HomeMy WebLinkAboutPermit Building 1991-12-5
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK' Ell l?"".J1...... WlJ
n 0 ~?,t.f ) ~
ASSESSORS MAP:
LOT:
:1-1
.BLOCK'
~~. tf1 ;.j~ ._J~
}1. .1..4.. ~ ./a._ -
OWNER'
ADDRESS: dt; ~.J-
&A~-
CITY:
s:-PIC..
DESCRIBE WORK'
NEW ~ REMODEL
CONTRACTOR'S NAME
GENERAL: ~ (1 I~-
PLUMBING: c....J__. 6'.1-__ I. J
MECHANICAL: ~.' Lf:-
ELECTRICAL' AIz....!_o ~.J
'(} ~
STATF'
~r-
.
9//3'38
ADDITION
DEMOLISH
OTHER
JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
TAX LOT'
. ..
SUBDIVISION:~,.I4....1 I?.rh!:r
.;l.;.;t!. /1r/J.-tuA/
c.f,lS'.iI/(
>
PHONF'
ZIP'
~11/")
ADDRESS
,:), ~'" MJ:...tJ.,:
~L.
o
3~L/'J g.r..rf.. Ivn
CONST.
CONTRACTOR'
'f.}vol .l(_"t;~
('","I ..]U/J'/
E.. ..] () 2- 1/ .;J
F'L- .z 7or_r-
PHONE
Clj.sJ/7 ~
</d S II v,,(-..
7VI-C/oe I
~If"L 3,--,
71'}C) ? ~ t/ ~L' Itl
- OFFICE USE -
EXPIRES
(.!.~ ?
(, It; ?
dL/~ I
3/~ L.
QUAD AREA: ::::l~ II! IAJ LAND US~' III J FLOOD PLAIN'
. OF BLDGS: I # OF UNITS: I ZONING CODE: --L-..flr?
OCCY GROUP: 'J:) ~ 1 JII\ CONSTR. TYPE: \//1/ . OF BDRMS:
f
. OF STORIES' HEAT SOURCE:_ ~ ~A SECONDARY HEAT: FA I' S7VYC
WATER HEATER: -< .+'r' RANGE: ,z:=-L SQUARE FOOTAGE: .!lL./ :;l<"S-r)
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.
j}([Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
!"VI Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
~erected but prior to concrete
placement.
~ Underground Plumbing - Prior
to filling trench.
1"\71 Underflooce'.:::L.,,9\!'echan.lc(ll
~ - Prior to liis...,.....J(, or decking.
~ Post and Beam - Prior to floor
Insulation or decking.
~ Floor Insulation - Prior to
~decking.
1Vf' Sanitary Sewer - Prior to fitling
~ trench.
'f':?f Storm Sewer - Prior to filling
~ trench.
'"'R7'!- Water Line - Prior to filling
~trench.
~ Rough Plumbing - Prior to
~cover.
REQUIRED INSPECTIONS
"f'::/f Rough MechanIcal - Prior to
~ cover.
~ Rough Electrical - Prior to
~ cover.
~ Electrical Service - Must be
~approved to obtain permanent
electrical power.
~ Fireplace - Prior to facing
~ materials and framing Insp.
~ Framing - Prior to cover.
~ Wall/Ceiling Insulation - Prior to
~ cover.
~ Drywall - Prior to taping.
~WOOd Stove - After Instailation.
o Insert - After fireplace approval
and Installation of unit
~ Curbcut & Approach - After
~ forms are erected but prior to
placement of concrete.
fVT.Sidewalk & Driveway - After
~excavation Is complete, forms
and sub-base material in place.
~ Fence - When completed.
~reet Trees -'Wh'en all requirea
"-.. ~ ;rees are planted.
'K71' Final Plumbing - When all
~ plumbing work Is complete.
~ Final Electrical - When all
~eJectrical work is complete.
~ Final Mechanical - When all
mechanical work is complete.
~ Final Building - When all
~ required Inspections have been
approved and building is
completed.
~ Other 'P::Aa::ptJJiA. I [)e.Ylc5
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.
o Final - After all required
Inspectlons are approved and
porches. skirting, decks, and
venting have been installed.
Lot faces -N-.- Lot Type. Setbacks . THE PROPOSED WORK IN THE
Lot sq: Itg. ~ ""--Interior I P.L HSE GAR ACC HISTORICAL DISTRICT, OR ON
IN 20' THE HISTORICAL REGISTER?
Lot coverage ~o Corner Is If yes, this application must be signed
~ and approved by the Historical
Topography Panhandle
K Iw '5' Coordinator prior to permit issuance.
Total height Cul-de-sac
IE I.' I
, '/ ,II , APPROVED:
BUILDING PERMIT
sa. FT.
[},OLfi
J,'I'1..5..
X $/sa. FT.
-#1.70
-/-!f /0
ITEM
VALUE
8/7.",-
--S~SI
Main
Garage
Carport
aq~/ 7
3q1.~
/c;.1P
$I~ ?()
SYSTEMS DEVELOPMENT CHARGE (SDC)~
(B) ';'-z.o~
Total Value
-...,J..7 J- 0'0
Q ~y" 0
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ?
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
"PAt:.-lC.plflAJ ~
Plumbing Permit
State Surcharge
/ ~O .(}()
J~PO
/7560
8.7S'
/~.'<,.7S-
Total Charge
(C)
MECHANICAL PERMIT
~.C>O
-1- 5"0
q.oo
/ ~ ()o
7,c>0
2..0'0
'2,9.S'0
//?,~o
/.92>
~&)J..,g
Furnace
Exhaust Hood
Vent Fan
N'
-2.
Wood Stove/Insert/Fireplace Unit
Dryer Vent
/,;A-5
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk P?>o It
Curbcut 2"1 It
22.~
/ ~~.1B
Demolition
e~~
FeNCl!..
0""
~eJ;/r 8
V1
~:<lO.).
~.OO
<-/23<72.)
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electri4_?~~5
(A, B, C. D, and E Combined)
I
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 A'rAi~ns. of said ordinances.
Plan Check Fee: C:J~ 4-rJ ~ 1t8V:'
Date Paid: l \ . \?,q\ 2~.r.=~1
Receipt Numbea ~1122-
ReceiV.A: 97;?~ J
Pla~ By
J~~~/
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
:1~~ #S'AY/ 1k~,.,?)
r2v,~^"APrL 10,7)(
~
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 alt times during constructIon.
Signature
~q~
Date
1/ /n./f t'
VALIDATION:
RECEIPT NUMBER 6o?'Z Yj'"
DATE PAin 1-::2-'5'-"7 r
AMOUNT RECEIV~n --:b77"7. S ~
RECEIVED BY // ~
////-
- V