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Home My WebLink AboutPermit Building 1991-6-19 ~ JOB NUMBER " .~ 225 Fifth SI'eel 'aJI Springfield, Oregon 97477 LOCATION OF PROPOSED WORK: 4, \ Q \ 0 A\. ,_P-;\ A_~ Q \:)~~~ \J...n -H)/ ASSESSOR$MAP: r'70~ ~&L1 ~ TAX LOT: n':'JrYYJ ..~-.'. .. ..' ~ ," ~.' .. '-""" RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Offic~: n6'3759 LOT: SPRINGFIELD C11t'folJ't SUBDIVISION: OWNER: ~~~'1~~_"~lAt0t\9,j?J ' _ PHONE: f\~lJ) lDS\') 'APDR>=~S" ~~O\C'~tJ.0\~~ODq\l~~ t~,~.. "" CITY~\(~~ '.' STATE (~Cj? I ZIP q l41PJ DESCRIBEWORK '<-Jo d\ cnm u:&L'lCuJ"LnJL) NEW REMODEL} ./ CONTRAcroftM:~ GENERAL' ,~\Qf'~ PL,lJ.MB1N<;3: ,~f\,l~. '-)- MECHANICA' ,C\. - "ELEC!.RICA,Lt~ ~~ )$\.9 Jf ) QUAD AREA: ~\2..~~ h OF BLDGS: \ OCCY GROUP:, ~ S h OF STORIES: WATER HEATER: BLOCK: DEMOLISH OTHER ADDRESS CONST. CONTRACTOR h PHONE REQUIRED INSPECTIONS D Rough Mechanical - Prior to cove~' , , 'R;7I Rough Electrical - Prior to, ~cover, D Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp, ~Framing,.,.... Prior to cover, '!";2f Wall/Ceiling Insulation - Prior to ~ver, ~ Drywall - Pri?r to taping, o Wood Stove - After installation, D insert - After fireplace approval and installation of unit. D Curbcut & Approach - After forms are erec,ted but prior to placement of concrete, ' D Sidewalk & Driveway - After excavation is complete, forms and, sub,base material in place, D Fence ...;;.; Whe~ completed, o Stre~t Trees ....;;..When'all requfred trees are planted, " EXPIRES FLOOD PLAIN' ZONING CODE: LJ) e- ref C$ I ' , , SECONDARY HEAT: ' SQUARE FOOTAGE: ~4 h OF BDRMS: To request an inspection, you must call 726-3769, This is a 24 hour recording, All inspections requested befor(e 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, - OFFICE USE - LAND USE: \ \ \ '\ hOF UNITS: \ CONSTR, TYPE: \/ 1\/ HEAT SOURCE: RANGE: D Final Plumbing - When all plumbing work is complete, D Temporary Electric D Site Inspection -, To be made_, , after excavation, but prior to setting forms, D Underslab Plumbing/ElectricalJ Mechanical - Prior to cover. D' Footing -' After trenches are excavated" D Masonry - Steel location, bond beams, grouting. 1'::>Cl Foundation - After forms are / ...... .arected but prior to concrete placement. D Underground Plumbing - Prior to filling trench, D Underfloor Plumbing I Mechanical - Prior to,insulation or decking, ~. Post and Beam - Prior to floor ~ insulation or decking, ' l'V1 Floor Insulation - Prior to ~ decking, rl' . D,Sanitary Sewer - Prior to filling trench, ~ Storm Sewer - Prior to filling ~ trench, Dwater Line - Prior to filling trench, o Rough Plumbing - Prior to cove~ , ~ Final Electrical - When all ~electrical work is complete, , D Final Mechanical - When all mechanical work is complete, , ~ Final Building - When all y......\,.required inspections have been approved and building 'is " completed, D Other MOBILE HOME INSPECTIONS D 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 connected to the service, panel. ....., '---... D Final - After all ~~ir.ed , inspections are 'approvecr-and porches, skirting, decks, and" "venting have been installed, Lot faces Lot Type Setbacks J THE PROPOSED WORK IN THE Lot sq, ftg, Interior I P,L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON IN THE HISTORICAL REGISTER? Lot coverage Corner If yes, this applic'ation must be signed Is and approved by the Historical Topography Panhandle Iw Coordinator prior to permit issuance, Total height Cul,de,sac IE APPROVED: BUILDING PERMIT ~~4 X~1T6 I~~ ITEM Main Garage Carport 15"fW;o ,~8J 122.,~~ . SYSTEMS DEVELOPMENT CHARGE (S~DC)" . Total Value Building Permit Fee State Surcharge Total Fee (A) (B) PLUMBING PERMIT ITEM FEE Fixtu res Residential Bath(s) NO Sanitary Sewer FT, FT, Water Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Fu mace Exhaust Hood Vent Fan NO Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Su~charge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) , (A, B, C, D, and E Combined) 122.:;5 ']- 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 ,rf3voked at any time upon violation of any provisions of said ordinances, Plan Check Fee: 'l~. 'l,~-' Date Paid: to.4 ' q I 4ir(f / Systems Development Charge is due on all undeveloped properties within the City limits which are being improved, ADDITIONAL COMMENTS 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 pertai ni ng to the work descri bed 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 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 ti me, 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 Sit~ j all time~ duri\,~ '-uflstruction, Signature~_\..h. -\rl4~ , Date {~ \ <1 I C1 1 VALIDATION: ~(" 1 0 RECEIPT NUMB'lR - ( DATE PAID' { 0 c I Lf <I AMOUNT R~~ ',- -~' 4 ~-; RECEIV~D~~h_J . .. Permit No: . ~ \()~ Address: LhoVft \.;l L l&- \:1, ~~ 0-- Issued bY:~ Date: 07q.q I FOR: OFFICE USE ONLY ST A TEM ENT: INFORMATION NOTICE TO PROPERTY OWNERS " ., ABOUT CONSTRUCTION,RESPONSIBIUTIES .' Note: Oregon Law, ORS701.055(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.'LicensedArchitect ,'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: r./J 1.r~ ,'./ 2.A.1 /' I own,' reside in, or will reside in the completed structure. Mygenera,1 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. OR -; It /11 will be my own general contractor. r If I hire subcontractors, I will hire only subcontractors registered with the , Construction Contractors Board. If I change my mind and ao hire a ~eneral 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. ' Signature of Permit Appl'icant C NSTRUCTION CONTRACTORS BOARD 0244J 1/90 /ffl!q J q I Olt" .:~ COPY TO ISSUING AGENCY PERMIT.FILE \" I~K"'COPY TO APPLICANT ~0~ @.