cover. rVI Wall/Ceiling Insulation - Prior to l;!:..J cover. [Kj Drywall - Prior to taping. o Wood Stove - After installation. D Insert - After fireplace approval and installation of unIt. o 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. o Fence - When completed. o Street Trees - When all required trees are planted. [KJ Final Plumbing - When all plumbIng work Is complete. 1\71 Final Electrical - When all ~ electrical work Is complete. o Final Mechanical - When all mechanical work is complete. IKJ Final Building - When all required Inspections have been approved and building Is completed. DO'her MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. o Plu~bing 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 0" porches, skirting, decks, and venting have been installed. . , THE PROPOSED WOI'IK IN T-.HE Lot faces Lot Type Setbacks Lot sq, ftg, Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON IN I THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Is I ana approved by the Historical Topography Panhandle Iw I Coordinator prior to permit issuance. Total height Cul-de.sac IE I APPROVED: BUILDING PERMIT SQ, FT. tf'h,'=61 ITEM MaIn Garage Carport Total Value Building Permit Fee State Surcharge Totai Fee X~~~~b =4Vr1)\ J - ~ (A) 4.ml, 4-~. -5"t:::> -2..;>3 ~.1/3 SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM Fixtures ~ Residential Bath(s) N' Sanitary Sewer FT, Water FT, Storm Sewer FT, Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan FEE ~._If> (C) ~.. <>t:> /.. ;5'&> p/..50 Dryer Vent Wood Stove/Insert/Fireplace UnIt N' Mechanical Permit Issuance State Surcharge Total Permit Mobile Home MISCELLANEOUS PERMITS (D) \S.OJ \ D.aU (. fK5 , QLt? ,f:).'v State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 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 adopted by the City of Springfield, inciuding the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisi'l5 of said ordinances. Plan Check Fee: ~ ~a ,n~ Date Paid: Receipt Num~ R Received By:L~ 1m 41:iew:d'?~ -~ ~-~ ~'?'/ Date Systems Development Charge is due on all undeveloped properties within 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. I further agree to ensure that all required 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 :~g:::u:~e~J;:;i( z:; Date _"-- /ti'/ v/ -; w ,,- VALIDATION: 0/ RECEIPT NUMBER !J ('in; 6 DATE PAIr> ,~:'A ,q / AMOUNT RECEIVED I ( -4 J . c;, ~ RECEiVED BY ~ ~ ~. ..' .. . . Permit No: q \ [)?P/7 Address: 804 I....ID JJ/'JV.JV i-b - 0 Issued by: ~ I [)() ) Date: ~l!3/Cf 1 FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: 1.h{1 / I own, reside in, or will reside in the completed structure. 2. A. c=:::::J My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR "7 I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and Clo hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above Information Is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the Ig'afttre l'permit pplicant b~ie CONSTRUCTION CONTRACTORS BOARD 0244J 1/90 &f' COPY TO ISSUING AGENCY PERMIT ~ILE ~~Py TO APPLICANT <P!.