HomeMy WebLinkAboutPermit Building 1991-12-5
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORt<.
.
SPRINGFIELD
.f 'I).... r? G ,A/ .ALL
ASSESSORS MAP'
..J ( O"("""I:J~..:J t;:J'~~
LOT: rr,)-0..:J. ,.1_ tUrf -/ BLOCK'
OWNER'
ADDRESS:
f6.1;;:1 ~ IJ.. .
d)~f.2 ~.#:IN ~
CITY'
~
~ /. ;r-_.1
S,A.J.- If'
V
DESCRIBE WORK'
NEW V REMODEL
CONTRACTOR'S NAME
GENERAL: I:.IOAAJ ~,J,. n
PLUMBING: (..'C'To..... f'(,,_ ~
MECHANICAL:tf-R{.. JJ....~
ELECTRICAL:/L,L 1~/~jJ
(J (\
~UAD AREA:
I f!..NVJ
I
l'Q.6-t./VJ
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER'
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STATE: _0.'
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ADDITION
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.
JOB NUMBER
q //'=5 39
DEMOLISH
OTHER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
PHON'"
~
SI';'~- 31? .k>
ZIP' i? 7 YO /
CON ST.
ADDRESS CONTRACTOR'
d-ffJ. /I1.~e~' A. r.. :Un ,,~~
K.. _ -Au-..-tI ~ lI.;ltJ, ') <-(
, ~
1.'[70 i;c,s/ (<{It. C-./ oJal V<.J
7 'i'70) f>U~J.:4(r:I () c '-
i<. ~ ...l'rllU'_'-
- OFFICE USE -
ill..!
I
CONSTR TYPE: V N
HEAT SOURCE:~;Z:;~'
LAND USE:
. OF UNITS:
RANG'"
EXPIRES
&.N1
~I 'T~
.:Jk 1_
-'1/~ '2-
PHONE
'-Id'f''?(7&
4/1os11 '-/~
7<110001.-
9VL-.i(7)
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
S~UARE FOOTAGE: 2.,<:",
To request an inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspectlons 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.
o Temporary Electric
~Site Inspection - To be made
~after excavatior.:!.r..but prior to
setting forms. ~~.s
o Underslab Plumbing/Electrical/
Mechanical - PrIor to cover.
~ Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting.
K::;;( Foundation - After forms are
~ erected but prior to concrete
placement.
~Underground Plumbing - Prior
~ to filling trench.
REQUIRED INSPECTIONS
K:71 Rough Mechanical - Prior to
~ cover.
1":71" Rough Electrical - Prior to
~cover.
f";.7f' Electrical Service - Must be
~approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
B Wall/Ceiling Insulation - Prior to
cover.
a Drywall - Prior to taping.
rvrUnderflOOl...c,,;;;;;;m!!k~chanica:D 'KA' .
~ _ Prior to inSUlation or aeC:K.lng. ~ Wood Stove - After InstallatIon.
c:;;r Post and Beam - Prior to floor
~ Insulation or deckIng.
f'Q'Floor Insulation - Prior to
~decking.
K:'7( Sanitary Sewer - Prior to filling
~ trench.
~ Storm Sewer - Prior to filling
..)CS,trench.
I'S71 Water Line - Prior to filling
~trench.
'fV11' Rough Plumbing - Prior to
~ cover.
o Insert - After fireplace approval
and installation of unit.
l"'<>l1 Curbcut & Approach - After
JL...l'forms are erected but prior to
placement of concrete.
~ Sidewalk & Driveway - After
)CS excavation is complete, forms
and sub-base material in place.
~ence - When completed.
~treet Trees - When all required
rees are planted.
I
~ rinal Plumbing - When all
plumbing work Is complete.
~/rinal Electrical - When all
,;.o.",..J electrical work is complete.
~Final Mechanical - When all
~ ~echanlcal work Is complete.
~Inal Building - When all
~ ~equlred inspections have been
approved and building Is
completed.
(8I'Other ~~ .M;I~
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
D 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
venting have been Installed.
.
Lot faces ~ Lot Type. Setbacks ., THE PROPOSED WORK IN THE
Lot sq. Itg. crP4 Interior I P.L I HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I .0' I THE HIS1DRICAL REGISTER?
Lot coverage ~o Corner If yes, this application must be signed
~ Is I I~' I Jl". and approved by the Historical
Topography Panhandle
Iw /2- ' I Coordinator prior to permit issuance.
~ ~Cul'de.sac
Total height IE )1,'$, ' I
"!\PPROVED:
BUILDING PERMIT
ITEM sa. FT.
X $/SO. FT.
3? :;;>e>
/y../O
Main
?.//P
tfL/5
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Totar Fee
(A)
VALUE
~~7. ~~
6'2 2'Y',S'"
,?'!Z/J I'AI
~~
2/)~
42lo.'3~
SYSTEMS DEVELOPMENT CHARGE (SDC)""t>.
oIL 1<; .......-
(B) W -'2dJ \ -
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N" ;;z,
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
~FUz.; .J8v/,..~
Plumbing Permit
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Fu mace
Exhaust Hood
Vent Fan
N'
4
Wood Stovellnsertl Fireplace Unit
Dryer Vent
.L;A< L M~
Mechanical Permit
Issuance
/' /5tate Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft-
2.1
It
It
Curbcut
Demolition
dj
0JOj
(/J
. State Surcharge
FEJVcE
FEE
--/!1z:!.1/)
J'::; d-'O
2O'7,'5D
-LO~
Z/7.,2Je>
/" .tw
~.f!> 0
J'2..C}O
/6,6.9
.'<:..bD
Z .p..f;)
4:; so
.
/ /J PO
2. 13
~.<j. c.3
..1(0.90
-L3 "(,0
t:::;.6-D
8S.SiD
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) 7QI!:1S,#
(A, B, C, 0, 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 "rpvl~s of ~d ordinances.
Plan Check Fee: QlLV-:).qU
\ \ . \.7.; q I
Date Paid:
Receipt Number:
Received By:
~~~
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Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Informatlon 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 BuJldlng 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~.~ ~ ~
1/ /;v/;/
Date
VAliDATION:
RECEIPT NUMBER
6':U, ~
C>t:> -.a; <- ,-::;--~
DATE PAIr>
/ '2 -~-"7 /'
, ,
AMOUNT RECEIVED ,~",??/
RECEIVED BY / ~~
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