HomeMy WebLinkAboutPermit Building 1995-5-31
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK: ?I'"3"B S " ~~/ ~
ASSESSORS MAP: /::>..0:;;>-"5 <=" -_~C::,.I
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ADDRESS: / ~E~ h.4~/~
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DESCRIBE WORK: r:;;.~~~~ __~. ~. ~~ ~ 't' ~~
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REMODEL ADDITION ~ DEMOLISH OTHER
LOT:
OWNER:
CITY:
NEW
~;>< .
BLOCK:
STATE:
JOB NUMBER
9~~~
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225 Fi fth Street
Springfield, Oregon 97477
TAX LOT:
~o/
SUBDIVISION:
PHONE:
/:::>6' "O/Z? /"
ZIP:
25?-/"5..>- /~--~-.<'
CONST.
CONTRACTOR'S NAME ADDRESS ~ _~. ~RACTOR It EXPIRES PHONE
J~// -z:::? - ~ ~7<"2'~~, :::t;:-
GENERAL:V'/L'.~cE/'~_/c~~~~CY~~ r- ....._;,;....;~_/~~ ~..~::>
PLUMBING'
MECHANICAL:
ELECTRICAL:
QUAD AREA:
It OF BLDGS:
OCCY GROUP'
It OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE:
It OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
RANGE:
FLOOD PLAIN:
ZONING CODE:
It OF BDRMS:
SECONDARY HEAT:
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,
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms,
o Underslab Plumbing/ Electrical!
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 f111lnQ trench,
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Bea/Tll - Prior to floor
Insulation or d~9~ing, .'
o Floor fnsTJlation' - 'Prior to ", ';' "
deckl ng,
o Sanitary Sewer - Prior to fi/iing
trench,
o Storm Sewer - Prior to fi/ling
trench,
o Water Line - Prior to filling
trench. _ .
D Rough Plumbi~g - Prior to
cover,
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover,
o 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.
[K] Framing - Prior to cover.
o Wall! Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - After Installation.
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 place,
,D Fence - When completed.
o Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing W()rk Is complete,
o Final Electrical - 'When all
electrical work is complete,
o
Final Mechanical - When all
mechanical work Is complete,
1EJ Final Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set. Up - When all
blocking is complete,
D Plumbing Connections - When
home has been connected to
water and sewer,
D 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
inspections are approved and
porches, skirting, decks, and
venting have been installed,
Lot 'faces
Lot Type
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM
SQ, FT,
X $/SQ, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
Setbacks
I P.L. HSE GAR ACC I
N
S
Iw
IE
VALUE'
"
~~
,.
'":ilt'::::> S<:>
J"'.
1.1"~
.~
c.;/,~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
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)
FEE
~. - "
, " .. .'~
.0 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 to permit issuance,
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Ihis 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 cOf)struction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Date Paid:
Plan Check Fee:
'2 5',,0"=3>
Receipt Number:
/Zy:.
.~
Plans;Reviewed By
I-
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
5-3~S-
Date -
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed appljcation 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 thaI NO OCCUPANCY will be made of any
structure without permission of lhe 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 at ,all ti,mes ~ur~~
Slgnature:.4..~~NcJd- (7
:7/i/" /!f>
/
Date
VALIDATION:
1/5$7
?-3/-9~
~_ b:A.
/h-~
_f?" -
DATE PAID
RECEIPT NUMBER
AMOUNT RECEIVED
RECEIVED BY