HomeMy WebLinkAboutPermit Building 1998-9-30
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JOB NUMBER q V 10 7'1
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: <K6 ~
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WA?t
TAX LOT: ~/,-/2 'f
ASSESSORS MAP'
LOT:
BLOCK'
SUBDIVISION:
OWNER'
PHONF'
f/Vt7\P1
;
ADORE"''''
9;-Cf77
CITY:
STATE: _h.
ZIP'
DESCRIBE WORK'
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CON ST.
CONTRACTOR N
CONTRACTOR'S NAM!7,
GENERAl' l54 AI -r
CfA.,,-CU l1'
&m.4'!- f
ADDRESS
EXPIRES
PHONE
'.~
.fJ /"1"" t, " :r
PlijW ~
PLUMBING'
MECHANICAL'
ELECTRICA' .
- OFFICE USE -
I equires you to
QUA~I"",.nreaon aw r UtilltfND USE:
f\l 1=--". do ted by the Ulllilon
N OIlo!lQ'O'd!!les a p _\ . _ _ _..Ioe are set fp~ UNITS:
..N,otification l,;em"~1~ ;h;;~gh'OAR 952-001-
O'1h''6\!.~OO1=fI. . if the ru'eslil~STR. TYPE:
I obtain copies 0
N cOO!lfuFlil!S!Tlay .tl'.-. 'ho telepho'WEAT SOURCE:
calling the ell"''''' \ -'Utility Notification
WAT'1fuM~Tllifil:th".Ore9.?n .. -",,,44). RANGF'
~__'o".. 1-BOO-3;Jt
~:
TUIS rr-r-'IITSHAZONING CODE:_
. . ~r... LL EXPIRE
AI ITHOA'''ED UNDNEQF BDRMVHE WORK
. '- H THIS PERMIT'~ N
r.(lM^A~~~(:ED OR I~ECQt)lQA..RY HE:Ai: OT
Al'lANlJONED FDA
ANY lRfi 1'11\'( PFA'l~R.UARE FOOTAGE:
FLOOD PLAIN'
To request an Inspecllon, 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.
b Fln'~lumblng - When all
~~ng w~HI< Is complete.
D Temporary Electric
D Site Inspection - To be mado
after excavatlon. but prior to
setting forms.
D Rough Electrical - PrIor to
cover.
D Final Electrical - When all
electrical work Is complete.
~al Mechanical - When all
echanlcal work Is complete.
D Underslab Plumbing/Electrical!
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After trenches are
excavated.
D Final BUilding - When all
required Inspections have been
approved and building is
completed.
D Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting.
D Framing - Prior to cover.
DOther
D Foundation - After forms are
erected but prior to concrete
placement.
D Wail/Ceiling Insulation - Prior to
cover.
D Underground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Wood Stovo - After Installallon.
D Blocking and Sel.Up - When all
blocking Is complete.
D Post and Beam - Prior to floor
Insulation or decking.
D Insert - After fireplace approvlll
and Installation of unit.
D Floor Insulation - Prior to
decking.
D Plumbing Connections - When
home has been connected to
water and sewer.
o Curbcut & Approach - After
forms are emcted but prior to
placement of concrete.
D Sanitary Sewer - Prior to filling
trench.
D Electrical Connecllon - When
blocking, set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Sidewalk & Driveway - After
excavation 15 complete. forms
and sub-base material In place.
D Storm Sewer - Prior to filling
trench.
D Fence - When COi'flpleted.
D Water Line - Prior to filling
trench.
D Final - After all required
Inspections are approved and
porches, skirtIng, decks, and
venting have been Installed.
D Rough Plumbing - Prior to
cover.
D Street Trees - When all requIred
trees are planted.
Lot faces
.
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Panhandle ,.
Topography
Total height
Cul-de.sac
\] ';'1
BUILDING PERMIT
'.
"
't
ITEM
sa. FT.
X $/SO. FT. =
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
f
Residential Balh(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dry"r Vent
lAAc.7
wo~
Mechanical Permit
Issuance
State Surcharge
Total Permll
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slate Surcharge
Sidewalk It
Curbcut It
Demolition
State Surcharge
Total Miscellaneous Pennlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
. ~I'; \';;; \i~ I
( 'THE PROPOSED WORK tN THE.
'.HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I P.L. HSE GAR
IN
Is
-"'1.- _
,E
VALUE
"
<=<=<=
~
/ [;;() ()
/0,9D
'II /75
u 1.#
Accl
I
I
I
_J
APPROVEf"
. '!to 'j l!
BUILDING VALOE, 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 Cily 01 Springfield, including the
Development Code, regUlating the construction and use of
ouildlngs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number:
Received By:
Plans Roviewed By
Date
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 perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without pennission 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 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 a . es d ng c truCtlo
Slgnatur~ &-
Date~/ q ,
VALIDATION:
{)3/ it II
RECEIPT NUMBER / I
DATE PAID q '50/ f't
AMOUNT RECEIVEQ' , '2J/: /J
RECEIVED BY oJ! vr/J