HomeMy WebLinkAboutPermit Building 1994-10-24
MA~/ ~/p....) ~~
/tl?// PLL~A7t,/ (JiT
.,
c:5/~~ AJ/AJ:A'tp:;./~A STATE:'
DESCRIBE WORK: c:;~ ~
NEW ........- REMODEL ADDITION
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
XSSESSORS MAP: / "7 /') '3
LOT:
I ~ PIIL.A- ,&- t..:
OWNER:
ADDRF'>C"
CITY:
.
BLOCK'
/0
.
I - 31
,...-w
, DEMOLISH
OTHER
JOB NUMBER
~/Sz.'Z
225 Fifth Street
Springfield, Oregon 97477
, TAX LOT:
SUBDIVISION:
t? 7. ., -~ /)
N",,..ft,..4, S'!:: AolJ,
PHONE:
74/ - ~'7'79
ZIP: '5'74? 7
CONTRACTOR'S NAME
GENERA" e-d/.riJlC);~&7'_
PLUMBING'
t
CONST.
CONTRACTOR #
(ISD.~1
ADDRESS
EXPIR~
f).t~,y~
i~~7
MECHANICAt.
ELECTRICAL:/~"'L/.P'S C(--~7';-
QUAD AREA:~Q\\ 1.,,-')
- OFFICE USE -
\\\.\
LAND USE'
# OF BLDGS: \ # OF UNIT!>'
OCCY GROUP: 'fi. CONSTR. TYPE: \J(\J
# OF STORIES: HEAT SOURCE:
WATER HEATER' RANGE:
FLOOD PLAIN'
,
LDkL
ZONING CODE:
# OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
:-)~ ( fL
To requesl an Inspection, you must call 726-3769. This Is s 24 hour rscordlng. All Inspections requested before 7:00 a.m. will be
made ths asme working day, Inspections requested sfter 7:00 s.m, will be made the followlng.work day.
REQUIRED INSPECTIONS
[]J Temporary Electric
O Site Inapectlon - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Eleclrlcall
Mechanical - PrIor to cover.
r-;-] Footing - After trenches are
L+J excavated. . .
o Mesonry - Sleel location, bond
beams, grouting.
r\il Foundetlon - After forms are
L.4J erected bul prior 10 concrele
placement.
o Underground Plumbing - Prior
10 filling trench.
o Underlloor Plumbing/Mechanical
- Prior 10 Insulation or decking.
o Post and Beam - Prior to 1I00r
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
f\f1 Rough Mechanical -: Prlol, to
~ cover. ~I
~ RoughEleclrlcal ~ PrIor to
L-PJ cover. ',.;',
..
..
[1] Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
rn Framing - Prior to cover.
i
rn Wail/Ceiling InsJlatlon - Prior to
~ cover.
~ Drywall - Prior to taping.
o Wood Slovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
O Sidewalk & Driveway - After
excavation Is com pIe to, forms
and sub.base material In place.
o Fence - When completed.
o Street 'n'eos - When all required
trees are planted.. .
o 'Final Plumbing - When ell
plumbing w9rk Is complel,e.
PVl Fln"al :Eleclrlcal - \^./.hen all
'-tJ e"lectr~~a! work Is complete. C
. '.~;.f ,:!' ..". "
r\tl Final' MocHnnlcal - When ari'
~ mechanics!" work Is complete.
rxl Final Building - When all
'\ required Inspections have been
approved and building Is
completad.
OOthsr
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to '
water and sewer.
o Electrical Connoctlon - When
blocking, set.up. and plurTlblng
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 TY.
_ Interior
K Corner
Lot sq. ftg.
Lot coverage
.,"J".
;\t~'
.IS THE PROPOSED WORK. IN THE. :
....HISTORICAL DISTRICT, OR ON
....THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.,
Setb,cks '
HSE GAR I ACe' I
I
I
I' I
, P.L.
IN
Is
.Iw\
IE
Topography _ Panhandle
'~otai h~lght -lL~:' .::) _ CUI.de.sac ,.,.
, '( I 04' Yo-:
BUILDING PERMIT
ITEM SO. FT. X $/SO, FT. ~ Vf'LUE
Main
'.,
Galage
>5~
Carport
Total Val ue
Building Perml t Fee
State Surcharge
Total Fee
",'O~* '?'"G
(A)
,. ',~
" ':::;S9.i
s; ~ ~VI
S"-~O
~,Q..
~t<a.
SYSTEMS DEVELOPMENT CHARGE (SDC) Jb....
oi-I c;;~ T'!--'
(B) ... 11..<;>-
PLUMBING PERMIT
tTEM
Fixtures
,
Residential Bath(s)
Sanllary Sewer
N'
FT.
, Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
lssuahce
State'Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk ft
Curbcut It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
~
fX
rt
l tl,c,. Sf>
APPRov~n.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall, In all respects, conlorm 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 01 any provisions of said ordinances.
7]
Plan Check Fee: 3(;:, .
J,Q/#5'L
Receipt Number- /J.7'~()
A'/~
\
Date Paid:
Received By:
Pla1\!;e:ed By
~;,%t~9
Systems Development Charge Is due on all undeveloped
properties within the ClIy limits wtjlch are being Improved.
ADDITIONAL COMMENTS
l\~bbt.\q .sJ.~~~
. . 1 '
~l\. ~t>."f:! ""tt...
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 01 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 01 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 prope~ty, and the proved set f Ions will remain
on the site at al'~rlng co . ~
Signature ~ I
".. ~ ~'r;j2:
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
_.
/~2~ ?
~
/~-<2f./~v
~.~~~~.~
~...R~/ .
~/ ~
V