HomeMy WebLinkAboutPermit Building 1991-11-15
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT: -iJ.).. .,---
OWNER'
ADDRESS'
CITY'
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DESCRIBE WORK'
NEW ^ REMODEL
s-r~
ADDITION
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C1 J /'TI'L-
SPRINGFIELD
JOB NUMBER
225 Fifth Slreet
Springfield, Oregon 97477
TAX LO'!'
SUBDIVISION' i?",....!.,.... I:::~.J.. ~,-
~c:L 4~ I.. ft.../
PHON~. <,lit'S- .:1,7 b
ZIP' "7 V<J/
CON ST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR #
GENERAl' I::.... 1-._ _, A 14 ~ ..Lf'fl- flu fo/,.."r e.. .J(. <lflj
-J
PLUMBING: CU ..1-""",- PI..-. j,"'~f .11,7 L K:.....!-...."'.>e' Ii". pon L/
MECHANICAl .~(j.~;/t",(_..,IJ J.}f.J iY /<lft. . i?'<-\ ".20; Vc.:>
I / ...J 3Jid$1,
ELECTRICAL: 1.....-_~-/ i:'ht-...,: 1~ 7{,:J 0 () ~~t. ilL Cc- .'.:u:- t. ,-
, )
QUAD AREA: \ Q ~l9..)
. OF BLDGS: f}
OCCY GROUP: t\.:~ ~ ~
\
# OF STORIES:
,
WATER HEATER:_4
BLOCK'
STATE: 0"",__../
, J
DEMOLISH
OTHER
EXPIRES
14/~1
1./ If ,
J/'f L-
7!.x-/
PHONE
(.t6;-]'7(
Y.Ir,--I/V(_
;
71./1-",00L-
f V L - .N.., '--
FLOOD PLAIN: rf\-{) )
ZONING CODE:~) IL-/
# OF BDRMS: ..... ~~~
SECONDARY HEA:; b,
SQUARE FOOTAGE:
To request an Inspectlon, 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.
~ Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
W Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - PrIor
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
CKJ Post and Beam - Prior to floor
Insulation or decking.
CRl Floor Insulation - Prior to
decking.
[Xl Sanitary Sewer - Prior to filling
trench.
m Storm Sewer - Prior to filling
trench.
C&I Water Line - Prior to filling
trench.
rf:;;, Rough Plumbing - Prior to
~ cover.
- OF~IH ~SE -
LAND USE: \\ \ \
\ '
CONSTR. TYPE: V N
HEAT SOURCE: .~ <::;:;
~- .
# OF UNITS:
RANGE:
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
cover.
n Rough Electrical - Prior to
Lp cover.
(1] Electrical Service - Must be
approved to obtain permanent
electrical power. .
rn Fireplace - Prior to facing
materials and framing Insp.
[KJ Framing - Prior to cover.
rYl Wall/Ceiling Insulation - Prior to
LL1.J cover.
IZl Drywall - Prior to taping.
o Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
[lI Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
ell Sidewalk & Driveway - After
excavation is complete, forms
and sub-base materIal In place.
rn Fence - When completed.
rn Street Trees - Wherf-all required"
trees are planted. '
[Xl Final Plumbing - When all
plumbing work Is complete.
~ Final Electrical - When all
electrical work is complete.
r\7I Final Mechanical - When all
LA-! mechanIcal work Is complete.
rv1 Final Building - When all
LA.J required Inspections have been
approved and buildIng is
completed.
o Other
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.
D Final - After all required
inspections are approved and
porches, skirting, decks,' and
venting have been Installed.
Lot faces $- lot Type. Setbacks . THE PROPOSED WORK IN THE
lot sQ. ftg. 7Lfi?> ~ .)!. Interior I P.L HSE GAR ACC I HISTORICAL DISTRICT. OR
IN I THE HISTORICAL REGISTER
Lot coverage 22 Corner 32- If yes. this application must
~ Panhandle S $/~:iY' I and approved by istorical
Topography
/;;1 I Coordinator prior to permit issuance.
Total hel ght Cul.de.sac W
IE ,fj~,'" I APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
LB.2.8.5:
C;;)~
'?9...Ao::>
/~/P
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
72.,~/. 'r?~'
~ .:?&>
7> 95/.6S
7:;4::).-
Lg_S<>
3'~~. s.:=:>
SYSTEMS DEVELOPMENT CHARGE (SDC) f!Ii
..Ii c;so+
(B) 'Il'\"lo,{D-
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' -:2
Sanitary Sewer FT
Water FT.
Storm Sewer FT.
Mobile Home
p'AC.K~ P~I/~='"
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu mace
Exhaust Hood
Vent Fan
N'
'?-K":?
Wood Stove/lnser~ireplace Unit)
Dryer Vent
~~5 ;:z;}JP/~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk Jt?7' ft
FEE
~
/&>
...L,70.0<:>
8.;50
.L7B.5o
b.-
4"-~
0,' ",,4>
---r--" .
/'5: --
";;J-~
2 ~...c
"5'~ ..~O
/L>. -
/ . 9'8
5/.$18
'2 -:z. .6c>
Curbcut ~ ft 1"/ . Sod>
Demolition .f:.,ift!l>/T F<>A f'l::1'iV' 71cV/tc~
State SurchargePV-RmrAF,y7. ~:::/qC_5,)>
~c~ .",......---
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C, D. and E Combined)
t./'::2 ./.c>
a.. ~ _I' .~ J~.c'
~-.....
-:zY'Y-<.87.
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.
.:l2, '51.c, OS
Date Paid: In . -,~-q I
Receipt Number' ::11 ~ ~
~ecelved By: ~
~..-_..Y~
6>laI1":0fevlewec0k' - /' '
Plan Check Fee:
1/"7'~-9/
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
~~forL ICf,?,
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 j n 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 OAS 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 ~ <[ ~~4.
t..,h / 9/
Datp
VALIDATION:
RECEIPT NUMBER ~I ~f..t:;
DATE PAIr> 1'1-1&1-1/
AMOUNT RECEIV:D '2b~.3 7
OM.",
RECEIVED BY