HomeMy WebLinkAboutPermit Building 1991-9-25
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP'
30
LOT:
OWNER'
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ADDRESS:
CITY' /?' "-~- ...
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.
SPRINGFIELD
6' .-s'~ ?',.I-f......
t..Y~
BLOCK'
STATE' 0....... _A/
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DESCRIBE WORK'
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ADDITION
NEW
)/
REMODEL
CONTRACTOR'S NAME
GENERAl' ~ /"'-'- ?, l.f.~ oJ'?9..
PLUMBING: .(" r~"" PI,,_ 1,,_,
H""') J
MECHANICA' . IT.. I ,,~ f.k" r.;<
ELECTRICAl' ;!'!LQ" _ j t: k:I-~~~
(/
QUAD AREA: -LR-/V \^J
. OF BLDGS: I
OCCYGROUP:..2:<. It-AII
. OF STORIES' 1
. c:.,...;oo:\
WATER HEATER: ~
DEMOLISH
OTHER
.
JOB NUMBER '9//.02.2
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION' t;>" UJ 1,...., kerf< h
d!...tal -4,//,1,0,..-'
PHON'"
(./1 J' - J /J h
ZIP:
<17Vu!
,
ADDRESS
CON ST.
CONTRACTOR'
3(,'{f'i
REQUIRED INSPECTIONS
r7I Rough Mechanical - Prior to
~ cover.
~ Rough Electrical - Prior to
~ cover.
~ Electrical Service - Must be
approved to obtain permanent
electrical power.
l29 Fireplace - Prior to facing
materials and framing Insp.
ClJ Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
~ Drywall - Prior to taping.
D Wood Stove - After installatlon.
D Insert - After fireplace approval
and Installation of unit.
I7l Curbcut & Approach :- After
LpJ forms are erected but 'prior to
placement of concrete.
IV! Sidewalk & Driveway. - After
L,CJ excavation is complete, forms
and sub-base material In place.
[2g Fence - When completed.
~ Street Trees -"When all required
trees are planted. .
EXPIRES
b/O
j, J}. 'I.
d/~L
3)fL
PHONE
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SI~rllv(
7 <//-019" 'L-
7YL -302-
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7~7tJ<, Di/,>J. /)1 C(,.,
eta'1 <I
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lo-'.7Iot
- OFFICE USE -
LAND USE:
I \ II
I
FLOOD PLAIN:
ZONING CODE:
&~-
LT'lR.
4
. OF UNITS:
VN
HEAT SOURCE: 4<..-v r~ -
eC dC:-7 ~
RANGE: _
CONSTR TYPE:
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: ;::).joq
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
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
erected but prior to concrete
placement.
[LI Underground Plumbing - Prior
to filling trench.
l2l Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.
rMl Post and Beam - Prior to floor
ULJ insulation or decking.
ell Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
rn Water Line - Prior to filling
trench.
ell Rough Plumbing - Prior to
cover.
rn Final Plumbing - When all
plumbing work Is complete.
~ Final Electrical - When all
electrIcal work is complete.
r71 Final Mechanical - When all
~ mechanical work Is complete.
IVf Final Building - When all
~ 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 Connecti~n - 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 e;. Lot Type Setbacks IS THE PROPOSED WORK IN THE
Lot sq. Itg. ~"I Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN ?" I THE HISTORICAL REGISTER?
Lot coverage L~"" Corner If yes, this application must be signed
Is , I
&'-l.'%- ('J8 and a p proved by the Historical
Topography -; Panhandle Iw I Coordinator prior to permit issuance.
Total height ~ K Cul-de.sac ~'
IE ~,IS", I APPROVED:
BUILDING PERMIT
ITEM SO. FT.
X $/SO. FT.
?f:1.7
~4.1
VALUE
~.5?<.)
'7 / ,?': 1'&:>
~. '.
Main
~d.OY-
_'l.9q~
Garage
Carport
Total Val ue
9t;S?i~'
't.//8.00
'At:> - <? ~
'/38.91>
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) "2&>76.~2
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' "3
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
-g~~~~
Plumbing Permit
State Surcharge
Total Charge (C)
FEE
192~C>
/.0:;::-
'"?&>7~~
/tJ?~ 3'~
-:z I 7-B@.
MECHANICAL PERMIT
h.~
q".5l:'
/"
/2--
Furnace
Exhaust Hood
Vent Fan
N' t../
Wood Stovellnsert/Flreplace Unit
Dryer Vent
~~,-:J:._/V~
5,-
.C;: ---
-::?&>. So
/6.-
~~;:J
t/7-:>?
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk 'I Sit /6.7);
Curbcut '2 To!) It ~ -'..Y.I'3'
c ... ~/T~ ~_'2~/o?,"
_o..._...._n /7Cy,,~P"V~?-f"'? . ,
State Surcharge
7"E7f<c.t
t~
"f:>: eots
- / g,t.;. 07
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electricai) ::z $"~<9' 86-
(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 provisions of said ordinances.
Plan Check Fee: -:2,4;/. q. ~ 5~".:.-c..P ~ r-
t/=~ 5'~~ ,.
Date Paid: P:-~' ~/ /... .--_
r/c.--~ ..",/-_0....;:-
Receipt Number:&/ /6'7"./7 g;~.fL--- """"
- ~/ -7 ;/"---'-y;
Receive By: /--'d::;;;;"~-- -,
r_.. "~_ .?
evie;;d ByV' ~)--=--
<7-;;>"7'<=7,,-
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 wltl 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 ~ f3 < ~.
Date r /50/7/
VALIDATION: 1\ \~\I"\ V'I\A \ (
RECEIPT NUMBEP., f C)( \J "'\-0(. ~ \\
DATE PAil" U; ';.lS.o\
AMOUNTRECEIV~t f7~"'. /1
RECEIVED BY <: ~ f'Yr\.
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