HomeMy WebLinkAboutPermit Building 1991-10-21
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JOB NUMBER...2(/ /3./
SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
225 Fifth Street
Springfield, Oregon 97477
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LOCATION OF PROPOSED WORK: ~5"t::)
ASSESSORS MAP: /7-t:)"$-'9<;1-/2
TAX LOl' ~~<::5C>
SUBDIVISION: 7i/Vi!ilf1/r4.L,c;
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BLOCI<'
LOT'
OWNER: /f~E r
ADDRESS' 971
CITY' <;"p/,l/
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PHONE:~f1- 7Jso
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STATE: _/? --<
ZIP:
SFO
DESCRIBE WORI<'
NEW V
REMODEL
ADDITION
DEMOLISH
.OTHER
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", ADDRESS - ~
//1fL-:-5 c;.,-1r.
CON ST.
CONTRACTOR #
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CONTRACTOR'S NAME
GENERA" 7/?F . ~A~
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PLUMBING',E'""".l""M<' P4-_i.
MECHANICAL: /A?,,<.=;;" .~t SSh'!}.
, I' - C
ELECTRICAL: ~.N__~ :A..-._
~P)-ElES PHONE
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2.2JI)'LfE l4hlln l
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- OFFICE UfE -
LAND USE: III
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QUAD AREA: t R \\)\ 0
\
OCCY GROUP: 0 ~.-t- IV\.
"'-2-
WATER HEATER: h~
FLOOD PLAIN: <-
ZONING CODE: _LJJ\2.-
# OF BDRMS' ~ -
F~_
SQUARE FOOTAGE: (3D \ '({
# OF BLDGS:
# OF UNITS:
CONSTR. TYPE:
HEATSOURCE:C~, A(';z>./r/
~ ~' ~.
RANGE: ~_-"'Y" . ~..
# OF STORIES:
SECONDARY HEAT:
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.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
[Z] Temporary Electric
[Z] Final Plumbing - When all
plumbing work Is complete.
[Z] Site Inspection - To be made
after excavation, but prior to
setting forms.
[2] Rough Electrical - Prior to
cover.
r7l Final Electrical - When all
tA-J electrical work Is complete.
[l1 Final Mechanical - When all
mechanical work Is complete.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
r:7I Electrical Service - Must be
L,L-J approved to obtai n permanent
electrical power.
~ Footing - After trenches are
excavated.
II7l Final Building - When all
~ required Inspections have been
approved and building Is
completed.
[ZJ Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting.
[l] Framing - Prior to cover.
o Other
r:71 Foundation - After forms are
1AI erected but prior to concrete
placement.
[K] Wall/Ceiling Insulation - Prior to
cover.
o Underground Plumbing - Prior
to filling trench.
[1] Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
[Z) Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stove - After Installation.
o Blocking and Set.Up - When all
blocking Is complete.
~ Post and Beam - Prior to floor
Insulation or decking.
o Insert - After fireplace approval
and Installation of unit.
o Plumbing Connections - When
home has been connected to
water and sewer.
[KI Floor Insulation - Prior to
decking.
~ Curbcut & Approach - After
. forms are erected but prior to
placement of concrete.
~ Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set-up. and plumbing
inspections have been approved
and the home is connected to
the service panel.
[K] Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
[lJ Storm Sewer - Prior to filling
trench.
o Fence - When completed.
ILl Water Line - Prior to filling
trench.
o Final - After all required
inspections are approved and
.. porches, skirting, decks, and
venting have been Installed.
[l] Rough Plumbing - Prior to
cover.
IVl Street Trees - When all required'
l,C-J trees are planted.
Lot faces ~ Lot Type. Setbacks . THE PROPOSED WORK IN T~
Lot sq. fig. a.6'-'" ~nterior I PL. HSE GARIACCI HISTORICAL DISTRICT, OR 0
IN 19 I THE HISTORICAL REGISTER
Lot coverage ~ _ Corner If yes, this application mus e signed
Topography ~ Is ~~., !1/ I and approved by Historical
Panhandle Iw Coordinator prior to permit issuance.
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Total height' 3 Cul.de-sac
IE I 'ZGI'
I~C I I APPROVED:
BUILDING PERMIT
ITEM sa. FT.
X $/SO. FT.
Main
"::l'778
/bY~
d.-'?' Z>
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
VALUE
1 1/7, ?':>b.~
. ,
~q.P"
(A)
a//.~.~
,
"-~9. '2~
-::lr. Y6
1J/"5. 7 L
SYSTEMS DEVELOPMENT CHARGE (SDC)~
(B) 1J.'2-I.fI.;?~.:J
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N' ~
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N' '""3
Wood Stove/lnserClfireplace unn:>
Dryer Vent .tiI!'2.
~~R~ //,/;1J
4"~/"'/~ -~ t' ~/./'
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk lIS I fI
J-~
Curbcut - ~ ft
Demolition
State Surcharge
Total Miscellaneous Permits
FEE
J <1':2,.'5"0
/<92-5'~
q,~3
"Z02 .~
~.60
'-/. f5(?
q. ... t:>
/s:.-
?- -
-::c:--
?-
'" '
(0/'2. ;50
It':? _ CTD
,
?_C~
~/"3
Gi1S-
''5'.''?t7
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,v /.",,--
r 1.10
~" .
(E)
~?:- s5"
TOTAL AMOUNT DUE (excluding electrical) ::;',;.-7"7';," g."
(A, B, C, 0, and E Combined)
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'
=?/8.t!5/
"1 ~-::z.;:: --9 /
Date Paid:
Receipt Number:J'("""~
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Reviewed lJy Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
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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 the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Bui/ding 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.
Slgnatur4Av4~
.Date //;. J 2/ / f';;f
VALIDATION:
RECEIPT NUMBER
;;),1[.;32
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DATE PAIP
AMOUNT RECEIVEP
RECEIVED BY