HomeMy WebLinkAboutPermit Building 1995-6-16
LOCATION OF PROPOSED WORK:
><ASSESSORS MAP: /7 D:2,
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OWNER: ("..O.,/C 11_ CI:...-L
ADORO"'."-''!/OO fJ(e.:t5ct..7 .s1.;.~ef
CITY: Sh~'1 a, f..:' cJd
RESIDENTIAL
PERMIT APPLICATION
"
Inspections: 726-3769
Office: 726.3759
, v
OESCRIBE WORK'
1ft/eo toAd
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' .
Ii
PLUMBING:
MECHANICA' '
ELECTRICAl'
QUAD AREA: ~'L I2.tJ IA 1
I
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
rY\
I
.
SPRINGFIELD
I-?, I
.
JOB NUMBER 7'5(J~g 7
f 7'"":
BLOCK'
STATE:
OMf/OVl
Co
225 Filth Street
Springfield, Oregon 97477
. TAX LOT:
.nc;., / C> 0
1-1../1.. 4eo k.. . o;-'"~ AM,
~
CG v-C9"-e..--
AODITION r:
DEMOLISH
OTHER
SUBDIVISION:
PHONE: 74-6- 99-' 7
ZIP:
971r-77
ADDRESS
CONST.
CONTRACTOR'
PHONE
. ,
- OFFICE USE -
LAND USE: 1III
. OF UNITS: I
CONSTA. TYPE: --YN
HEAT SOURCE:
RANGE: __....
EXPIRES
FLOOD PLAIN:
ZONING CODE: _L-Df2...
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: _!::1.1'Jf'l
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, Afllnspecllons requested belore 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.
D Temporary Eloctric
O Slto Inspoctlon - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
~ Fooling - After trenches are
L....AJ excavated. , '
D Masonry - Steel location, bond
beams, groutlng.
IVl Foundation - After forms Bre
L-f"J erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam' - Prior to troor
InsulatIon or decking.
D Floor Insulation - Prior to
decking,
D
Sanitary Sewer - Prior to filling
trench.
D
Slorm Sewer - Prior to filling
trench.
D Water line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
r\7I Rough Electrical - Prior to
L,AJ cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - prior to facing
materials and framing Insp.
CAJ Framing - Prior to cover.
I\7l Wail/Ceiling Insulation - Prior to
~ cover.
'r".Drywall - Prior to taping.
D Wood Slovo - Arter Installation.
D Insert - After fireplace approvlll
and Installation of unll,
D
Curbcut & Approach - Arter
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavatIon Is complete. forms
and sub-base materIal In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing work Is complete.
f'VI Final Eleclrlcal - When all
~ electrical work is complete.
D Final Mechanical - When all
mechanical work Is complete.
rxl Final Building - When all
~ required Inspections have been
approved and building Is
completed.
DOthor
-
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blockIng Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected 10
the service panel.
D Final - After all required
Inspections are approved and
porchos, skirting, decks. and
venting have been Installed.
Total height
~
(/.0 ')
, , ...... ~ THE PROPOSED WORK IN THE.
Lot Type. :'! .
Setbacks
L Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Corner If yes, this application must be signed
Panhandle Is I and approved by the Historical
Iw I Coordinator prIor to permit Issuance.
Cul-de-sac
IE I APPROVE["I'
Lot faces
Lot sq, ftg,
Lot coverage
Topography
BUILDING PERMIT
ITEM SO, FT, X $/SO, FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
~
I.:;C 1'0 "5t:PFO
This permit is granted on the express condition that the said
construction shall, in all respecfs, conform to the Ordinance
adopted by the City 01 Springfield, including the
Development Code, regulating the COllstruction and use of
buildings, and may be suspended or revoked al any lime
upon violation of any provisions of said ordinances.
Main
Carport
Total Fee
(A)
Received By:
p~t'lewed By'
Plan Check Fee: -:<,(;,,7:1
~...:~;::'/_~ 7q7.r
Receipt Number: /7.:;4r:q
-;.~~,~
_(g_jJ~/,r;
Date
Date Paid:
Total Value
Building Permit Fee
Stale Surcharge :l ,'8 ~-+ \,1D
Systems Development Charge Is due on all undeveloped
properties within tho Cily limits which are being Improved.
PLUMBING PERMIT
ITEM
FEE
Ao.c.ITIONA~ COMMENTS
t\ ~-{f-U-u,., ~"
, ~~.~ ,,;~~ -'~,~,~ (~\\)J.MH~C\J
Fixtures
Residential Bath(s)
Sanitary Sewer
N'
Water
FT.
FT,
-
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Tctal Charge
(C)
%
MECHANICAL PERMIT
Furnaco
Vent Fan
N'
By signature, I stale 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 Sprl,ngficld, 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 OAS 701.055 will be used on this
project.
Exhaust Hood
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
C7f
,
I further agree (0 ensure that all required inspectlons 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~ _7' ~ q ~
Datp G' (, - 9 'J-
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
VALIDATION:
RECEIPT NUMBER
/7~&'~
h//C,/5'F
((,,(;.,3,7
~//W.
- "
~
Total Miscellaneous Permits (E)
,--fh
\ Cd;., ,1.., 7
DATE PAIr>
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
AMOUNT RECEIVED
RECEiVED BY