HomeMy WebLinkAboutPermit Building 1992-3-17
IJLUS, Ii( 01< Ouya s: ,
. ;( f./ ;2 ,t./~ h. a 01 y I (]I "7 ~
)()rl,,?q~f/C/ .
- I /
eOt/1
REMODEL V
,
RESIDENTIAL
'PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT:
~
OWNER:
.ADDRESS:
CITY:'
. TAX LOT:
SUBDIVISION:;:-~
11 Q'" l/ r: k9'k Oc,s#GNl:: 5- 0 3
/l ,/
/J r I t/ ~
SpRINGFIELD
-'~'~'4 .
I
.II
j'"
id
BLO<::K:
STATE'
Dr
.. TO-.
JOB NUMBER
92tJ4tj -1
225 FifthStreet
Springfield, Oregon 97477
s/'
"A'
I
J
ZIP:
')
"
DESCRIBE WORK:
~'.f>';' -ti:'" ~
.J
ADDITION
cr Qrt:pqe
v -
DEMOLISH
;.~ Ie) c!pt/1':' QV101 .:;,~,'f' \,h;:"~b~"~
OTHER
NEW
CaNST.
CONTRACTOR'S NAME ADDRESS ". Co'NTRACTOR 1/ EXPIRES PHONE
G EN ERA L: ___' _ tf3/~C L",,___2L__,A:-~tfQ.~,~_:{S_~---tJ.-tJ--';Li~.:~:~,/z?o/-l (j;e-L~ '* ',2S~L~....__.~ ~~~~_~~ 0 C?? (;)
PLUMBING: __,_.
MECHANICAL:
ELECTRICAL:
/rpV,;""
Q uj,:b A"R EA:' J: : .
. ..- - ...
, ,
II OF BLDGS:
OCCY GROUP:
. ....
',\
--.\;
1/ OF STORIES:
\" .
WATER HEATER:
Sch2-/..~
, .:':z:t
'" _~ L 0'" ~jd~ s7 ~ (?t3 Jo ff'g r::r
3'/'1 ,..2 ~ol
- OFFICE USE -
d~~,ND\JSE:
, ':.' ~ ~:
. /I OF WN'ITS:
c_'~t.....\\ ~-~. ''':,')
, CONSTR, TYPE:
. HEAT S:OURC>'"
''1. '. \.- ~ ~, ~', \'
. RANGE:
FLOOD PLAIN:
ZONING CODE:
/I OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you must call 72'6-3769. 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 worl< day.
R EQU I R EDI NS P ECTIO N S
D Temporary Electric
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing I Electrical {-
Mechanical - Prior to cover. .
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting. .
o
Foundation - After forms are
erected but prior to concrete
pi acemen t.
o
Underground Plumbing - Prior
to filling trench.
D
Underfloor Plumbing! Mechanical
- Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or decl<ing.
(
"- .. ~.
o Floor Insulation :- Prior to
deckl ng. ; '"
'- ", \. "
o
Sanitary Sewer - Prior to filling
trench. .
o
Storm Sewer - Prior to filling
trench.
... ~ ., -:.:
o
Water Line - Prior to filling
trench.' . '\\',
o Rough Plumbing :-,_ P.rio'r to
cover. . ';".' ~<"" . ',', r:
o Rough Mechqnical - Prior to
cover. '
K7l' Rough Electrical
)6.l cover.
Prior to
o Electrical Service - Must be
approved to obtain permanent
electrical power,
D
Fireplace - Prior to facing'
materials and framlrig Insp.
~i=raming - Prior t6 cover.
K7f' Wall/Ceiling Insulation - Prior to
AI cover. .
% Dry~all - pr:ior to taping.
D Wood Stove .:- After installation.
Dlnsert - After fireplace approval
and Installation of uriit.
D
Curbcut & Approach - After
forms are erected but prior io
placement of! concrete.
o Sidewalk & Driveway - After
. excavation is; complete, forms
and sub-base material in place.
i
D Fence - Wh,en completed.
o Street Trees - When;all r~quiJed
trees are pla~ted. ,..... .
o Final Plumbing - When all
plumbing worl< is complete,
'1><"( Final Electrical .:-.- When all
- e.lectrical work is complete.
D Final Mechanical - When all
mechanical work is complete. .
t\7f Final Building - When all
~ required inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS.
D Blocking and Set-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 home is connected to
the service panel.
'.
o Final - After all required
. inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot sq: ftg.
Interior
Setbacks
I PL. HSE GAR ACC
Lot 'faces
',.
Lot TYR~
Lot coverage
Corner
N
Topography
Panhandle
S
Total height
Cul.de.sac
W
LE . . .
_______.2.._
\
BUILDING'. PERMIT'
ITEM SO. FT, X $/so. FT VALUE
Main
Garage
Carport
("m ,~~.I!JtI 29d /7- ~~ . 5~3~ o-D
Total Value.,
l:)"'~ ,>0
2t,~>
.-5c:t~ '33
SYSTEMS DEVELOPMENT CHARGE (SDC)
-1l/A-
Building Permit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT
Water
FT,
. 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
Mecllanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
.Sidewalk
ft
Curbcu.l
ft
Demolition
Slale Surcharuc
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
-51 ,'33
1~'Tf.jE.PROPOSED WORK IN THE
l-fisi'ORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?_
If yes, this application must be signed
and approved by the Historical
Coord i nator prior to permi t issuance.
APPROVED'
BUILDING VALUE,' PLAN 'CHECK
AND BUILDING PERMIT
Recei pt Number'
Received By: .
~
~---------
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are bein(J improved.
ADDITIONAL COMMENTS
i
By signature, I state anel agree, that I have carefully examined
the completed application and do hereby certify thai all
information hereon is true and correct, and I further certify
tllat any and all worl~ performed shall be dohe In accordance
with tile Ordinances of the City of Springfield, and the Laws
of the Slate of Oregon pertaining to the worl~ described
herein, and 'that" NO OCCUPANCY will be made of any
structure wit,hout permission of the Building Safety Division.
I further certIfy trat only contractors and employees who.
are in compliance with ORS 701.055 will be lIsed on this
project.
I further agree to ensure that all required inspections are
requested atthe proper time, that each address is readable
. from' the street, that the perm'it 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.
Signature.~C ;,S' ~-</~Af?/)____
Date
9,-/1 ~/Cj92.
VALIDATION:
RECEIPT NUMBER
DATE PAID _
AMOUNT RECEIVED
RECEIVED BY
4020
_.3~L7 - 7' Z
~'7'_3.:r
~~.