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HomeMy WebLinkAboutPermit Building 1990-11-6 Reaeipt ,I{ / Rio c<:--1 ... RESIP~~TIAL-.. APPLICAtS);i'"!f;yPERMIT 225 North 5th Street Springfield~ Oregon 97477 Building Division 726-3753 . ~. r' Lo ~'3 ~ A:sur' Sl1\ 00 r # .I-I)Dd3t~1 Tdwt#m~ Job Loaatian: Asaesaorz Map SUbdivision: CAmel': .\ )\ l0_\CL/A(lli~e\.ln ] Address: l D'1 f) lo uf\~~X'"~ City' ~)L\~fQ~C'D) ~ Date of Applicatien Contracto~~ Address 'General L\..A.. ~JC1 ; Plumbing'1rn.ij.JL.LA,\-Jlro~ .' , , Hechanical :-\. \ \ \l f..-)\ '8,~~ '\~\ J\ \0\ O_A~ EJ,~ctri!:al \D\ ~\L ~ .' S 11 pe!7'!.lrt!;;T.1g~~ec t r ~ c i<l n New Additien l Rem~del RiD, r _(orq,O I ,'.[obi le lloma ID ~ o FOOTING 'l FOUNDATION: To be made after.trenches are excavated and forms are erected, but prior to pouring ecnaret~. UND'SRGROU.^!D PWM3ING. SSWER, W.1TER, DRAIt/AGE: To be made priol' to fi l- Zir.g trenches. o o Ut/DERFLOOR PLUMBING & MECHANICAL: To be made prior to installation of 11001' insulation or decking. POST AND BEAM: To be made prior to installatien of floor insklation or decking. ROUGH PWMBI!}G. ELECTRICAL & MECll- ANICAL: No ~ork'is to be covered ,until these inspections have beer. made and apPl'oved. FI~EPLACE: Prior to plaair.g facing mater'ials and before framing inspea- tion. pRAft1JNG: Must be requested after approval of rough plumbing, aleatri- aal & meahanical. All roofing bracing & chimneys, etc. nr~st be completed. No work is to be con- i ceded until thin inspection has 'been made and approved. o o D o Phona: f\4fl- Cl ~()~ Zip: ql4l~ , Value J () (y)(), dJ ! ~ or~ Sig"d,Mf/Y1 J_ Date: '~//--I/J -C//) Expices , Lise. . It Bldrs Board Reg. Phon? t () St Or'-,} ~ ~ .... 4/n/Gf J ., -, D INSULATION/V/lPOH BARRIER INSPECTION: To be made after all insul~tion a~~ . required vapor barriers are in place ',;": ;'.'.-' but before any lath, gypswn beard or wH covering is applied, and before any insulation is concealed. r:-yDRYWALL INSPECTION: Te be made ~ r;fter aU drywaU is in plaae, . but prior to any taping. , , D MASONRY: Steel location, bond beams, grouting or verticals in aaaordance with U.B.C. Seation 2415. D WOODSTOVE: cempleted. After installation is DEMOLITION OR ;'.:OVED BUILDIi/GS ==:J Sanitary s~~er ~apped at prop~rt~ lir.e '; .", I , ...\1 J.~~l, 11",IJI:~IH:'~li"';'r'~I~~~.!",jji rfl~"fhIL .'~'~' :==J Septic tank p~~ed and filled with gra~el I Final - f.'hen above items are aompleted ~ and when demolition is complete or stru~- ture moved and premises ~leaned up. , Mobi le Hemes ~ Blocking and Sat-up =:J Plwnbing aonnections s~er and water ~ Electriaal Connection - Blocking, set-u~ ~ and plwnbing aonnections nr~st be approved before requesting electrical inspectio~ =:J Accessory Bui lding I Final - After parches, skirting, decks, ~ etc. are completed. o AU :project aonditions, auch as the installation of str'eat trees, 'cO."'1pletivn of the required landscaping, etc., must be satisfied before the BUILDINC FINAL can be requested. It is the responn~bility of the permit hoUier to see that all innpections are made'at the'proper time, that each ~ess is readabZe from the street, and that the perrrrit card is lCJCated at the front of the property. 'Bui!ding Division approved plan shall remain on the Building Sits at all times. P,70CSDURE FOR INSPECTION RE'QUEST:CALL 726-3769 (reaorder) state your City designated job number, job address, type of inspecticll requested and when you will be ready for inspection, Contractors or OWners ncme and phone number. Requests received before 7:00 ~ ..'ill be made the same day, requests made after 7:00 am will be made the next :uorking day. qo' j"?" ~ i A _" Your City Deaigr~ted Job Nwnbcr Is: ,--~-~ . Reouir>ed InsDp.ctiens - I SITE INSPECTION: To be made after excavativn, but prier to set up of forme. UNDERSLAB PLUMBING. ELECTRIC,1L & MECH,lNICAL: To be made before any work is covered. ~ FINAL PLUMBING Q'FIN/lL MECHANICAL ~INAL 'ELECTRICAL 0' FINAL BUILDING: The Final Building Inspection must be requested after the Pinal Plwnbing Eleatrical, and Mechar.iaal Inspec~iona have been made and approved. [] ~RB & APPROACH APRON: After forms ~~e erected but prior to pouring concrete. . n.. SIDEfMLK & DRIt'EW:Y: For all con- ~ crete paving within street right- of-uJC.Y, to be made after aU exca- vating complete & fo1':71 work & sub- base material in place. D ~ENCE: 'h'hen.complete -- Provide gates or movable sectienn through P.U.E. 'AU !.f/lNHOLES AND CLEANOUTS !1U8T [iF: ACCESSIBLF:, ADJUST!fENT TO BE MIIDE n NO ('(1ST TO CITY P~fle! of 2 o . -oJ'" - JOB NO. SOL A R Aloe E S S R E Q.- L -CO c-1t '" . Zone: Occupancy Gre LOT TYPE Type/Const: Bedrooms: Lot Sq. Ftg. Z of lot Coverage: Ii of Stories TotaL Height Topogl'ilphy [,at Faces - I I Enerrf!! Sources I I Heat Access. I I Water !/eater I I Range I I Fireplace I I Wood;;tove I I T'IDe PanhandLe CuL-de-sac Setbacks P.L. House Carage North East South f"est Interior Corner -- Fees ITEM SQ.FTG x Value Building Value & Permit Main Garaae This permit is granted on the express condition that the said construotion shalL, in alL respects, oonform to the Ordinanoe adopted by the City of SpringfieLd, inc!uding the Zoning Ordinanoe, reguLating the oonstruction and use of buildings, and m~y be suspended or revoked at any time upon vio- Lation of any provisions of said Ord~r~nces. Carport Aooessoru Is. D.C. TOTAL VALUE (vaiue) 1.5 x BuiLding Perrrrit Plan Cheok Fee: Date Paid: I Recdpt 1/: I Signed: State Suroharge Total Charoges I ITEM NO. I Fi:I:tures Residential (1 bath) FEE Plumbing Permit Water No person shaLL construot, instaL!, alter or ohange any new or existing pLumbing or drainage syste~ in whole or in part, unLess suoh person is the Legal possessor of a valid plumber's license, except that a peroson may do pLumbing work to property which is owned, leased or operated by the appli- cant. Sanitary Sewer Plumbing Perrr.it , -'- State Suror~rge -J .. - I ~ Total Charoes ITEM NO. FEE CHARGE Electrical 'Permit Res. Sa. fto. Naw/Extend Cirouits Temporary Servioe' Where State Law requires tr~t the electricaL work be done by an Eleotrioal Con trao tor, the eLeotrioal portion of' this permit shalL not be valid until the LabeL has been signed by the ELectricaL Contraotor. Eleotrioal Permit ITEM . NO.' ,.--... \[\ \~ -,) .~~ Mechanical Permit State Suroharge Total Charfies FEE Furnaoe PTU' S Exhaust Hood Vent Fan W:;odsto:Je Permit I;;suance Total Charoeo -- ENCROACHMENT -- ~.ou \;;}Sl .&/ O,~S I ~ Mechanical Permit State Surcharae Se~~rity Deposit Plan Examiner uate Storage Pormit I TotaL CharGes I eurbcut I Sidewalk I Fence I Electrical Label I Mobi le Home ~ I HAVE CAREFULLY EXAMINED thE compLeted applioation for permit, i:md do hereby oertify that al? info~ation hereon is true and oorrect, and I fUrther certify that any ar~ all work perfor.ned shaLL be done' in aocor- danoe with the Ordinances of the City of Springfield, and the: L<<~s of the ~ State of Oregon pertaining to the work desoribed herein, and that NO OCCU- PANCY wiLL be made of any struoture without permis3ion of the Building Di- vision. I further oertify that o:'lly contractors QJui e.~pL:;yee8 who are in o~~pLianoe with ORS 701.05S will be used'on this projeot Maintenance I TOTAL AMOUNT DUE: ~ ~ I I f I r--?? . ...1.' \-J 110, r; ~ . ~.iall~d f."" 'I, r-. D~ "_s\ ~~.'" ~t\\ l\ t>x0 ./ .' Permit No: q () ::-6( __0 Address: {O~~~ <i\Asr~ r S+ . Iss.ued by: )t;p I [)(D Da-te: J / / ~Jq() . (....:.. J) _ I I 7- 'STA TEM ENT: , INFORMATION NOTICE TO PROPERTVOWNERS . ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law,ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to.. sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: .1.1\.,]) lawn, reside in, or will reside in the completed structure. 2. fi. I' My general contractor is ' , . Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and 00 hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. -------' \-",- \ , \'\ "'-5'- '\. ~ ~ .r \. \." r<:~'" ,,\.1 'l Signatille-ol-PermitApplicarH - - - C.r-... \ \ . \\ \\~\ ~\ CJ Date \ \, CONSTRUCTION CONTRACTORS. SOARD', ; 0244J 10/24/89, p' , ~l/l1 .' , . . " wt:Iij=E COpy TO ISSUING AGENCY PERMIT FILE ~PY TO APPLICANT @.' Pending issuance of a policy, at which time this Binder will be void, and subject to all the declarations, terms and conditions of the policy hereby applied for as currently being issued by the Company designated hereon, this Company is hereby bound to the insured applicant and legal representatives on the property as described hereon for a term not exceeding ninety (90) days from the effective date. It is a condition of this Binder that, in the event of a loss before the expiration of this Binder, the premium due this Company shall be fixed at the full annual premium for the sum insured. ': '.', ,I, This Binder is made and accepted subject to all the foregoing and shall not be valid unless countersigned by the duly authorized agent of this Company, . . OJ" ".'- :, '.... " ''',)'.' . )',,',. 'C)/~';tl": ~ ..."d.~~~f . ....,~...~,!I.l"t;;;;~/~ '("""j')l ; ~ ,~~tyC4yc , t. J:,-,'" ':";::"::""l~"tf.<,:, I ....."'.. " . HOMEOWNER'S/CONDOMINIUM ~te Fann Fire and 0 State Fann General UNa.TOWN~R'S BINDER-RECEIPT ~C::sualtv Company Insurance Company NEW' REW.' E OF I 'COUNTRY' OF POLICY NUMBER , FjF.Erl.VEJ!!. JEr/1'/'.." I TERM II: : : HOME : {", l . . ,~ I LA~T NAME. FIRST NAME I I- ~~'::,~rint ,(I ( , / cJ / I J j J I { /-{ /-) ( I...... i') . Z\ Mailing UNIT ANO/OR STREET ' JI~. ~l..~.NP STRE'ET. ) r -r .' Cl7 () address ff'..jr~ ./,(-" /'-f ) I ('1/ -> :J Location (IF DIFFERENT FROM MAILING ADDRESS) , &: of premises <l.. TOWNSHIP OFFICE USE ONLY M~ iME O~INITIAL (1.((,1,1""-} CITY OR TOW}"" 1 . _'".)~ rJ 6 \ A7.I,!<;ANT"S BIRTh. ?J - J _ /. J, ., ~ r r' " I : soc. ,!AL SECUI!I..TY., NU~'Y'!'l ,. J I"~ SPOY~FS ~IRTHD..y Ed : .!/L/ '/ 'lL If-..) 'I II ~ -;L ,,~J ': t. f '..t:;'t"{ .r'.~:I;.~ U\::l:.J. -'.:.',;:'0",) !C'r ~ ~f"' _~'It!..~ :.:1. Dated a,t/k~/',I(l~/il1/ ; -; t/r , · -I.... . ";?" "'iL/((...' - .)~;j,~~ ,",,',""1'....", "J~l...{....i ' th is f.? '-- J' )~..'i I' ',' ..,f,C<' ;:..)p'. .,\...;,;,;;.' , j") {,; , . ~ :',:; ?: :;. ,i , !;: -~~.. ~Jf""" f t ,.,,.~J" : ..:.L~!r;";iJ~ .j..: ;~h;.J SPOUSE'S FIRST NAME AND MIDDLE INITIAL (IF APPliCABLE) . , ZIP'<;opEp '1'lL/I/ d' ZIP CODE ; COUN7 .' , ,/!JV {/, 'Sp-CIAL SECURllY NUMBE;R .'" I TELEP!'J9NE NUMBEP_.. P. f' itJ j(7 (') r~5~ ( '/'(/1 7 -~ 0(") (' flATE / lB'H DB . I ~~i ,I:: ,.'j 'I' !,,; ~ . t, ,19fo . Agent ~~~~~~S:;I. KAY W. VINJE President STATE FARM INSURANCE CORNER OF 47th & MAIN 111 So. 47th Springfield. OR 97478 Ph. 747-4266 . t/~/~ Secrelary , , , '(' Form: 0 1 0 3' I 4 0 ". 6 I I I I d , . I ,.', Deductibles: ; $.J!;tJ : . Date Policy Book Delivered I I : O'her (Specity) '$ J ') .Limits, _ ~ .. $ - - - (,-- (('( - : 7 ~:::r:'~=lTY I Application) I Theil I ~$ ~CWelry and Furs (JF) CJ) ubmitlist of items) I- 1000/2500 0 $1500/5000 L W Silverware Theil (SG) ~ 0 (submit list of items) m Tolallimit $ LL. o r\..l'leplacement Cost- $ .mmmm Cl Y'Contents (RC) rrWTT.ry',1WL . r , 7' r 1'" Z' ,'Z~'I::!:!.. 0 Firearms (FA) , I " r 1'" Z ','ZZ'en , II' { ,;., z :rZy.:z 0 Incidental Business (10) 'fJ Lt<.:.( ',',0 (describe In Remarks) ,J,./ Z. ". /. ,.".1- , . " /" jQ. 0 Business PursUits (BU) " 'j 7 '.' .' '~'Il '0 (describe In Remarks) ~., .,./., ",7.' '1 j 'J:~ ,.';):: ':'ZZ :,' ~ 0 Home Computer(HC) " . ,/,1./,..j l}, ..Ii /' ,I 'XU .j MPP ~~ j-~~ ,rt:(/Jlrl.j Ace!. No Copy - 0 Insured ENDORSEMENT BILLS: o Mortgagee ?YE NAME AND ADORES,S) , ~ / 0 Loss 0 Named Add'llnsured (explain {....-r (1/ /.)/ JJ ((.I !Z LYMtg. Payee J ontereston Remarks) (~i' .... a: ;;JC~)~lU' r (1/)/X /f';'-:S ~.;//ifJ I L w I '2nd b o Mtg, Base Premium Dwelling or building property .oWeliing extension - W (total amI. incl. 10% <.9 Irom Cov, A) <t: -I a: cj Personal property Ww 6 en I Loss of use U (add 'I living expense) $ '-:OJ r('{) $. ,~.../ .,.) Actual Loss Sustained Condo. loss assessment (Complete section on back) $ , ~~r4tYC = Personalliability r i, (each occurrence) ~ Medical payments to others (each person) j RENEWAL BILLS: Original - in , $1,000 : $ [J.,(nsured . [J Mortgagee TOTAL , PREMIUM $ Original - 0 Insured o Mortgagee .I' S')!/-JtI r/J 1"))' I') I} VI 's ZIPC~PJ~/1.t~oan ( number (GIVE NAME AND ADDRESS) Loss o Payee O Named Add'llnsured (explain interest in Remarks) OSvc. Agt ZIP CODE I understand that coverage is ol6i~ding 0 not binding under this application. I hereby apply for the insurance indicated and represent thaI I have read both sides of this application and the statements hereon are correct. I undersland that the premium shown above must be in compliance with the Company's rules and rates and is subject to revision. Agent's Code Stamp Applicant's . - ,---- - '. Signature X " "-., Premium Premium o Merchandise Samples (SA) (describe in Remar1<s) o $2500 0 $5000 o g~;i~~~~~~r:~~~nd $ $ $ , o Earthquake I Endorsement 0 Ded. _ % - - - - -. - - - -, - - rYES '-NO Does dwelling have 0 0 masonry veneer? " -------- -,IY-ES-I,NO- II yes, is coverage I desired on veneer? 0 0 I o Other: $ /1 II:! : Amount / ~ 'J' . ~' ~ paid $ (r Copy - 0 Insured o Mortgagee fk }/;') /It/-/ k.J;(l~ i I Mortgagee .ubset cod.. Loan number Mortgagee subset code Date and Time 01 Application Mo, Day II /, Yr. %0 ..., !../ lli:M. oP.M, Houri , I .; I'