HomeMy WebLinkAboutPermit Building 1995-10-4
.
.
SPRINGFIELD ,,,,
RESIDENTIAL
PERMIT APPLICATION
'9 7'tP 75c;;:>
JOB NUMBER
JIIIIL. tiP
~ !? 'Z'_
-:::> ~Pt.._:,:
225 Filth Street
Springfield. Oregon 97477
Inspections: 726,3769
Office: 726.3759
."') ~.
p' /-j/-;'
TAX LOT: _~ 2~
LOCATION OF PROPOSED WORK: _ ,? ~b"
/8'z!9:Z~6'~-/2-
ASSESSORS MAP'
SUBDIVISION'
BLOCK'
LOT'
?f/ Y~69h"~
,
jffi~A:' E~?/?/'-7~
g~ -se"3~ ~r.
5p~7)
~
~L/
PHONF'
OWNER'
ADDRESS:
CITY'
q? 'Y?~
0.7.< .
ZIP:
STATE:
~/yyCd==' /~ 6~::r:-~~ ~,.:
DESCRIBE WORV'
OTHER
DEMOLISH
ADDITION
REMODEL
NEW
CONST,
CONTRACTOR ·
EXPIRES " PHONE
ADDRESS
CONTRACTOR'S NAME
GENERA' ,!(4tp~
PLUMBING'
MECHANICAL'
ELECTRICA' '
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF,UNITS: ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORI ES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: _ 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.
REQUIRED INSPECTIONS
o Final Plumbing - When all
plumbing work Is complete,
o Rough Mechanical - Prior to
cover.
o Temporary Electric
rAl Rough Electrical - Prior to
L..L.:J cover.
O Slto Inspection - To be made
after excavation, but prior to
setting forms.
r;7l Final Electrical - When all
I,A-J electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Underslab Plumbing' Electrical'
Mechanical - Prlor to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
IXI Final Building - When all
required Inspections have been
approved and building Is
completed.
o Footing - After trenches are
excavated.
o Fireplace - Prior to facIng
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
[Zl Framing - Prior to cover.
.'
OOlhor
o Foundation - After forms are
erected but prior to concrete
placement.
c;rJ WalllC'olllng Insulation - Prior to
cover.
o
Underground Plumbing - Prior
to filling trench,
141 Drywall - Prior to taping,
MOBILE HOME INSPECTIONS
O Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stove - After Installation.
o Blocking and Sot.Up - When all
blocking-Is complete,
"-"
o Plumbing Connccllons - When
home has been connected to
water and sewer.
o Post and Beam - Prior to floor
Insulation or decking.
o Insert - After fireplace approvel
and Installation 01 unit.
o Floor Insulation - Prior to
decking,
o Curbcut & Approach - After
forms are erected but prIor to
placement 01 concrete.
o Sanitary Sewer - Prior to fltllng
trench.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
o Sidewalk & Driveway - After
excavation Is compiete. forms
and sub.base material In place.
o Storm Sewor - Prior to fillIng
trench.
o Fence - When completed.
o Water Line - PrIor to fitling
trench.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
ventlng have been Installed.
o Street Troes - When all required
trees ar.e planted.
o Rough Plumbing - Prior to
cover.
Lot coverage
Corner
Setbacks
I P,L. I HSE I GAR ACC
I N I I
I S I I
Iw I I I I
lL.LLL _I
-IS 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 10 permit issuance.
Lot faces
Lol TYP.
Interior
Lol sq, fig,
Topography
Total height
Panhandle
Cul-de-sac
APPROVED: ,
BUILDING PERMIT
ITEM SO, FT, X $/SQ, FT,
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
Garage
"
This permit Is granted on the express Condition thaI the saId
Constructlon shall, in all respects, conform to the Ordinance
adopted by' the City 01 Springfield, i,ncludlng 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.
Carport
c:?&/,E
Plan Check Fee:
TOlal Value
Dale Paid:
~~ -:>
~;S'(. / ~ "'--6i-
~ . -.::::"'5"
,r:? .- ~'7'
. .
..,L1h - 2..::>
SYSTEMS DEVELOPMENT CHARGE (SDC)
Building Permit Foe
Receipt Numbcr:_~.
Slale Surcharge
Received By:
Tolal Fee
(A)
-_. --..-
Plans Reviewed By
Dale
PLUMBING PERMIT
ITEM
(B)
Systems Development Charge Is due on all undevoloped
properties withIn tho City limIts which are being Improved.
FEE
ADDITIONAL COMMENTS
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
FT,
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
By signature, I state and agree, that I have carefully.examlned
the completed application and do hereby certHy that all
Information hereon Is true and correct, and I further certffy
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 cerl/fy that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Wood Stovellnsert/Flreplace UnIt
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from the street, thai the permtt card Is located at the front
of the property, and Ihe approved ;~:uo:~s will remain
:~g:::u:~t~,' .,~;;""~
Dale ~t?_ < ..-- ,
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slale Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
Slate Surcharge
VALIDATION:
RECEIPT NUMBER
/9/~=.>
.-- .y'.?<s
Total Miscellaneous Permits
(E)
DATE PAID
TOTAL AMOUNT DUE (excluding clec\[lcal)
lA, B, C, D, and E Combined) ,
AMOUNT RECEIVED <,,6~ <="'
RECEIVED BY a.?'-J.zr.:2-'
~/'