HomeMy WebLinkAboutPermit Building 1991-9-25
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP' (
d 'f \
LOT'
OWNER'
ADDRESS'
fi<.:It.~~
~Y9J....
E ;jo~~
tvu.1o/'~r /J ~
CITY'
-;>
t::. ",",-c:.. C'.N"-L
U
DESCRIBE WORK:
s....eLL
'-.J
NEW'\..
REMODEL
.
SPRINGFIELD
J- ,s-{g
~tt,.J+-"'"
0<-(
BLOCK:
STATF' 0-.....--'
o
h^,. /,
J
ADDITION
I'2t"T'l,pU'
DEMOLISH
.
JOB NUMBER q / //?"2-::S
225 Fifth Street
Springfield. Oregon 97477
TAX LOT:
)
SUBDIVISION'
t\Q,I,v t)t'.o L..~r'rcfrr-
--n- AN --I. 1-", .v
PHONE: ~_. _<11
~J-S'~.Y 7 '"
ZIP' q 7YG)
OTHER
CON ST.
CONTRACTOR # EXPIRES PHONE
f(P V'i? ("/n </J5317 "
oJ '/7 Y h/~~ <..1';-'-/1 (./ (~
,
d'''- v GI .2/fL 7V/_oc.>o L
d 0;"'/7/,., C. .3/7'7 7Yl.-Jfc7 L
CONTRACTOR'S NAME ADDRESS
GENERAI'~;'<<'-' eJ-.k......r .-Jt;h M,/"I-H L?~,
. ..j
PLUMBING:.(~ r-L.~ P/"~lu;j K.'/'dnnJ, t:::~..J
MECHANICAl' \i? ( ~ r #U..t,.;, J S70 2. nI- I)lft..
ELECTRICAl' ;,j<.":J.....".! E("-<--;'~L~ '7 '170? 1) (/;oJ,., (1)
- OFFICE USE -
,gA)lA)
I
OCCY GROUP: :Q:2.. 8'. tV\ I
# OF STORIES: :J
WATER HEATER: A$--5
QUAD AREA:
# OF BLDGS:
WI
I
\/N
HEAT SOURCE: c:;;;;~ M ~
RANGE: _6C'=-=--/ .
LAND USE:
# OF UNITS:
CONSTR. TYPE:
FLOOD PLAIN'
ZONING CODE:~~-DR
~
# OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:_~~":I~_
To request an inspection, you must call 726.3769. This Is i"24 hour recordIng. All Inspections 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.
~ Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
~ Footing - After trenches are
excavated.
D Masonry - Steer location, bond
beams, grouting.
~ Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
r;] Underfloor Plumbing 1 Mechanical
l,AJ - Prior to insulation or decking.
IY Post and Beam - Prior to floor
~ Insulation or decking.
171 Floor Insulation - Prior to
~ decking.
r-;J Sanitary Sewer - Prior to filling
lAJ trench.
fYl Storm Sewer - Prior to fllrlng
7t' trench.
~ Water Line - Prior to filling
~ trench.
I1rl Rough Plumbing. - Prior to
cover.
REQUIRED INSPECTIONS
r7l Rough Mechanical - Prior to
~ cove~ .
rJ:;J Rough Electrical - Prior to
l..kI cover.
~ Electrical Service - Must be
LAJ approved to obtain permanent
electrical power.
eEl Fireplace - Prior to facing
materials and framing Insp.
c:tl Framing - Prior to cover.
lZJ Wall/Ceiling Insulation - Prior to
cover. .
rn Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - After fireplace approval
and inst~n of unit.
r--:/J Curbcut & Approach - After
~ forms are erected but prior to
placement of concrete.
.~ Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
[Xl Fence - When completed.
1KJ Street Trees -'WhEm a'lI required
trees are planted.
fl7l Final Plumbin9 - When all
L..J::J plumbing work is complete.
. 00 Final Electrical - When all
electrical work is complete.
IX] Final Mechanical - When all
mechanical work Is complete.
[Xl 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 Connection - When
brocklng, 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 IS THE PROPOSED WORK IN THE
Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON //..4
Lot sq. ftg. IN 7r I THE HISTORICAL REGISTER? '
Lot coverage Corner If yes, this application must be signed
:ire> . ~ l1li. l:li? ~ I and a p proved by the Historical
Topography ,- Panhandle I Coordinator prior to permit issuance.
Total height .51 Cul-de-sac W ~.
IE ~.:4' , I APPROVED:
W1,~~UO
~.-=-
/R.fiJO
'?Ltf. g~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) -:2'''~. "33
BUILDING PERMIT
SQ. FT.
I~J<g
i-lY,,"
X $/SQ. FT.
~q.7
Jy., I
ITEM
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' --:3
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
j?4eJ:~; ':..~ PEfP/~t:t:'
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu mace
Exhaust Hood
Vent Fan
N' II
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
~~>>~f/#::#J
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk '-1"3' It
Curbcut "2k.S- It
-GemoIilion /"?.$P/r#-9'?"4 7'~
~e=y/~~
Stat~rCh"g~ .~ ~'r\l\
,_A.~~ '-\.:)W
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
VALUE
':1!l. S'5/... (j)
C, ') Jti .g. )
FEE
14?-s-e>
/ ..s: AP
"2t?7. ~
/,t), "223
2/? &13
~.-
o/_5't/>
/Z__e>
~.-
5"': -0
'":!~_SC7
/4/- -
'"2 .<::9
ij2~;)?
16. yS'
/"?9t5
7.00
~~
-_'1"?.-~
277B_ 77
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.
?#e=c...&> 1?JzviE"
P'~ ::z VY- $".:,
~"'CG _,tC'
7.~ ~~~
~a:..6---.
9-::< c:(--9/
Date
Plan Check Fee: Jiz..::z '3"~ ?;O
Date Paid: B-3c-Q/
Receipt Number:-c4( ~s.r
Received By: 6::-""",,~..-.."""""
4 ~.-~
"P'iafrs Reviewe~'13y y
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
>=?y~ ~<,"","";>/<:"~.A7 r?: .li/.#./-=./_~
~ . , - . ,
.4. Z?~7q,,--,/ =- ft~~~ -~ _ /Y"--=-
,. /'''""/ / #c, , -"
t:.C{'''~J5i!? ON h<:..E' h-:rR7"__
C:;T'Y ~/~~;~ ;z:;.-VL<:/~
h~~ ~--4~~
-. .."...- - ~-
/ ~..::. L f:'~~-;~--:-~
~,;D.
// '
~-2 Y-"7/
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 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.
Signaturp
f? ~,Uz
Date )r)_7Im/,,/
VALIDATION: ~\ 4 0' /\\4N7t
RECEIPT NUMBtR I D D-+ "rJ... U~
DATE PAID V\ '_ .Z).~ \
AMOUNT RECEiVED0\tf Ii "'~'f: "27
RECEIVED BY M)
- -