HomeMy WebLinkAboutPermit Building 1991-4-15
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RESIDENTIAL
PERMIT APPLICATION
.lnspections:726-3769
Office: 726-3759
SPRINGFIELD'
~6J
.. C'tLtJro6\o
JOB NUMBER
q '08~lo
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: Olo r"J C;() .
SUBDI~'SION. (~!\ d.P ~ \~,b
:::::SS\.~~~~~. \ll\i)~PHONE 3\~ '-oloC\\
CITY:. C( A ~Q--, STATE: (~Q ~--r:-- ZIP: q~\,D ~
.s., ~, ~ Jl ,C)lG Q_fL~ \J
- -
LOT:
DESCRIBE WORK:
NEW ~. REMODEL
BLOCK:
4
ADDITION
DEMOLISH
OTHER
CONTRACT~~'~N~~h ~~ ADDRESS
GENERAL: _'" ,~O rf\l\$\-J'
. PLUMBING: ()~ )a()
. ,. . ,.., ryr--... \ (71:); -...
MECHANICAL: \'<1 ) ~~
E,L.ECT, R'ICAL: . (\\.~fCDrl._
.. -- -' .-~, . -
CONST.
C~T~~ r;Q]~fW 74;E. L8J
~q{)1 T () cQ){J qf).
OJD~1() (),f71Jq~-. - .
~4LoC\() \\'/1 c\ It{ '\
- I.
- OFFICE USE -
QUAD AREA: LW.<SS LAND USE: 1 \ \ I FLOOD PLAIN:
# OF BLDGS: ~~""\~ # OF UNITS: \ ZONING CODE: \.,\l \2--'
OCCY GROUP: CONSTR. TYPE: VA) # OF BDRMS: 4~.
# OF STORIES: & HEAT SOURCF' F''C.-. SECONDARY HEAT:
WATER HEATER: r/ RANGE: ~ SQ'UARE FOOTAGE: 2- J (5
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 I'nade the following work day.
~TempOrary Electric
REQUIRED INSPECTIONS
l"X'i Rough Mechanical - Prior to
~ cover.
'M'Site Inspection - To be.made .. MROU9h Electrical. - Prior to
~ after excavation, butlrior to ~ ~cover.
setting forms. -SOl CllJNl>/7/W
o
Unde.rslab Plumbing/ Electrical/
Mechanical - Prior to cover,
o Footing - After trenches are
excavated.
D
.Masonry - Steel location, bond.
beams, grouti,ng.
~ Foundation - After forms are
~erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling .trench.
~ Underflo~lumbi~chan~
~ - Prior..to 1'i'i",ulclllon. Qr uecKlng.
~ Post and Beam .~ Prior to floor
~nsulation or decking.
-f;Z1' Floor Insulation - Prior to
" ~decking.
~ Sanitary Sewer - Prior to filling
~ trench.
~'Storm Sewer - Prior to filling
~rench. .
~Water Line - Prior to filling
~trench.
d Rough Plumbing - Prior to.
~cover.
~ Electrical Service - Must be
.Y"approved to obtain permanent
electrical power.
~ Fireplace - Prior to facing
~ ..materials and framing Insp,
~ Framing ,...... Prior to cover.
I\./r Wall/Ceiling Insulation - Prior to
~ cover.
~, Drywall - Prior to taping.
. .
, . . ., ,
.D Wood Stove - Afte'r .installation.
o Insert -'After fireplace approval
and installation of unit
f"ii71" Curbcut & Approach - After
~ forms are erected but prior to
placement of concrete. .
'~Sidewalk& Driveway - After
~excavation is complete, forms -
and sub-base material in place.
, . D Fence ~ When complete9.
~i? ~eE!.t}'rees ....:. Wheriail required'
~ ees are planted. ,
,- " .
~ Final, Plumbing - When all
~plumbing work is:cbmplete.
..
15<(Final Electrical - When all
- electrical work is cOrT)plete.
~ Final Mechanical - When all
r ......mechanical work is complete,
..l><J FinalBuilding - When all
..equired. inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
. blocking is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o 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
... in?pections are approved and
., '~po'rches;skirting, decks, .and
venti.ng have been installed.
Lot faces Lot Type Setb",cks IS.<:: PROPOSED WORK IN THE
Lot sq. ftg. Interior I P.L. HSE GAR Accl HISTORICAL DISTRiCt, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage l' Corner If yes, this application must b signed
Is I and approved~by the Historical
Topography Panhandle
85" Iw I Coordinator prior to permit issuance.
Total hei ght $ Cul-de-sac
IE I APPROVED:
BUILDING PERMIT
so. FT
\ \0C\~,
4'L1O
X $/SO. FT = VALUE
oC\ .1D lO'1 \ f) 'L.
\4 . \D (j)O(Jl.c
'J~\ '15
~~
J7.15
.372.7$
SYSTEMS DEVELOPMENT CHARGE (SDC)
. (B) JtJt17.," 1
ITEM
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO ~
Sanitary Sewer FT
Water FT
Storm Sewer FT
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk 1ft ft
Curbcut 2.G, ft
Demolition
(A)
FEE
/92 50
(C)
9'3
20213
7..
-660
-45'''
e;'d-O
~~ #-D
(D)
2'2-~D
/0 ,..
1.~3
3+- 13
'2.. 1 90
J 3 'fO
State Surcharge K
PLAw ,;f4'Itic.J 2IJtS.(!itl)~
Total Miscellaneous Permits (E)
eo4J-iJ
1- ~. &;
-I-7S.? .~e
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
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 revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
~w
Date Paid:
Receipt Number'
Rece~~
PI~~iewed B'Y
4 -/~ -". J
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
. ADDITIONAL COMMENTS
~\=l~~'* U)
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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 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 7.01.055 will be used on this
project.
I further agree to ensure that 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 a?proved set of plans will remain
on t te at all ti e dl ri construction.
"'t ........
\
I.
Date
\
;.
VALIDATION: q
RECEIPT NUMBER. \ f):::!D
DATE PAID 4 . is. q I
AMOUNT RECEIV~~/; ~JA (,{:L(n
RECEIVED BY r=J) (/'f.::t j
- / - -
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
. INSPECTION REQUEST: 726-3769
OFFICE: '726-3759
1.
LO~~ ~lfmQ\o ,
~(')~O;&ON0g rlofJa)
~ JOB DESCRIPTIQ!>+-. r () ,......
\ Qsy\_~ ~ ~\ \:JU--.).
Permits are non~transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor' GrQ.ffid .
Addres~f)~f) (011~NYlfif' ):tf2fc;
Ci ty 2--':){:(f'j~ . Phone 1)41 ~ t 3[ 0
\ \.
Supervisor License Number ~~~~
Expiration Date t () I ( !qV
. Constr Contr. Number 51lcf1'O
Expiration Date. In! /q/q;
Signa ture of Supervising Elec tridan
)-1.~4'~A~. ...
. Owners Na~_~,Q~/ftif}-J D.
. Address c<)-4CJO LrnQ1~
Ci ty ~)Q~LPho~e 0<1 ~- (dfl/
. OYNER IM-ALLATION
The instillation is bein~ made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
~~~~~~-:frj~~2~=----------
RECP.TVP.n TlY. ~
,
ELECTRICAL PERMIT APPLICATION
Ci ty Job Number Cf 1 U ~2u
3.
COMPLETE FEE SCHEDULE BELOV
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
1500 sq~ft. or less ~ $ 85.00
Each additional 500
sq. ft.or portion
thereof ~ $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeders 35.00
B.
Sum
g-~.
30
Services or Feeders (10 Branch Circuits
included). Installation, Alterations
or Relocation:
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reco,nnec t Only
C.
$ 35.00
$ 60.00
$ 90.00
$130.00
$300.00
$ 35.00
Temporary Services or Feeders .
Installation, Alteration or Relocation
200 amps or.less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
Branch Circuits
{ $ 35.00
$ 40.00
$ 80.00
volts see "B"
.(~c:s
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Signal Circuit or
limited.energy panel
One Circuit
. .Two to ten Circuits
Each Addt'l ten or
portion thereof
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
$ 35.00
$ 50.00
$ 15.00
not included).
$ 36.00
. $ 36.00
$ 36.00
I:S).(X)
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