HomeMy WebLinkAboutPermit Building 1995-3-27
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
>(ASSESSORS MAP:
'<LOT:
.
BLOCK'
.-
JOB NUMBER
"7~o79 /
225 Fifth Slreet
Springfield, Oregon 97477
&? <2~c>
SUBDIVISION:
OWNER: A \ l<:/n' ---s..rloo y.
ADDRESS: ~ L "':;, s, \'2nd (,,)'001) ~,
CITY' ~.QJ , . '. STATE: 1'2:5<
DESCRIBE WORK: .bf?~~~.,;q~~~ /,,,,,,,, ~.!!',;;;r,,;
NEW REMODEL V ADDITION DEMOLISH OTHER
.....
PHONE::J U -a8 <;""0
'..-.t:::
ZIP:~
'..2?~J"V~~~.
, - .
?
CONTRACTOR'S NAME
GENERAl' (j/).yV'~
PLUMBING'
MECHANICA' .
ELECTRICAL: n I. .........oAa....
t
ADDRESS
CONST.
CONTRACTOR'
PHONE
EXPIRES
- OFFICE USE -
OUAD AREA' LAND USE: FLOOD PLAIN:
. OF BLDGS' · OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' SOUARE FOOTAGE:_
To requesl an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requesled before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the lollowlng work day.
REQUIRED INSPECTIONS
o Temporary Eloctrlc
O Silo Inspoctlon - To be made
after excavation, but prior to
settlng forms.
o Underslab Plumbing I Electrlcall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underfloor Plumblng/Mechenlcal
- Prior to Insulation or deckIng.
D Post and Boam - Prior to floor
InsulatIon or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prlor to filling
trench.
o Storm Sewer - Prior to flIlfng
trench.
O Waler Line - Prior 10 filling
trench:
..
o Rough Plumbing - Prior to
cover.
o Rough Mochanlcal - Prior to
cover. (
r7l Roug~ Eloctrlcal - Prior to
L..,Atr.J cover..
i
o
Electrical Service - Must be
approved to obtaIn permanent
olectrlcal power.
o Fireplace - Prior to facing
materials and framing Insp.
G!J Framing - Prior to cover.
o Wallle'elllng Insulation - Prior to
cover.
rn Drywall - Prior to taping.
o Wood Stovo - Atter Installation.
o Inserl - After fireplace a'pproval
and Installation of unit.
o
Curbcul & Approach - After
forms are erected but prior to
placemont of concrete.
o
Sidewalk & Driveway - Alier
excavation Is completo, forms
and sub.base materIal In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When DIl
plumbIng worl( Is complete.
I7l Final ElectrlcDl - When all
l.LU electrIcal work Is complete.
o Flnnl Mechllnlcal - When all
mechanical work Is complete.
!Xl
Final Bul/dlng - When all
requIred InspectIons have been
approved and building Is
compleled.
OOth.r
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is completo.
o
Plumbing Connections - When
home has been connected 10
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
Inspectlons are approved and
porchos, sklrtlng, decks, and
venting have been Installed.
Lot (~ccs
Lot TYP.
InterIor
LOI sq. fig.
Lot coverage
Corner
Topography
TOlal helghl
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SO. FT.
Main ~Lt:.-&'"
X $/SO. FT.
Garage
Carport
TOIDI Value
Building Permit Fee
~
Slate Surcharge
Tolal Fee
(A)
. r~: , j;; .,~.
Setbacks
I P.L. HSE GAR ACC I
IN
I S I I
Iw II c I
lLLLL
VALUE
/,",e?; -
"
l7-f;:
.~~
/$ .~t
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~;/'I -
PLUMBING PERMIT
ITEM
FIxtures
Resldenilal Bath(s) N'
Sanitary Sewer FT.
Waler FT.
Storm Sower FT.
Mobile Home
Plumbing Permit
Stato Surcharge
TOlal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
Stale Surcharge
Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slale Surcharge
Sidewalk
ft
Curbcut
fl
Oemoli tlon
Slate Surcharge
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrlcal)
lA, B, C, D, and' E. Combined)
FEE
_IS THE PROPOSED WORK IN THE.
. "'HISTORICAL DtSTRICT, 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 granled on the express condition Ihalthe said
construction shall,ln all respects, conlorm to the Ordinance
adopled by the Clty.of Springfield, InCluding the
Development Code, regulallng the construction and use of
buildings, and may be suspended or revoked at any lime
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
/1. "75
---
7....<>~~ .
/6/ Y "'7
/7_
/L........-a_
~
~-
Date
Systems Development Charge Is due on all undevelopod
properlles within 11'0 City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I stalo and agree, that I have carefully examined
the completed appllcallon and do hereby cerllfy 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 01 the City of Springfield, and the Laws
of the Stale of Oregon pertaining to tho work described
heroin, and that NO OCCUPANCY will be made 01 any
struclure 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 streel, that the permit card Is located at the front
of the property, and the approved set of plans will remaIn
on the site at all times during construction.
Signature Q~~~
Date~/.l1 /g~ /
/ 'j
RECEIPT NUMBER /h? Y9
J"- <'';>.5-S--
?? V/
~~-,;._-........
VALIDATION:
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
'/-