HomeMy WebLinkAboutPermit Building 1993-3-15
RESIDENTIAL
PERMIT APPLICATION
Inspeclions: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORi<' q 0 I Pre s (0 rr-
17-0 ~- 3'f - /1- OOCo/ Z.
OWNER: Of'n n; <; T 0 {"a",,,., e
ADDRESS' 74~ T Shul
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5;;:' ~,
I. ASSESSORS MAP'
'*5
LOT'
CITY'
DESCRIBE WORK'
NEW
><.
REMODEL
ADDITION
BLOCK'
t)owa.k
STATE:
f)r~""""
.
9502.3:,$
DEMOLISH
OTHER
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION: U IJpe r /I i e vJ
, ,
PHONE: -Z.I{~ -7'1 ~ /
ZIP: q7477
CONTRACTOR'S NAME
GENERA" (')1J.JYl f' r
PLUMBING: ~e.4 5
CONST.
ADDRESS CONTRACTOR' EXPIRES
5a-me as Q6~
OIILA'n'-"'Y1:J 5'1'1 W q(/1 Sf, 5,4'l", ~S
i MECHANICAl'
ELECTRICAl' (')UJYl~o('
\~\\Jll) - OFFICE USE -
OUAD AREA: LAND USE: \ \ \ \
. OF BLDGS: II OF UNITS: \
OCCY GROUP: R-~M CONSTR. TYPE: ---J.L-..A/
. OF STORIES: :J HEAT SOURCE:_fl?
WATER HEATER: E- RANGF' ~.
PHONE
FLOOD PLAIN'
ZONING CODE:U \A!
. OF BDRMS: -=-~
SECONDARY HEAT:
SOUAREFOOTAGE~~~
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 ntter 7:00 a.m. will be made the following work day.
%Tcrnporary Electric
l'v'f Sitc Inspection - To be made
~ after excavation, but prior to
setting forms. So I L
o Underslab Plumbing/Electrical'
Mechanical - Prior to cover.
"'fV7f Footing - After trenches are
~ excavated.
o Masonry - Steel location, bond
beams, grouting.
~ Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~cover.
.1":.:7f' Rough Electrical - PrIor to
~ cover.
rV1 Electrical Service - Must be
~ approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~Framing - Prior to cover.
f"9r Wall/Ceiling Insulation - Prior to
~cover.
~ Drywall - Prior to taping.
K71 UnderfloQ(1'lumbln9Je'lechanic~
~ _ Prior to inSUlation or ut;:t,.1'.1 n{j. 0 Wood Stove - After installation.
~ Post and Beam - Prior to floor
~ Insulation or decking.
~ Floor Insulation - Prior to
~ decking.
"f':I1' Sanitary Sewer - Prior to filling
~ trench.
.kSl. Storm Sewer - Prior to filling
trench.
C8l Water Line - Prior to filling
trench. I
~ Rough Plumbing - Prior to
~ cover.
o Insert - After fireplace approval
and installation of unit.
f\:7f Curbcut & Approach - After
~ fOlnlS are erected lwl prior to
) placement of cencrete.
'ts:?r Sidewalk & Driveway - After
~excavatjon is complete, forms
and sub.base material in place.
D Fence - When completed.
~treet Trees - Whl;n all required
~trees arc planted.
"1<i7T Final Plumbing - When all
~Iumblng work Is complet,e.
"'K7'f Final Electrical - When all
..J6.J electrical work is complete.
"'K71 Final Mechanical - When all
.J6J. mechanical work Is complete.
lv1' Final Building - When all
~equlred inspections have been
approved and building Is
completed.
DO'her
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.
~
I
Lot faces ..Y:L. Lot Type . Setbacks .'HE PROPOSED WORK IN THE
Lot sq. flg. ~O ~terior I PL. HSE GAR ACC HISTORICAL DISTRICT, OR ON
IN THE HISTORICAL REGISTER?
Lot coverage 2/% Corner s-+ If yes, this application must be signed
~;V. Panhandle Is S and approved by the Historical
Topography Iw 30 Coordinator prior to permit issuance.
Total height Cul-de-sac
IE ./J1.. tl~
APPROVED'
BUILDING PERMIT
ITEM sa. FT.
X $/50. FT. ~
S"'6!-O
/4/(7
VALUE
/2/cP/'1
'/$
Main
Z1~
5'~
Garage
Carport
/2.t:ta;2-
.5en~
7-5.03
S2.- C:;. 5"3
SYSTEMS DEVELOPMENT CHARGE (SDC) 1h
..a ; ~ I'F"
(B) ~'2-Z-7/-
Total Value
Building Permit Fee
Slate Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N' ~
Sani tary Sewer FT.
Water FT.
Storm Sewc:r FT.
Mobile Home
'619--, !?O
PlumbIng Permit
State Surcharge
1~3
2.rp t 3
Total Charge
(e)
MECHANICAL PERMIT
/ ~-o
-L;:' .
4. '5'0
/2..00
Furnace
Exhaust Hood
Vent Fan
N~) 4
Wood Stove/Insert/Fireplace Unit
Dryer Vent
~.oo
Mechanical Permit
?~.so
/n.oo
~
J 2.8
3~?e
Issuance
State Surcharge
Total PermIt
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk r-..+ fl
Curbcut 3h fl
! q."O
J :S".40
Demolition
State Surcharge
Total Miscellaneous Permits (E)
35.00
~O'b.77
TOTAL AMOUNT DUE (excluding electrical)
(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 Fce:
Date Paid:
40-~9.3
Systems Development Charge is due on 'all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
\, sA--+ \ ~
GJf\\~\[\
.
l'A 15\ ffiLri ~~
\ CJ (A'liJ
- -
'l--'\ leh
~1.
By signature, I state and aqree, 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 perronncd shall be done in accordancu
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon penalning to the work described
herein, and tllat NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certi fy tllat only contractors and employees who
are in compliance witll ORS 701.055 will be used on this
project.
I further agree to ensure that all rCQuired inspcctions 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.
.:::><wnaturr"
I
Date
VAll DATION: () CA\ ::>
RECEIPT NUJ"4JlER, . I t'I-U ~
DATE PAiN' I G .q~
AMOUNT R~~ ('_~?"7-. 5. a z.
RECEIVED ~\() _)