HomeMy WebLinkAboutPermit Building 1991-8-23
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT: ...l.7 BLOCK'
--" 3 d.._
OWNER: r",I<<<-<-
ADDRESS' ';'f'i~ M.... -f. f. u, r
~
CITY: ~ (.( ( e-/L
<J
( 0.... r 1-.< t /0../
DESCRIBE WORK'
NEW ><- REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl' h..1..~ ~ 4,,_, J
PLUMBING: (.. rl ^_ PI.. ..,1."... .
MECHANICAl' /?ol ~1' flc4f';1'
ELECTRICAL: flu (1- f r;'~_"-
QUAD AREA: . \ \( \\11", )
\
OCCY GROUP: ~-'\-N\
\
6/X'
# OF BLDGS:
# OF STORIES:
WATER HEATER:
..
.
~/C>"7'S1d
F 3 '-I t:? t< f ..r{-"'<-L
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:R&..,Ih..... e.rf.t;. f)..,JJlcIc!)
PHONF' ~r 3/7 G.
p-
ZIP' 1'7'/0/
STAT'" O~c.../
<..J
S ...~/(. h... f) Po. / ....,<-<'
DEMOLISH OTHER
CONST.
ADDRESS CONTRACTOR # EXPIRES PHONE
.:J ff.L 111.. {.I,. I 02 '<.J '?14 'Iff {. I '1~ 4UJ171o
J(,,,,-IwJ.~~ e-'r .;)a /1 ..; It>/r~ (j,j J/N~
J
3 no e.,f Nfl. JO:lYO .2/<; L 7 '11-000 L
]~ 10J, VII S,{..I(J ~ 0 -17' '- "3 J 9L. 7Y'.l~Io? 'L
- OFFICE USE -
LAND USE: \ \ \ \
# OF UNITS: \
CONSTR. TYPE: if }J
HEAT SOURCE: 6~.~4,
RANGE:
FLOOD PLAIN'
ZONING CODE:
ill Y2--'
4-
# OF BDRMS'
SECONDARY HEAT'
SQUARE FOOTAGE: ---2.P->e..'1
To r9quest 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.
[It] Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electricall
Mechanical - Prior to cover.
lZl Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting,
r71 Foundation - After forms are
~ erected but prior to concrete
placement.
[]I Underground Plumbing - Prior
to filling trench.
r7l Underlloor Plumbing/Mechanical
LAJ _ Prior to Insulation or decking.
r:l Post and Beam - Prior to floor
L.:;A-J Insulation or decking.
~ Floor Insulation - Prior to
decking.
I')l Sanitary Sewer - Prior to tilling
~ trench.
!:":l Storm Sewer - Prior to filling
7fJ trench.
r7I Water Une - Prior to filling
L.....!\-J trench.
rn Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
L...,.L1J cover.
[2!] Rough Electrical - Prior to
cover.
~ Electrical Service - Must be
approved to obtain permanent
electrical power.
[Z] Fireplace - Prior to facing
materials and framing Insp.
[1J Framing - Prior to cover.
r-v1 Wall/Ceiling Insulation - Prior to
L..".tU cover.
~ Drywall - Prior to taping.
[X] Wood Stove - After Installation.
o Insert - After flreplace approval
and Installation of unit. .
[K] Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
[Xl Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
[Z] Fence....; When completed.
[Z] Street Trees - When all required
trees are planted. . .
[X] Final Plumbing - When all
plumbing work Is complete.
[2J Final Electrical - When all
electrical work is complete.
r7l Final Mechanical - When all
L.,..6.J mechanical work Is complete.
Cil Final Building - When all
required Inspections have been
approved and building is
completed.
[Z] Other W~t.v"
p~V/'/c!=
MOBILE HOME INSPECTIONS
D 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
;iospections 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.
Lot faces 2- Lot Type. Setbacks ., THE PROPOSED WORK IN THE
Lot sq. Itg. interior I PL. HSE GARIACCI HISTORICAL DISTRICT. OR ON
IN ;;;y~ ' I I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Topography d-~ Panhandle Is /8' I I and approved by the Historical
~ Iw I I Coordinator prior to permit issuance.
Total height $!6'~ )L Cul.de.sac ::;t:J'
IE ,Fo// , I I APPROVED:
BUILDING PERMIT
ITEM sa. n x $/SO. n
VALUE
9'? ~Ff':>
$. gy~. '?~
,
Main
2L<?7
b~7
.~~
/<1' ./If?
Garage
Carport
Total Val ue
~~,~U;O
t./.';?C/. 0<0
Building Permit Fee
-::::(. ::?O
t/'7~ ::2~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~ -z.o \ to 1<>.1 ~
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' '2
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
-lb/). e%?
Mobile Home
~_o'O":CPd pee V/Ce
/6,=
/29, .-.,
.8 ,So
/7€?So
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
h.Pe>
~.St!!>
/2.. Or<:>
/5;~
iG_e>'f::>
-;z ,-'C>
4/5': 5'" ~
Ie.? -b
-2 ..:?8
4"~. -;zg
Fu mace
Exhaust Hood
Vent Fan NO <;I%9'~-
000d Sto~lnsertlFireplace Unit
Dryer Vent i #J;[o#7?! V.<F'-?'T
r:;~ /~r>/nz:::;
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk /~:z. It 2-~~
Curbcut :::;".0 It /q.5"..::::>
Demolitlor>- ?<44 jlb:~~4>~ qt:', a:>
State Surcharge
frH<:6
(1S)(jJ '>
<:: =-D
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) ~7J?=?q'$'
(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:~4.f?'."">. SrE ~
gy"'J z;>~ - ,
,....-;
Date Paid:
~-
Receipt Number.
~~.-_~.
//
Received By:
Plans Reviewed 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 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.
Signature R. ~
Date
4J 2t Y/7/fl
VALIDATION: 0
RECEIPT NUMBEf /1 I C1l
DATE PAIr> t 9\uq . t~~ l qq I
AMOUNT RECEIV.:e..; A ~ ~ -, l 01
RECEIVED BY \. _ ~ (~ :;