HomeMy WebLinkAboutPermit Building 1995-7-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
o ftiee: 726-3759
.
SPRINGFtELD
LOCATION OF PROPOSED WORK' I.') <IF .f:'., '.A h,,~. Or
ASSESSORS MAP: /7.....:1'?J-~"")-~
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ADDITION 1 DEMOLISH , OTHER A'Q/,,,,:-V""
CONST,
CONTRACTOR'
LOT'
OWNER:j:;:'f'<:.--d 5, ;>"..L J('?l
ADDRESS: OJ 9h# A/ t;'1I
CITY: ~/r't.f-f,,..-/j
DESCRIBE WORK: Ii ";::~'r-
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL~~~
PLUMBING'
MECHANICAL'
ELECTRICAL.
" -
QUAD AREA:
\\Z\\lQ
~
. OF BLDGS'
OCCY GROUP'
. OF STORIES:_
WATER HEATER'
BLOCI"
/? t)d_h '('
STATf'
If) ,.-'
~
JOB NUMBER 9. ~?~/
225 Filth Street
Springfield, Oregon 97477
TAX LOT: ~ ~ c,./c:::>~
SUBDIVISION'
PHONE: ..:z!L/~- 0'79 4-
ZIP:
q >tI-//
ADDRESS
- OFFICE USE -
\\ \ \
LAND USE:
. OF UNITS'
CONSTR. TYPE:
I
VN
~.-t,...<;
EXPIRES
PHONE
HEAT SOURCE:
RANGF'
FLOOD PLAIN:
ZONING CODE: ill~
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording, All Inspections requested belore 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 Plumblngl Electrical I
Mechanical - Prior to cover.
f)(l Footing - After trenches are
l.f::JJ excavated.
o Masonry - Steel location, bond
beams, grouting.
rYl Foundation - After forms are
~ erected but prior to concrete
placement.
o Underground Plumbing - Prior
to fllllnQ trench.
o
Underlloor Plumblngl Mechanical
- Prior to Insulation or decking.
JRJ
Post and Boa,.." - Prior to floor
insulation or deckIng.
()(J Floor Insulation - Prior to
/ decKing.
o
Sanllary Sewor - Prior 10 filling
trench.
jAJ
o
Storm Sewor - Prior 10 filling
trench.
Water Line - Prior to filling'
trench.
o Rough Plumbing - Prior 10
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - PrIor to
cover.
r:;(t 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.
(2J Framing - Prior to cover.
m Wail/Ceiling Insulation - Prior to
~ cover. .
IfQ. Drywall - Prior to taping.
o Wood Stovo - After Installallon.
o Insert - After fireplace approval
and InstallatIon of unit.
o
Curbcut & Approach - After
forms are erected but prIor to
placement of concruto.
o SidewalK & Driveway - After
excavation Is complete. forms
and sub.base material In place.
o Fence - When completed.
o Street Treos - When all required
trees are planted.
[:zJ Final Plumbing - When all
( plumbing w9rk Is complet.e.
l\:71 Final Electrical - When all
LN electrical work Is complete.
o Final Mechanical - When all
mechanIcal work Is complete.
m final Building - When all
'-r required Inspections have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
o BlocKing and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connoctlon - When
blocKing, set,up, and plumbing
inspecllons have been approved
and the homo Is connected to
the service panel.
o Final - After all required
inspectIons are approved and
porches, skIrting, decks, and
venting have been installed.
'''.'
L03;~ . (1 . ., THE PROPOSED WORK IN THE.
Lot faces Setbacks
I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
Lot sq. Itg. Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corner II yes, this application must be signed
Topography Panhandle Is I and approved by the Historical
Iw I Coordinator prior 10 permit issuance.
Total height Cul'de.sac
IE I APPROVED:
BUILDING PERMIT
ITEM sa. FT. x $/SO, FT. ~
Main ~?~l7-S- ?r--?t:>
VALUE
L~~a> y
Garage
"
Carport
~~,
~""?5: 2?
-,.,%,
/'./t?
~/,.
Total Value
t~'~V.6;
I B. $..Q
\ &.1;.1
\ 1 \. \51.
Building Parmi I Fee
Stale Surcharge "T,"! 1. + l.\,1b
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) 1k
ll:. ,?,W
(B) "Z-z.17 -
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT. 5c'\
Mobile Home
d..S,~
PlumbIng Permit
Slate Surcharge
'2"'):'..0
~~ 1:~
"7"2~
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unil
Dryer Vent
Mechanical. Perml t
Issuance
State Surcharge
Total Permit
~
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
~
. "-I&,~l:l;
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, 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, including the
Development Code, regulating the cOQstructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: _/~.o--::!s
-<.5"b-.:9-;;-
Date Paid:
Receipt NllmbCl:__.~.7:;:::>
/kg- r"
,/,
Received By:
:1~~evlewed By
r
....f6h
~~te
Systems Development Charge is due on all undeveloped
properties within the City llml~ts which are being improved.
ADDITIONAL COMMENTS
f\.5Lr',,-' '~~,L ,l\t\\~~ ~~
~fJ l ~ ,HI), ..\.j,
By sIgnature, I state and agree, that I have carofully examined
the completed application and do hereby certify that all
In(ormatlon 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 tho work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the BuildIng Safety Division.
I further certHy 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 lhe proper time, lhat oach 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 at all times during construction.
Signature '-:::Z..A J / --/] /...... ~.:
~r-r ~ . /'
Datp 7-1 ~ -'1 -r
VALIDATiON:
RECEIPT NUMBER ~_'7,atf.
7-/ ~~ S"-
.-. __ I
AMOUNT RECEIVED -Lj'!)'3,56
~~
DATE PAID
RECEIVED BY
~