HomeMy WebLinkAboutPermit Building 1992-4-17
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CONTRACTOR'S NAME
GENERAl' r:Ju,,,- tJ, r!o-....
PLUMBING: t.. 'd=_,~' ~ L-.L
MECHANICAL~' .d_'t:-~J 5n;) z.~ /l/ft. f:.
ELEGrRICAI . ~-1) l/b-J:;_. 7( HJ ~ iP rJ 5"" iJ Ju.-
QUAD AREA' \\Z..\\JL0
. OF BLDGS: \
OCCY GROUP: \('?) -\- tv'
I
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORt<.
ASSESSORS MAP'
LOT:
:JI ?~
OWNER'
ADDRESS:
CITY'
DESCRIBE WORK'
NEW A REMODEL
'--
. OF STORIES:
WATER HEATER'
OTHER
CONST
CONTRAGrOR . EXPIRES PHONE
3'-19'1 (pIn 1.I-I'.5/? b
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,;JQ.).. '10 ..,;tI~ .3 7 V/ t)cO L-
dO -/16 C '?/9'? 'lVL--.$CD77
.
SPRINGFIELD
.
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STATF'
ADDITION
DEMOLISH
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: /~
SUBDIVISION.~c;,"/bO\oV E .skh,.-
PHONE: _'AI :r- 3/7 fa
ZIP'
FLOOD PLAIN:
ZONING CODE:
11)Q)
.r1,
ADDRESS
.-'l6~J ~nt1..t1",
A2..
elL
:)
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: o.t~, t=:=l
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. Inspectlons requested after 7:00 a.m. will be'made the following work day.
.'
REQUIRED INSPECTIONS
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrlcall
Mechanical - Prior to cover.
K7"f 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.
K71' Underflo.r:Plumbl~echanicii!>
P - Prior tei-InSUlatlOn OJ Ul;:l,.;l\lng.
~ Post and Beam - Prior to floor
~ Insulation or decking.
lXf Floor Insulation - Prior to
. .Jecklng.
'"f':71 Sanitary Sewer - Prior to fitllng
~ trench.
"'fV71 Storm Sewer - Prior to filling
~ trench.
~ Water Line - Prior to filling
~ trench.
'C7'I Rough Plumbing - Prior to
~ cover.
- OFFICE USE -
\ \ \ \
. OF UNITS' l
CONSTR. TYPE: V AJ
HEAT SOURCE: r~
.LAND USE:
RANGE:
1C7l Rough Mechanical - Prior to
~cover.
K:If Rough Electrical - Prior to
~cover.
~ Electrical Service - Must be
~pproved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~raming - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywail - Prior to taping.
~ Wood Stove - After Installation.
o Insert - After fireplace approval
and installation of unit.
1'::71' Curbcut & Approach - After
~ forms are erected but prior to
placement of concrete.
r\/f Sidewalk & Driveway - After
~ excavation is complete, forms
and sub.base materIal In place.
% Fence - When completed.
T9I' Street Trees - When.all required
~ trees are planted.
~ Final Plumbing - When all
~ plumbing work is complete.
~ Final Electrical - When all
~electrlcal work Is complete.
~ Final Mechanical - When all
~ mechanical work is complete.
rVf Final Building - When all
~equired Inspections have been
approved and building is
completed.
K71' Other r:u.-/({>/~ lJEr/~
~ -,
MOBILE HOME INSPECTIONS
o Blocking and Sel.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.
o Final - After all required
inspections are approved and
porches, skirting, decks, and
ventfng have been Installed.
Lot faces 2L. Lot Type. Setbacks . THE PROPOSED WORK IN TH
Lot sQ. ftg. t$5 _ Interior I P.L HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN /e' I THE HISTORICAL REGISTER?
Lot coverage ~ ~ Corner If yes, this application mus signed
<:;2.% Is .(!;' I and approved by the Historical
Topography Panhandle
\~ Iw /2.' 12.' I Coordinator prior to permit issuance,
Total height Cul.de.sac
IE , I
,It) , APPROVED:
BUILDING PERMIT
ITEM sa. FT.
X $/sa. FT
K 31,90
><. Jl! / v
VALUE
I
?/}~t, 70
, ;
~. Sf i .2J.J
Main
up:,
tf&A-
Garage
Carport
1(1' 71.;;. qo
I
-&...4-(Jt)
/'b~
d- f ~,(,. 0 (A) ~9.'Z.!!>
SYSTEMS DEVELOPMENT CHARGE (SDC) t!5
(B) (ller"!"! ~
I
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' 2-
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
/ kOD-O
Mobile Home
_fVt:;#a~/.NV ])Er/Jt'.f::
-1('OD
Plumbing Permit
State Surcharge
;;?~O
.125;.%1
Total Charge
(C)
MECHANICAL PERMIT
(,-,o-eJ
4C'{:J
qcro
/!)ctJ
3tH>
2.d't?
39;5"0
/0, &c>
I 'Ie
'S/~
Furnace
Exhaust Hood
Vent Fan
N' . ~
Wood Stovellnsert/Flreplace Unit
Dryer Vent
'-:;-1< L/IlJ,J!;
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
"75
~2>
..2..J, '2. >
11"~o
ft
Curbcut
ft
Demolition
State Surcharge
~C6
.
\ \':ltl
,
F;.6-0
#J:fS
?~le7
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
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 City 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:. :2~-be::>
Date Paid: '1- r~~
Recei pt Number: 7"2-"'-2
Recei~J)A"
PI<f~eViewed By
lic~l-
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS 7'/'<::16<:7
~~//f-s ~2/ .~?~~
~~~-,/
\ sAc\-\': \ AI\d. l {1\1nA) .,
~ ~MJL) r h to,: 10\'\ t n
-..
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 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 times during construction.
Slgnatur~ if? ~
'I/?/~ 1_
Date
VALIDATION: A "2( ----.)
RECEIPT NUMBER ' Ie J..h<
DATE PAIr> 4, \ l '17./' . _
AMOUNT REC~ J ~'3?J.}~!
RECEIVED BY I ffi --'
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