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Home My WebLink AboutPermit Building 1991-7-2 OWNER: 62 S'~.aH.'- ~ ADORES"'" q, R lt~ ~ ~~D DESCRIBE WORK' {l d!~ ~~ (L I ~ 4 NEW REMODEL ~AD~ITION DEMOLISH , .. RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726-3759 LOCATION OF PROPOSED WORI<" , ASSESSORS MAP: LOT' /'lrJ'1, CITY' CONTRACTOR'S NAME t0uJxJt3<? GENERAl' PLUMBING: MECHANICA' - ELECTRICAl' QUAD AREA: I {< tJ lA.J . OF BLDGS: OCCY GROUP: (Q~ . OF STORIES' WATER HEATER: . .. JOB NUMBER_q/ 6 fn It.{ 225 Fifth Street Springfield, Oregon 97477 TAX LOT: (j I ()(77J SPRINGFIELD 912 '!>f 2 I SUBDIVISION- PHONE: -9' II -;V '7Y1-o Z9)' BLOCK' STATE:~ ZIP- 97'-177 ~.,d:jll ),_~ REQUIRED INSPECTIONS ~Rough Mechanical - Prior to .l6J ~over. ~ Rough Electrical - Prior to cover. D Electrical Service - Must be approved to obtain permanent electrical power. .i1 Fireplace - Prior to facing materials and framing Insp. ~ Framing - Prior to cover. ~Wall/Ceillng Insulation - Prior to cover. ~DryWall - Prior to taping. IV1Under'IOO~MeChanical ~ _ Prior to 'n" .~. p - r5<f Wood Stove - After Installation. V, ......."'I'>...;.J. ~ Z&-- / . -"""~. """",",-,c..e ,=-.1':>. ~Post and Beam - Prior to floor ~ insulation or decking. OTHER ADDRESS CONST. CONTRACTOR' PHONE - OFFICE USE - LAND USE: J \ II . OF UNITS' CONSTR. TYPE: ~IIJ HEAT SOURCE: RANGE: EXPIRES FLOOD PLAIN- ZONING CQDE: LQt:2 # OF BDRMS: SECONDARY HEAT: SQUARE FOOTAGE: 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 (orms. o Underslab Plumbing/Electrical/ Mechanical - Prior to cover. ~Footing - After trenches are .~ excavated. o Masonry - Steel location, bond beams, grouting. ~oundation - After forms are erected but prIor to concrete placement. D Underground Plumbing - Prior to filling trench. / ~ Hoor Insulation - Prior to decking. ~ Sanitary Sewer - Prior to filling .lL::i trench. D Storm Sewer - Prior to filling trench. rvl Water Line - Prior to filling ~ trench. ~ Rough Plumbing - Prior to ~ cover. D Insert - After fireplace approval and installation of unit. D Curbcut & Approach - After forms are erected but prior to .placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms an~ sub-base material in place. o Fence - When completed. D.Street Trees - When all required trees are planted. K/t Final Plumbing - When all ~plumblng work Is complete. ~ Final Electrical - When all ~electrical work is complete. R/I'" Final Mechanical - When all ~ mechanical work Is complete. ~ Final Building - When all required Inspections have been approved and building Is completed. DOlher MOBILE HOME INSPECTIONS D Blocking and Set. Up - When all blocking is complete. D Plumbing 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. D Final - After all required inspections are approved and porches, skirting, decks, and venting have been instatted. ..' Lot faces C lot Type . Setbacks . THE PROPOSED WORK IN THE lot sq. ftg. 1~,Il. ) ~Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT. OR ON IN , I THE HISTORICAL REGISTER? Lot coverage .J. ( Corner /0 If yes, this application must be signed Is II' I and a p proved by the HistorIcal Topography Panhandle Iw Ic/ I Coordinator prior to permit issuance. -1!:L Cul-de-sac Total height IE 17Si I APPROVED: BUILDING PERMIT ITEM SO, FT. X $/SO. FT. VALUE Main Garage Carport I ~b/l) ?!~.7.o :S'<Je,. 2.0~ , Total Val ue Building Permit Fee Itfr;.~o 7, H 1~3.';n State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' qr.2-D Sanitary Sewer FT. Water FT. FT. Storm Sewer Mobile Home Plumbing Permit qr, AD tf-.7G 'ffi..76 State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnsert/Flreplace Unit I >. ()O Dryer Vent Mechanical Permit I C;.OO If). CJcJ I. '7.. 'i ;<6 .?. 'i Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) fE;L7t;. <t;'f (A, B. C, D. and E Combined) BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition thaI 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: ~?t:;. 2.3 /"-/2..-9/ ?-eJ :) Yt;. A'Y~~ 0/2-?,h/ / DaV " Date Paid: Receipt Number' Received By: -1'~X ~,aM Plans-Ffeviewed By v Systems Development Charge is due on ail 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 wlll remain on the site at all tlmes during construction. Signature ~r~ 7-..<'-7'/ t.?- -, ~ Date / VALIDATION: ~O~' or RECEIPT NUMBER ~() , \ DATE PAID 'f~.{. \- ..'_ AMOUNT RECEIVEr> ~ j w ~\ f") I 1'-1- RECEIVED BY \.. ~\.(\r~ . "~ , . . . Permit No: 1... Date: Address: Issued 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'r 2. A. L-J / I own, reside in, or will reside in the completed structure. 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' B.~ 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 00 hire a Qeneral 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 reverse side of this form. ,;7. ,a.~ P-c:l J.?<-? ~~C: Signature of Permit Applicant 7- A'- p/ Date " CONSTRUCTION CONTRACTORS BOARD 0244J 1/90 Ql.