HomeMy WebLinkAboutPermit Building 1995-6-12
RESIDENTIAL
PERMIT APPLICATION
Inspecllons: 726.3769
Ottlce: 726.3759
LOCATION OF PROPOSED WORK'
11 o:?
ASSESSORS ~AP:
'I ,I
:.J. t
LOT'
OWNER:
M.II,&)IZF.D (...."\~A
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~f,.\~PM)
ADDRESS:
CITY'
DESCRIBE WORK: i--k:VldJOcV1
NEW
REMODEL
225 Filth Street
Springfield, Oregon 97477
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TAX LOT: -I x-: ! 10017 10'0(;
"'OU"'G~..l....", J
SUBDIVISION: ..J ,...,........,
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.
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BLOC/<'
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Ef.s'"UlUT.'
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- PHONE:~ ~~-("C;II
STATE: -02. '
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"l eA-1:I-\~ A-oot.n~
ADDITION ~. DEMOLISH
OTHER
.
5-'-/57
~
JOB NUMBER
q 5050/
,
,
ZIP'
- 311 ';)~
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR'
GENERAL: ~ (6.JM~l2IJatD..\4'kl. ~tJ~.J~ aulD
PLUMBING'
MECHANICAl'
ELECTRICAl'
eftS
QUAD AREA: ~/l)
. OF BLDGS' I
OCCY GROUP:-W
I
. OF STORIES'
WATER HEATER:
-
- C),FFICE USE -
W-I
I
CONSTR, TYPE: V"
HEAT SOURCE: ---.lQ..t'
LAND USE:
. OF UNITS:
RANGF'
EXPIRES
PHONE
14 L ~'Zl.'~1
FLOOD PLAIN:
ZONING CODE:---W.12-
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
-
?IT)
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
D Site Inspoctlon - To be mado
after excavatIon, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ Footing - After trenches are
~excavated.
o Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
~erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
I<::7I"Underfloor P!9mblnq11ljlechanical
~ ..... Prior to Insulation or decking.
.:
~Post and Boam - Prior to floor
~Insulatlon or decking.
1Y1 Flo~r Insulation...... Prior to
~ dec,klng,
O Sanitary Sewer - Prior to filling
trench.
o Storm Sewor - Prior to filling
trench.
o Water Line - Prior to filling
trench.
'r';7I Rough P~umblng - Prior to
~over.
REQUIRED INSPECTIONS
"'f'>Z1' Rough Mechanical - Prior to
~cover.
r'\:i'f Rough Electrical - Prior to
~over.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing lnsp.
~ Fra~lng - Prior to cover.
rxI Wail/Ceiling Insulation - Prior to
~over.
~ Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit,
o Curbcut & Approach - After
forms Bre erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is completc, forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. .
I'Y'1' Final Plumbing - When all
~ plumbing W9rk Is complete.
'F::7f Final Elcctrlcal - When all
~ electrical work Is complete.
'FV1 Final Mechanical - When all
7""\ mechanical work Is complete.
I'Yf 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.
o PJumbtng Connoctlons - When
home has been connected to
waler and sC':Yer.
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
Ins'pections are approved and
porches, skirting, decks, and
venting have been Installed.
N
Is
Iw I
~-L
;;.
Lot faces
LotT.
Lot sq. IIg.
Interior
PL.
Lot coverage
v
Corner
Topography
Panhandle
1,- / .
Total height ~
,. Q;!t{)
BUILDING PERMIT
sa. FT. x
'57!-<1"0. .
Cul.de.sac
ITEM
$/SO. FT. ~
:5(;; :2- 0
VALUE
2/] &, <:; cY
Main
, .
Garage
"
Carport
"
.
. ,
Total Value
Id/ <{;O
~~,
/). 7.3.
,
/5~.2. 3-
SYSTEMS DEVELOPMENT CHARGE (SDC) .b
JS. 0;"1 'fP
(B) ~ 410 -
Building Permit Fee
State Surcharge
~ ~ .
7.~.3 +4."'0
"'Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
~~
Fixtures
3
Residential Bath(s) N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge / ,$'0...,....90
Total Charge (C)
"Z. ~ C>
32- tc'o
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Van t Fan
)
~/,..) .
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
/~6Q
/b"C:>
/,2.0
2.JC, ;:2..0
Issuance
State Surcharge ,7 S- ?,,-, ~ 5
Total Permll (0)
MISCELL,~NEOUS PERMITS
Mobile .Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
Slate Surcharge
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C, D, and E Combined)
/.02 7 .-f<:J
ACe' I
I
...
~
IS THE PROPOSED WORK tN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Hlstorlcel
Coordinator prior to permit Issuance.
".
. ,
. APPROVED;
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
" ,
, .' ,This permit Is Qr~nted'on. the express condition that the said
. construction shall, In al,l respects, conforfl) to the Ordinance
adopted by the City. of .Sprlngfleld, Inctudlng the
Development Code, regulating the.constructlon and use of
buildings, and may be suspended 'or revoked at any time
upon violation of any provisions of said ordinances.
95"2.. ~ !
L)-/-5'J
11-/ 12..-
Plan C~eck "ee:.
Date ,Paid:
Receipt Number:
Received y:
,.~..
".... .
.' . ~ 4>J'\A-
pra Reviewed By ~
. .' , . ,.' . '$"~"'/"~
7 ~a(e
Systems Development Charge Is due on all undeveloped
properties within the Clly limits which are being Improved.
ADDITIONAL COMMENTS
ft)A7# 1
~~ .&c7-.~/1 > ..-e~A"'Q)_
By signature, I stato and agree, that I have carefully examined
the completed appllcallon 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 01 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 agreo 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 sel 01 plans will remain
\
on the site at all \mes during constr lion.
~nature ~ t...J 'J
Date h If 2/ Jq--)
/ I
VALIDATION:
RECEIPT NUMBER
DATE PAID
/7/4 ~<I
~~V"r .
I . "'- " ~-/ 2 '7. /~
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..
AMOUNT RECEIVED
RECEIVED BY