HomeMy WebLinkAboutPermit Building 1991-8-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP'
LOT: '* 3/
.
SPRINGFIELD
flit;
BLOCK:
OWNER' /..o~"", Mib B-u-Hu
ADORESf" ~/3~ SW Wid't~ 51.
CITY: 1U.4In+iY/:
DESCRIBE WORK: t!.riH~+"ue..+it>t
NEW){ REMODEL ADDITION
CONTRACTOR'S NAME
GENERAl' ~IA/u.yt 8 J./CIfffi
PLUMBING: CuS~ P~"i"''5
MECHANICAL: U #fAi;";'
ELECTRICAL: I'IttfftJ lJ<te.-+lit...
QUAD AREA: \ ~\\)U ')
. OF BLDGS: \
OCCY GROUP: ~ \'(\
. OF STORIES:_.-!)
WATER HEATER: ~
..-,
STATF'
0,,"
.
9/o9~
JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
TAX LOc
SU~DIVISION: /(QinMtAJ &'S-/l1k5,;;t.
PHONF' u'fZ - ~3f~
ZIP: 17(){, 2-
St.'~ If! ~ IJ.Itw.LI fA YUr r1. t.J,f n
DEMOL({H 'OTHER
CON ST.
ADDRESS CONTRACTOR ·
Z~'2 Mffol"u,~Ju 3,,1/.,
KL lI-1wtfDl. ~ '-b 174
JJ1() FAr" '~/~~ Z/J2.tHJ
7q7D~ Otlijltt 'AI. frr :u /1&(;
- OFFICE USE -
LAND USF' \ \ \ \
'vrJ
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:4A"c;' :~-fZ .
RANGE:
EXPIRES
"/u
"/15
i./'f 3
sIn
PHONE
t/f!'-ll7 (,
&/,r .111//4
7 'II. (kJ~ '2-
'il/). -J~ 72-
FLOOD PLAIN'
ZONING CODE:
l~JV
. OF BDRMS'
SECONDARY HEAT: -
SQUARE FOOTAGE:.cQ~ 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, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
r:/l Footing - After trenches are
l,.CJ excavated.
o Masonry - Steel location, bond
beams, grouting.
[Z] Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
r:AI Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
CZl Post and Beam - Prior to floor
Insulation or decking.
W Floor Insulation - Prior to
decking.
[A] Sanitary Sewer - Prior to filling
trench.
[AI Storm Sewer - Prior to filling
trench.
[21 Water Line - Prior to filling
trench.
lLJ Rough Plumbing -,Prior to
cover.
REQUIRED INSPECTIONS
[Z] Rough Mechanical - Prior to
cover.
~ Rough Electrical - Prior to
cover.
[Z} Electrical Service - Must be
approved to obtain permanent
electrical power.
[l] Fireplace - Prior to facing
materials and framing Insp.
l2J Framing - Prior to cover.
~ Wall/Ceiling Insulation - Prior to
L,.l!J cover.
(1] Drywall - Prior to taping.
D Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
~ Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
rVl Sidewalk & Driveway - After
\.A-J excavation is complete, forms
and ,sub.base material In place.
[Xl Fence - When completed.
[Xl Street Trees - When all required
trees are planted.
I3J Final Plumbing - When all
plumbing work Is complete.
lZJ Final Electrical - When all
electrical work is complete.
~ Final Mechanical - When all
l...,C..J mechanical work Is complete.
IVl Final Building - When all
L,A-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
)'nspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are ap'proved and
porches, skirting, decks, and
venting have been Installed.
Lot' faces /)L lot Type.. Setbacks . THE PROPOSED WORK IN THE
lot sq. fig. Interior I P.L HSE GAR ACC I HISTORICAL DISTRICT. OR ON
IN /8' I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
~<!?J; Panhandle Is ~'I' I and approved by the Historical
Topography Iw I Coordinator prior to permit issuance.
Total height ~ ,X.. Cul.de.sac l'3t
IE 71 I APPROVED:
, ,
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT.
Main
/9'91& "'39,,?&>
"'b~. ~5 L'IJr/
Garage
Carport
Total Value
Building Permit Fee
VALUE
79 'q'2&:>.&:.c>
7/~~3
9.c. ~~~.~ '3
-:?9Y. _e>
State Surcharge /9- .::b>
Total Fee (A) ~/3. A::::>
SYSTEMS DEVELOPMENT CH~RGE (SDC)
(B) '2--0 \ So!l. ~.
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N' .-:g
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
~/UJJ,v j)E(//~E
PI u mbi ng Permi t
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan N' t/X~.-
~e?,f;;cfJt:::,'Fr;'~~. "
Dryer Vent
0/M'h p/no::;- .
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ~ S" fI
Curbcut ~ ft'
,Demo1ltl<>A- N/77 73 ~~
State Surcharge ( rfJ"
~~_ r')9)..)
Total Miscellaneous Permits
(E)
FEE
/-1:;2_ 5'0
/O.~
-:2;!)2. :SO
/tP-I"3
? 1'7.?;"3
h.-
<I. SiP
/2. 0rC>
"3.""""
~,-o
-:2_ -
~_ Sc.
/,0, ,..
-:2.~::lS
~7. ..;"'3
/9.7~
/-:;s "'7'0
::25 &;, . M>
5". -c:>
TOTAL AMOUNT DUE (excluding electrical) -:297.* ??
(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: _ --:Zt)tt:../C>.
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 witt 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, a he approved set of plans will remain
on the site at al t es .d~9 c"ruc.tio;.
Signature 117.1. U.~
Date#' I
VALIDATION:
RECEIPT NUMBER -:7 J~:5Y
DATE PAIP 9-:<0 -"7 /
AMOUNT RECEIVED.A/ S':? _2'2
RECEIVED BY r If ...-/,-/.
. ,