HomeMy WebLinkAboutPermit Building 1995-2-15
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DESCRIBE WORK: ~~~~ p:.A7
NEW ;/ REMODEL ADDITION "7 ~M~IS~
RESiDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
ASSESSORS MAP'
LOT'
OWNER'
ADDR~SS'
CITY:
-
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SPRINGFIELD
.-
9?o~.<
BLOCK'
STATE:
~.
JOB NUMBER
225 Filth Street
Springfield, Oregon 97477
TAX LOT:
/~:y
SUBDIVISION:
PHONF'
--::;:>Y?- Y;> 5'--'
ZIP'
-9;:>"2 .-"'?
~.J-~>- 0~)A..,... ~?- 5Gtf1'~
OTHER~ .
CONST, ~n~'--"
CONTRACTOR'S NAME ADDRESS CONTRACTOR # EXPIRES PHONE
GENERAL:/~~~ ~b.."5 -~~~~~. S~..,.~;>09~ ~ ~/""2
PLUMBING:
MECHANICA' '
ELECTRICA' .
OUAD AREA: rQQf\ JU )
# OF BLDGS:' \
OCCY GROUP' tv\.
\
# OF STORIES:
WATER HEATER'
- OFFICE USE -
\ \ Cjt)
# OF UNITS: I
CONSTR, TYPE: ~AJ
LAND USE:
HEAT SOURCE:
RANGF'
FLOOD PLAIN'
ZONING CODE: ~
# OF BDRMS:
SECONDARY HEAT:
SOUARE FOOTAGE:
4.r(j
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, Alllnspecllons requesled 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 Slto Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlca"
Mochanlcal - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
,beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench,
D
Underfloor Plumblngl Mechanical
- Prior to Insulation or decking.
D
Post and Boam - Prior to floor
InsuletJon or decking,
o Ftoor Insulation - Prior 10
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench,
D Rough Plumbfng - Prior to
cover. .
REQUIRED INSPECTIONS
D Rough Mochanlcal - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtaIn permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~ramlng - Prior to cover,
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After Installatlon.
D Insert - After fireplace approval
and Instailatlon of unit,
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavatlon Is compieto, forms
and sub.base materIal In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D
Final Plumbing - Whon ult
plumbing worl< Is complet.e.
D
Final Electrical - When all
electrIcal work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
MFlnal Building - When ail
~requlred 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 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 Installed.
Setbacks
HSE GARIACC/
I I
Iw I I I
~---1~
Lot faces
Lot Type
Interior
I PL.
IN
is
Lot sq, fig,
Lot coverage
Corner
Topography
Total height
Panhandle
Cul,de,sac
BUILDING PERMIT
ITEM
sa. FT.
X $/SO. FT.
VALUE
Main
Garage ~~qU::"" ~1-::?C /., __~:::b
Carport
Total Value
Building Permit Fee
State Surcharge 2."( J, -r j, S- 2.
59 ,$"'o
4.o~
2-/..55
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
-
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
FT.
/
/
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
,~
/'
/
Dryer Vent
Mechanical Permit
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)
~+.s-s-
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and' E' Combined)
., . ".
~.' _ ,';;. ..
~IS THE PROPOSED WORK tN 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 Clty.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: "3'":2 .R":3
Date Paid: /__';;;>o-i?~
Receipt Numbe?!Jt:
Received By: .._.' .
~~~'1
Plarf~evlewed By .
2~aAr
o.le ......
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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7/F}J)<' ~~..rrTA<,
:5Y_"'~ -1~~/~c-r ...t. P"}(?~
~~A'/N/r:
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 Ordinanc~s 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 re~ulred 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 :It :III_tImes during COL'~trllr.tlnn _
~a~ur:,~"~ /.~ >
Date
VALIDATION: . /2./'l"-;
RECEIPT NUMBER .\ \0')./'iJ
DATE PAID c-~ . \c:...Z-\ S-
AMOUNT REC\OIV~ - <;;; +-..:. 5" .r
RECEIVED BY 'iJ\VJO. _ )