HomeMy WebLinkAboutPermit Building 1994-3-14
"
I "RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT:
OWNER'
ADDRESS'
CITY:
DESCRIBE WORK'
Grid i-hcJ'rI
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL: _()u.rv::,.Oy
(), 1 fyJ,v
MECHANICAl' O\Ar-.--~
ELECTRICA" () A^^- o~
PLUMBING'
QUAD ARE~Q rDLJ
~.~
OCCY GROUP: I' - )
. OF BLDGS'
. OF STORIES:
WATER HEATER:
.
SPRINGFIELD
~t@
CjCI () 0 LA 2v-.." pj-J
,
1'1 0 ~ :J In LJ-:>
.
JOB NUMBER
C1 Lf OJ. ) l./
,-
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: 0 b /~
BLOCK'
SUBDIVISION:
REQUIRED INSPECTIONS
II7l Rough Mechanical "- Prior to
L.AJ cover.
IZI 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.
lZJ Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
[KI Drywall - Prlo( to taping,
o Wood ~tove - After J~stallation.
o 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 prace.
o Fence - When completed.
o Street Trees -. When all required
trees are planted. .. .'
PHONE:
/LfJ' 9c.. Lf P
~M~Q, ~JliJ./
C)q [) () I LA";' rAjJ:::.,
~,,^~~Li~
I ~J
STATE:
nP.
ZIP:_Q;'-flJ
~Ct..t{... vOrJV\"'\
,I
t(IO'{~~ )
"-
OTHER
EXPIRES
PHONE
DEMOLISH
ADDRESS
CONST,
CONTRAGfOR .
FLOOD PLAIN'
ZONING CODE:
[I VL/
- OFFICE U1E -
LAND USE:-11/
. OF UNITS' I
CONSTR, T.YPE: -.lL1\)
HEAT SOURCE: ,h/ Pc-7": ~(,~
,
RANGE:
. OF BDRMS'
SECONDARY HEAT: ,-,,\
SQUARE FOOTAGE: r-:;:qU
TO request an Inspection, you must call 726-3769. This Is a 24 hour recording. AI/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 Site Inspection - To be made
after excavatIon, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
[Z] Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, groutl ng.
m Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
[ZJ Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
(Z] Post and Beam - Prior to floor
Insulation or decking.
~ Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prlor to filtlng
trench.
D Storm Sewer - PrIor to filling
trench. .
o Water Line - Prior to filling
trench.
IZJ Rough Plumbing - Prior to
cover.
CKl Final Plumbing - When all
~um~ngwo~lscom~M~
IKl Final Electrical - When all
electrical work Is complete.
IZI Final Mechanical - When all
mechanical work Is complete.
fA7l Final Building - When all
Jt\--J required 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
wafer and sewer.
o Electrical Connection - When
blocking, set.up, and piumblng
Inspectlons have been approved
and the home is connected to
the service panel.
o Final - After all required
Inspectlons are approved and
porches, skirting, decks, and
ventlng have been Installed.
/L:J<./ s~-
~ :0; 3'
}09 . Z3
SYSTEMS DEVELOPMENT CHARqJ: (SDCJ-1$
(B) fP7(P(P~
Lot faces
Lot Ty pe
~ Interior
Lot sq. ftg.
Lot coverage
Corner
Topography /
Total height ~')
Panhandle
Cul.de.sac
/
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
_I D 1<d.L{~d.'10 <,~:;()
MaIn
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures ~
Residential Bath(s) N'
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'
/
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
~//V.
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
.
Setbacks
I P.L. HSE GAR
IN
Is
Iw
IE Sl'
VALUE
J~Lf8g
FEE
6'"~ ,pI>
6,,0. .-.
2~5.o
52,50
(,5:-
/t:7. -
, '/:7
'25775""
J~'?l ..,""
icJ/. .J~
5' 5"r.B2.
ACC I
I
I
I
I
(_~HE 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 granted on 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 provisions of said ordinances.
Plan Check Fee: IS (" 7 .C) ::2.,
d..~
Receipt Number: U'7 ':>..,'1
Recel;g;~ed. : 10~
/~~"'~~'V7
.P1a..,.r,; eVlewed B1
"
Systems Development Charge Is due on all undeveloped
properties withIn the City limits whIch are being improved.
Date Paid:
?-/o/-"7'Y
Date
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certl fy 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
on the site ~t( all ~~es durlng!O~struct~?n.
SlgnatureY '--!f-t771 ~~
Datp ~lt0J. /~; /C/t?cj
VALIDATION:
RECEIPT NUMBER
I ICl ':) ')
3) Iy I "iL./
-:5~9. 97
f:)A
DATE PAID
AMOUNT RECElv"n
RECEIVED BY