HomeMy WebLinkAboutPermit Building 1993-1-27
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP' /7 IJ ~
LOT: ~I
OWNER: ~,;:;. )
ADDRESS:' 3(p(- E.
~A.
. I
CITY'
,
SPRINGFIELD
DESCRIBE WORK: 'S. F ~~~ /OO(/('f~ ; 4:A.P..~"a
NEW ...............~EMODEL ADDITION DEMOLISH ____ OTHER
GENERAL:
PLUMBING:
ELECTRICA' '
,
QUAD AREA: _J /J ^/J1/
/
. OF BLDGS:
OCCY GROUP: ~~ ~ -+ M.
2-
?:
. OF STORIES'
WATER HEATER:
/
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/
,
BLOCK'
/ZR/Ar .
~~!!L
STAT'"
&e.
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JOB NUMBER QJ.CJ712-.
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:
/5' / cro
~/?nq HrL/.r:-
PHONE:
(p&;c;., .~I".1/
ZIP: 97 ~.r:;-
(REP'/ Sdr..J.r )
. ../
CONST,
CONTRACTOR'
REQUIRED INSPECTIONS
fV(nough Mechanical - Prior to
~cover.
~Rough Electrical - Prior to
~cover.
'K7f Electrical Service - Must be
J,.6J approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~Framlng - Prior to C?over.
rc;;(Wall/Celllng Insulation - Prior to
Y6l cover.
~ Drywall - Prior to taping,
o Wood Stove - After I~stallatlon.
o Insert - After fireplace approvQI
and Installation of unit.
[81.. Curbcut &: Approach ~ After
forms are erected but prior to
placement of concrete.
RJ1 Sidewalk & Driveway - After
.L6l excavation 15 complete, forms
and sub-base material In place.
o Fence - When completed.
~reet Trees - When all required
(Yees are planted.
EXPIRES
PHONE
FLOOD PLAIN'
ZONING CODE:~A#
4-.'
. OF BDRMS:
SECONDARY HEAT:
SOUARE 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.
- OFFICE USE -
LAND USE:
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FG/t/.Il...
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CONTRACTOR'S NAME ADDRESS
f34l5?Z)nr J &?r.7
~(".:'//J;n-= /JLWn?4
MECHANICA" /J/A1I? rrfi1.4'~(
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~ Te.mporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
K7I Undersl~ Plumblrill/Electrlcal1
j.6J Mechanlc~r to cover.
~ Footing - After trenches are
~xcavated.
o Masonry - Steel location, bond
beams, grouting.
rv;r Foundation - After forms are
~erected but prior to concrete
placement.
r\71 Underground Plumbing - Prior
~ to IIIl1ng 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.
f\:/( Sanitary Sewer - Prior to filling
~ trench.
f)(f'Storm Sewer - Prior to filling
~ trench.
I'<'7f Water Line - Prior to filling
l.O..J trench.
f\7l Rough Plumbing - Prior to
~ cover.
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
15<:1 Final Plumbing - When all
~plumblng w~rk Is complet.e.
fV1 Final Eleclrlcal - When all
~ electrical work Is complete.
r"\}'Flnal Mechanical - When all
-/- ....,echanlcal work is complete.
HFlnal Building - When all
~qulred 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 Connocllon - 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
porchos, skirting, decks, and
venting have been Installed.
<;.
lot TYP. Setbacks
Interior I P.L. HSE GAR ACC I
IN I
Corner
Is I
Panhandle
Iw I
Cul-de-sac.
IE I
Lot faces
lot sq, ltg,
Lot coverage
Topography
Total height
BUILDING PERMIT
tTEM SQ, FT,
Main
/971-
,#D
Garage
Carport
X $/SQ, FT.
.39.70
-1-4.10
Total Value (~l~~' )
Building Permit Fee ~~()- 3:f!,2.00
State Surcharge
Total Fee
(A)
VALUE
zsg ~~~
r~ '2LJ4 Oe
~f5n.:'
000
.30
/' "ilO
(P.
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) ,
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
N'
FT,
FT,
FT.
(C)
Dryer Vent
Wood Slove/lnsert/Flreplace Unit
N'
MechanIcal Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ftp
Demolition
State Surcharge
.&'AAJ t:P;:;v/a:,.J.
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
FEE
/
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/
/
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\& 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.
APPROVED:
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: Ac;, Lt....., ~l6a'e '2.t9P
Date Paid: ~.C<>
Receipt Number'
Received By:
Plan!l~~~~
~~(9a.
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 th"e 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 tI 5 d co on.
~Ignaturc.
/
Date
VALIDATION: f)
RECEIPT NUMBER \""2.J of)
DATE PAID \-,!JJ}- ('~ ~i:\
AMOUNT RECri~E,n ffro7:::LJ
RECEIVED BY\:)\)~