HomeMy WebLinkAboutPermit Building 1993-4-30
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
SPRINGFIELD
.
JOB NUMBER ~~1?~
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: :..c ~.~
ASSESSORS MAP: /7~ -L' I'-<~
~n-~"
TAX LOT: ;!:) SLp&> ___
OWNER: '17:b~ ~V~ ,
ADDRESS: "'ZZSt::> - ~~~c.y ~....
5~p STATE:_~/?'
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~11~/e:?~ ~~
REMODEL ~ ADDITION
LOT:
CITY'
DESCRIBE WORK:
NEW
CONTRACTOR'~ME
GENERAL: e/~~
PLUMBING:
MECHANICAl'
ELECTRICAL:
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER:
BLOCK:
SUBDIVISION:
PHONE:
/~/-t:::'9~
, -
ZIP:
q~7?
.r
~~
? -
OTHER
^; < _. -../~,-=- -- :
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~
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DEMOLISH
ADDRESS
CONST.
CONTRACTOR #
EXPIRES IJHONE
- OFFICE USE -
LAND USF'
# OF UNITS:
CONSTR, TYPE'
HEAT SOURCE:
RANG F'
FLOOD PLAIN:_
ZONING CODE:
Ii OF BDRMS:
SECONDARY HEAT:
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
D
Site Inspection - To be made
after excavation, but prior to
setting forms,
D
Underslab Plumbingl Electricall
Mechanical - Prior to cover,
D Footing - After trenches are
excavated,
D
Masonry - Steel location, bond
beams, grouting,
C\ZJ
Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench,
o
Underlloor Plumbing I Mechanical
- Prior to insulation or decking,
D
Post and Beam - Prior to floor
insulation or decking,
D
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.
D Rough Plumbing - Prior to
cover,
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover,
D Rough Electrical - Prior to
cover,
D Electrical Service - Must be
approved to obtain permanent
electrical power,
D
Fireplace - Prior to facing
materials and framing Insp,
/ZJ
Framing - Prior to cover,
D Wall/Ceiling Insulation - Prior to
cover,
o Drywall - Prior to taping,
D Wood Stove - After installation,
D Insert -- After fireplace approval
and installation of unit.
o
Curbcut & Approach - After
forms are erected but pri or to
placement of concrete,
D Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place,
D Fenc:e --, When completed,
o Street Trees - When all required
trees are planted,
D
Final Plumbing - When all
plumbing work is complete,
D Final Electrical - When all
electrical work Is comjdete.
o
Final Mechanical - Wilen all
mechanical work is complete.
~
Final Building - When all
required inspections hilve becn
approved and building IS
completed,
o
Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connccteu tu
the service panel.
o
Final - After all required
inspections are approv1,d and
porr;hes, skirting, deck!), and
venting have been installed.
.
L9.t faces
Lot Type
Lot sq. ftg
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de-sac
BUILDING PERMIT
ITEM .... '; SQ, -FT..
- '.-..
x
$/SQ, FT.
Main.
Garage
....
Carport .
k~.(7CL-
....
Total Value
Building Permit Fee'
State Surcharge
Total Fee
(A)
'(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mot)ile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permi t
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
. Demolition
State Surcharge " ,
?~/~k6
I ~.r J r
Total Miscellaneous Permits
(E)
IS THE PROPOSED WORK IN THE
q HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
Setb"lcks
IpL. HSE GAR' ACC
IN
Is
\W
IE
V A LU E
"'~~~
?c
FEE
_2~5
..
TOTAL AMOUNT DUE (excluding electrical) -;;::t.t5: 50
(A, B, C, D. and E Combined)
/_~~
I ......
~7~
./~-;;>
SYSTEMS DEVELOPMENT CHARGE (SDC)
APPROVED:....
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted onthe express condition that the said
'.""Gonstruction shall, in all.resp~cts, conform to the Ordinance
adoPte~ by ,the City at Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspel;1ded or revoked at any time
upon violation of any provisions of said ordinances,
Plan Check Fee: _~ '.?..~
Y-~-73
Date Paid:
:::::::dN;be, .~~-
~ ~~~~.
/Iar;rr~d \3y r ~
, , ,
Systems Development Ch~rge is due on all undeveloped
properties within the City limits which are being improved,
~-p~
Date ' -
ADDITIONAL COMMENTS
By signature, 1 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 ali 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 Divis,ion,
\ 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 pr~per time, that each address is readable
from the street, that the permit card is located at the front
of the property, an ., approved set of plans will remain
:~g:::u:;te all~ _d'"'~:iff~ .
Dale ,-Y-:;c::> ~,,:'S'
VALiDATION:
RECEIPT NUMBER
~3//
V-~,tf9? .
-::<~~
u-4~
DATE PAID
AMOUNT RECEIVED
FIECEIVED BY _____
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FLOOR PLAN ~
2250 BeVerly/~re~t
Springfield,OR 97477
1" = 10 I
GROSS LIVING AREA
Dwelling:
16 x 30 .. 480
24 x 25 .a 60e
1~ x 11 = 154
Total 12J~ SF
Garage:
22 x'23 .. 506 SF
Carport/Shop:
32 x 22 .. 704 SF
bedroom
30
><1
n bath/
o [2]1
bedroom
16
< Cl'
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bedroom
>
cl '
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-----1
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COY. deck
. r
dining
rocm
,
;.,.iA--:-
carpor-t
32
, patio
.
shop
"'-
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54
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