HomeMy WebLinkAboutPermit Building 1991-10-29
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT:
{,Ao.e~s - ,6AJ~
ADDRESS: ~~ Z?/;Jfl;?,Mr
C'-'1e,...~
OWNER'
CITY'
DESCRIBE WORK:
NEW V REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl' ~~,u~'e 01/k1
PLUMBING: ~/-kt .
MECHANICAl' -<h/'l/7 rG.J
ELECTRICA" /,l/,-fi"v'~, Ri.I~L- '
CONST.
CONTRACTOR'
L.4r/'1.J /klo/PJ
8/1/ A4/1j
.
~
~~
,.
JOB NUMBER
7/070tS
SPRINGFIELD
7/5' ~e65Co7T LAN'e.
BLOCK'
/JJJJ~AS~
U
STAT'"
(f)/Zp
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
/0000
DEMOLISH
OTHER
PHON'" u.r::{-#6f- W::rL"7?&'I"~ I
ZIP' 9740/
EXPIRES
PHONE
ADDRESS
&n'T
/?,,/ &arA:-t
- OFFICE USE -
QUAD AREA: LAND US". FLOOD PLAIN:
. OF BLDGS: . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: SQUARE FOOTAGE:
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/Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prIor to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbing/ Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decking.
o
Floor Insulation - PrIor to
decking,
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
1':?r Rough Mechanical - Prior to
~ver.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - After installation.
o Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation 15 complete, forms
and sub-base material in place.
o Fence - When completed.
o Street Trees - When all"requlred
trees are planted.
o
Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work Is complete.
~ Final Mechanical - When all
~echanical work Is complete.
o Flnat 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
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
Lot Type ~ Setbacks . THE PROPOSED WORK IN THE
Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Corner If yes, this application must be signed
S I and approved by the Historical
Panhandle I Coordinator prior to permit issuance.
Cul-de-sac W
IE I APPROVED:
Lot sq, ltg,
Lot coverage
Topography
Total height
ITEM
SQ, FT, ' X $/SQ, FT,
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
BUILDING PERMIT
Main
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.
Garage
Carport
Plan Check Fee:
Date Paid:
Total Value
Receipt Number:
Building Permit Fee
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Dryer Vent
&~ ! /LJ.F
'7 pit)
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Informatfon 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.
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Mechanical Permit
Issuance
Total Permit
(D)
,;0
'2/0
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.
Slgnaturo ~~(A . IJ.A~
"
State Surcharge
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Date
\D . 'LC\ ~ \
Curbcut
It
Demolition
State Surcharge
VALIDATION:
RECEIPT NUMBER
2./ 7/ r:..
\
/0 -2-9~5'1
Total Miscellaneous Permits
(E)
DATE PAIr>
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
Q./O
AMOUNT RECEIVED 2. /47
.~.
RECEIVEO BY