HomeMy WebLinkAboutPermit Building 1997-1-29
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
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LOCATION OF PROpr'SED WORK: _ ~ CS ~
ASSESSORS MAP: IJO~:)d3\ '
L\:
LOT:
BLOCK:
OWNEFf
JOB NUMBER_
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STATE(\)to~_ ZIP Q--r\L:)
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OTHER
DEMOLISH
CONTRACTOR'S NAME
GENERAL: 0./ ~
PLUMBei J._l-:>nO If:-J
MECHANICAL:
ELECTRICAL:
ADDRESS
CONST.
CONTRACTOR It
EXPIRES
PHONE
QUAD AREA:
It OF BLDGS: _
OCCY GROUP:
It OF STORIES:
WATER HEATER:
- OFFICE liSE -
LAND USE: _
It OF UNITS:
CONSTR, TYPE:
HEAT SOURQE:
RANGE:
FLOOD I~LAIN:
ZONING CODE:
It OF BDRMS:
SECONDARY HEAT:
SQUARl': FOOTAG E: ____
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,
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing -: After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting,
D:Foundatlon - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench,
D
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or decl<ing,
D Floor Insulation - Prior to
decking, '
~nitary Sewer - Prior t~ filling
trench.
o Storm Sewer - Prior to filling
trench,
D Water Line - Prior t'o filJin'g
trench.
D
Rough Plumbing - Prior to
cover,
, .
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover,
o Rough Electrical - Prior to
cover.
D
Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prior to facing
materials and framing Insp,
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
'0 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,
o Fence - When completed,
/
D Street Trees - When all req'uired
trees are planted.
D
Final Plumbing - When all
plumbing work is complete,
D Final Electrical - When all
electrical worJ< is complete,
o
Final Mechanical - When all
mechanical worJ< Is complete.
o
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
blockin~J Is complete,
o Plumbing Connections - When
home 11<15 been connected to
water and sewer,
o Electrical Connection - When
blocking, set.up. and plumbing
Inspections have been approved
and tile home is connected to
the service panel.
o
Final - After all required
inspections are approved and
porches, sJ<irting, decks, and
venting have been installed,
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I~' 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,
Setbacks
HSE GAR ACC I.
Lot faces Lot Type
Lot sq, ftg, Interior I P,L,
IN
Lot coverage Corner Is
Topography Panhandle \W
Total height Cul.de.sac ' IE
BUILDING PERMIT
ITEM SQ, FT,
X $/SQ, FT. VALUE
Main
"
Garage
Carpor!
'"
,
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t,
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Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
, ITEM
FEE
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/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
?tate Surcharge
Total Miscellaneous Permits (E)
/
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
,110 . /20
APPRO\(.ED: "
BUILDING VAUJE, PLAN CHECK"}
AND BUILDING PERMIT
This permit is granted on,the express conditio'n,that the said
construction shall, in all respects, coniorm to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use"of
buildings, and may be suspended or' revoke<;l:at;.any time
. __ .'\~ 4
upon violation of any provisions of said ordinances,
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Plan Check Fee:
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Date Paid:
Receipt Number'
Received By:
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Plans Reviewed By
Date
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Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon is true and correct, and I further certify
that any and,all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division,
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspections are
requested at t e proper time, that each address Is readable
from the stre t, that the permit card Is located at the front
of the proper y, and the approved set of plans will remain
on the ite t)l~times ing construction,
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A
Date
VALIDATION: 3:1
RECEIPT NUMBE~ J)/J{\) l...
DATE PAID I rQL I ,4"1 . _
AMOUNT RECE~ED- " / l.'O $)
RECEIVED BY, . I /\~ )
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