HomeMy WebLinkAboutPermit Building 1992-3-17
RESIDENTIAL .
PERMIT APPLICATION
Inspections: 726.3769
Orrice: 726.3759 .
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP:
LOT:
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OWNER: R'I \ \ 5,' l(OJ.((')(...\VCl f
ADDRESS: d y.:;' Y Shao!)1 Jan~
CITY: ~~/n~/e/d
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BLOCK: .3
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JOB NUMBER
c;201os
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225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: CJ ~ / /
SUBDIVISIO:N: -~b('71ft<JH(
PHONE: (C)O~~) )t./C/-09~o
ZIP:
77C/'/)
Ma'cv ~ Ko. It(Ol,rl a-.f
f) J,
fiVe
STATE'
OR
DESCRIBE WORK: (V()l) {/t?V!-/I/{? c;~,?; Y'"!..J() , Q;r..~1 r.,ipl\rI ~ 0...10 01 'rJ?1i1 'i.\~A IOO'TA'/
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NEW REMODEL X ADDITION DEMOLISH OT-HER
CONTRACTOR'S NAME ADDRESS
GEN~A~L:.~#-IS.&lrtJura \dY~~fh#rl(}flP,
PLUMBING:
i...~ CONST:
~,ONTRAC~OR II
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EXpiRES PHONE
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MECHANICAl'
ELECTRICAL: ).(eUt 17 . '5c/~q(Jpr -5'~ LLmdnYj.., 1f, ee137d rsr;scr
QUAD AREA:
.~. '. ''f!
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II OF BLDGS:
OCCY GROUP:
"\.
" OF STORIES: '
. "'. - "'.
WATER HEATER:
- OFFICE USE-
, , I . Lj\NDUSF'
.. '~.
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II.OF.,UNITS:
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L 5cJ:) sY~-r:lrfO/
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,
D Temporary Electric
D Site Inspection - To be made
afte,r excavation, but prior to
setting forms. '
o
Underslab Plumbing I Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated, "
D Masonry - Steel location, bond
beams, grouting.
D Foundation -:-, After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
-- Prior 10 insulation or decking.
D Post and Beam - Prior to floor
. insu/,ation or decking.
o Floor Insulation - Prior to
decking. , .
D
Sanitary Sewe'r - Prior to filling
trench,
D Storm Sewer - Prior to filling
trench.
, '- ' '
...." " .
O Water Line - .priorto filling
trench. . . ' . ' '
o Rough Plumbing '-:',~/ior to
cover, ,i . "'" :'
......... '
CONSTR. TYPE:
HEAT SOURCE:
", .... ~). . ,,~
RANGl='
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover. '
i
~ Rough Electr!cal - Prior to
,,-cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp,
l'5<( Framing - Prior to cover.
i' .
, '
1')(["'WalllCeiling !nsulation - Prior to
~cover., i '
.JZC Drywall - prior to taping. .
,
I
D Wood Stove -4- After install~tion,
I
.- ,
D Insert - Aft~r fireplace approval
and installatipn of unit. :
o
,
I I
Curbcut & Approach - After
forms are erected but prior to
placement of; concrete. '
o Sidewalk & Driveway - After
excavation is complete, forms
and sUb-bas~ material in place,'
! : "-
o Fence - WhEm compl'cted,;..< '
o Street Trees:"'" When all r~ci.uired
trees are planted. ."',', ,
D Final Plumbing - When all
. plumbing work is complete,
T'Y"1' Final Electrical - When all
~electrica/ work is complete.
o Final Mechanical - When all
mechanical work is complete,
M Final Building - When all
~required inspections have been
approved ,and building is
completed.
D Other
MOBILE HOME INSPECTIONS
o Blocking andSet.Up .:.... When all
blocking is complete.
o 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 hOlT)e is connected to
the service panel.
./ :;:: .....~j\,..<:._~.,,~:..
o Final - After all required
inspections are approved .and
porches, skirting, decks, and
venting have been installed,
~'I
.......-
Lot" facos, .
L?t sq, ftg.
Lot coverage
Topography
,Total height
''',- '., '" , " .
BUILDING PERiVfJT '
ITEM
SO. FT.
Main
Garage
Carport
.~2~
Total Value
Building Permit Fee
State Surcharge,
.Total Fee
Lot Type
Interior
Corner
Panhandle
Cul,de,sac
x
$1 SO, FT.
,S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
Setbacks
, I
P.L, HSE GAR ACC
I
N
S
W
E
VA LU E
-13.~$" 5~~ ~
(C)
Dryer Vent
Wood Stove/lnsertlFireplace Unit c
NO
Vent Fan
Mechanical Permit
Issuance
State Surcharge
Total Permit
NO
FT.
FT.
FT.
(A)
(D)
Mobile Home
MISCELLANEOUS PERMITS
State Issuance
State Surcharge
Sidewalk
ft
'$f
50 of/:)
2.gS
&)~_~3
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) N/,A
,
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
Curbcut
ft
Demolition
\
State Surcharge
f'LAr, R'6K/ew ~
Total Miscellaneous Permits (E)
FEE
.:,
, ,_<::~?,J
TQTAL AMOUNT DUE (excluding electrical)
(A, G, C, D, and E Combined)
-.!If;. . tJ(p
..~
APPROVED:
BUILDING VALUE, PLAN',CHECK
AND BUILDING PERMIT .
This permit is granled on the express condition that the said
construction shall, in all respects, conform to IIle Ordinance
i 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:
Date Paid:
:; Receipt Number"
I ~
:&;4~2-
Plan
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
: ,ADDITIONAL COMMENTS
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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 c'orrect, and I further certify
that any and all worl< 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 Division,
I further certify that only contractors and employees who
are in compli?nce with ORS 701.055 will be used on this
project.
" j
I further agree to e,nsure IIlat 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.
Sign~ture ~ -5 ~ f/n !~Joe--?____
Date '3- 1'7 -I q 9 fi....,,,.
,; VALIDATION:
I
4n/9
, .
.S - 17 -/2-
AMOUNT RECEIVED C)C", CJ~
,_>A7i7' .
'--.r~
. I RECEIPT NUMBER
i DATE PAID
RECEIVED BY _