HomeMy WebLinkAboutPermit Building 1992-10-5
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APPLICATION7~ERI1IT
225 North 5th Stl~eet
sp~ingfield~ O~egon 97477
Bui lcZing Vii,iDion
726-;)753
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ob [,oc::!:ion: Jtf ( (!A5c;fptf"' Zh __ ..... \
"",,'m '<or ,I f) () ~30 ~ ~ ,.~ wt/! (){)Y)aJ
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Date of ilpplicnticn
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Phone: 7V ( ~ /1 Jb . ~,i .
Zip: 97Jf7?-7JJ <{
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Date: '- / ~ (6~~.J!?? '
Address
Va Iue ~. c:::sr::>
Lise. g HIdrs ROilrd Reg.
Phone
Your' City Deaigmted Job Number' Ia:
Exp'i"c.es
It in the reaponaibility of the permit holder' to see that all inapections a1'e made at the proper' time, that ec:ch .::.ddr'e8s is r'ea~ab:e
(r'om the atr'eet, and that the per'mit ca1'd is located at the fl'ont of the proper'ty.
'~hl1".!di~g ':D-:.v'i~1".0~: approved plan ahc.ll l'emain on the: Bu-:.ld1".ng S-its at all times.
';:WCEDU!?E FOR INSPECTION lIEQUEST;CALL 726-3769 (recor'der) state your' City designated job number', job address, type of inspeaticn
..cqucsted a.,,:d when you win be l'eady for' inspcct-:.on, Contr'actor'S 01' OI.mers name and phone number'. Requests r'eceived befor'e 7: 00 c::1
,'i lZ be made the 'came day, r'equeats made after' 7: 1)0 am wi II be made the next ;,)()rking day.
?enU7: pet!. J n!)T)r?(! 't"?:Crl.c:
] SITE' IN,'il'EX','JON: To be made
excclvati:Jn, bu t prier' tc se-t
fOr'ms.
aflOe?'
up of
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UNDF.:RS[,ilB PLUt-rBING, ELECTRICilL,~
,','F:CII;lNICIlL: '1'0 be lIlade befor'e any
ti'or',': is ,-,overed.
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F'OO'l'INC ,p, FOUND,i'nON: To be made
a/ter' tl'el/CheD ar'e excavated and
j'O!"lI/D ,u'e erected, but pr'ior' to
P('1U2.<l:r.g ccnC11etc:..
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U:W'SRG.'?OU!W !'[,UN:JINC, SEf.fF:!?, f/.iTE.'?,
DHAU/..1GF: '1'0 be made pr'1".01' to fil-
T.,:/:u trenches. .
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UiJ/J!:.'!!F'[,OOR T'UH!TUNG ,~ MF;c!/ANTCilf,:
'to /)C lIlade Pi':io!" to i/,,;tattat;'idn of
j"I,ooI'inDul;;tion or decking.
."OST AND BEAt',!: To be made pr'ior' to
1:-;';,; I:a I !",L'iCI/ of flool' inm; lation or
(!cck.-l:ng.
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INSIJLilJ'ION/VilPOR BilRRIER INSPECTION:
To be made afte~ alt insulation a~n'
r'equir'ed \ vapor' bm'r'ier's a1'e in place
but befor'e any lath, gypsum boar'd Or'
wall cover'ing is applied, and befor'e
any inaulation ia concealed.
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DRYf/ilLL INSPECTION: To be made
atter all. d!'y'JaU is in place,
but pr'ior'to any taping.
MASONRY: Steel location, bond
beamD, gr'outing Or' ver'tiaals in
accor'dance UJith U.B.C. Section
2415.
WOODSTOVE: After' installation is
ccmpteted.
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CURB ,~ ilPPROilCH APSON: AfteY' fOmlS
are cr'ected but, pr'ior" to pour'ing
eon~rete.
.'IO!'''-;!/ !'UJ!!TJff!G. r::r.F:C1'II!CAT. r, MEC/I- D
;'ii'U'(;.'l!.: No c!o1'l: 'ii3't'O he cover'ed~
T~~!;':[i~U~osC] .~.n'C~pect-ioi:{J h-;rve beer.
!:In:!t:' ("nul C7.ppl'ov.e:? . ~ ... - ~" ~~'-
/T"::,'!'/..4CE: f'r>1".0r' to placing facing '.,.'
!;;~~-I~~,-;7',:;T;; ul1d hcfor'e fr'anring inspec- .
SIDEfII!LK ,~DRIl',.:f/I.Y: For' aU con-
cr-ete pav'ing w'itll'in str'eet r'ight-
of-wey, to be made after' all 'exca-
'v~ting compl,ete.. & fom'!JOr'k & sub-
"bas,e 'mater'va.?;' in :R~~ce., '.
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!'ENCR: h/her: complete -- Provide
gatea Or' movable aecticna thr'ough
'P./!. R.
_'"./_',] !'I!..1.'.'flJr;: :.Jw;t be r'equeatecl aj'tel' D
^':: ;:;i'/!."('t.1c;/.oj' !'oZiUh plumb1".ng, eleetr'i-,
""If, ,;; l/:e;,hull'ical.. ill,1 r'oofl".ng
f.J.(!,::inU .'; "hl".mnc!jH, ct~,. nnwt ue 0
c(:mlpZec.(yf. No uX:)J-.k is to he con-
e,~d,ed IInt,n,th1".S 'inapection haD
'h(;e,l Intul,:' ([!/(-! dpprovcd.
DEHOLITION OR ,~:OVE[; BUILDIiJGS
:=J Sanita1'Y se-Jer' capped ,at p:opcr'ty Zir:e
~ Septic tank p~~ed and filled ~ith gr'a~el
I Final - mIen abcve -items a1'e completed
~ and ~hen demolition is complete Or' 8tru~-
tUr'e'moved and pr'emiaes oleaned up.
Mobile Hemes
~ Btocking and Set-up
~ Plumbing connections sewer' and water'
I Eleatr'icat Connection - Blocking, 8e~-'U?
~ and plumbing, aonneations nr~st ce apPr'oved
befor'c r'equesting electrical inspec~ion
~ Accesaor'~ Building
I'Pinal - After' pOr'ches, skir'ting, decks,
~ etc. a1'e aompleted.. "
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ilU pr'oJect condit1:ona, mw!: aa the ~',nstaUation of str'eet tr'ees, co,.;pZetion of tne
.roequir'ed landsaapir:g, etc., must be satisfied befor'e the BUILDINC PINAL can be r'equested.
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PINAL BUnDING: The Pinal Building Inspection must be r'equeated after' tlze ,r!'inal Plumbing
Electr"icaZ, and Mechar.1:cal I1,1iJpections have been made and appr'oved. "
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'il U. /./MJ//C/Y:,: AN/) CU.';1NOUT" 'f/!,',"/, m: ACCF::,;,jTnLF:, ilD.JlJ87;,'!F,'N'I' TO .'Jp n~DF: .4T NO C:JST 7'.0 Cf'!'Y
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1~~(7e
of 2
\ JOB NO.
I Zone:
Lot Sq. Ftg.
:b of lot Coverage
II of Stories
Total Height
Topography
lITEM
SQ.FTG
Main
Garaae
Carport
I Accessorl/
I !#~/X
I'-
IS.D.c.
TOTA[, VAWE
(vaLUe)
1.5 x
BuiZding Permi t
State Sux>cha:rge
Total Charges
L-CU\,'
SOL A RAe C E S S R E Q.-
,~
Occupancy Gr/-,
LOT TYPE
Interior
Corner
Panhandle
CuZ-de-sac
x
VaZue
g~~
,
I
/7. 5'c;>
_ tJ 'B-
IP.."3~
FE'E
CHARGE
lITEM
Fixtux>es
ResidentiaZ (1 bath)
Sanitary Sewer
I Water
Numbing Permit
State Sux>cf:arge
TotaZ Char(1es
NO.
CHARGE'
ITEM
Res. Sa. fto.
New/Extend Circuits
Tempora:ry Service
EZeatricaZ Permit
State Surcharqe
TotaZ Charges
ITSM
Furnace ETU' S
Exhaust Hood
Vent Fan
I Woodstove
I
Permit Issuance
MeahanicaZ Permit
State Sux>charoe
TotaZ Charqes
-- ENCROACHMENT --
Se~~rity Deposit
Storage
Maintenanae
I Permi t
TotaZ Chargo8
eurbcut:
sidewaZk
Fen:Je
I Electrica Z
I MobiZe Home
I
I
I TOTA[, AMOUNT DUE: ~
[,abet
1.''10.
I NO,
I
I
FE,CE
FSE
CHARGE
I
I
79'- 76
Type/Canst:
B!-?dl~OClf,';r; :
I [,ot Faces -
I
I P.[,.
Worth
lEast
ISou th
!r,rest
F:nerf/21 So;n'~('r,
Heat
r,ratel' .'lea tel'
Range
FireDl.l1ee
Wood;; t01.:e
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_______n__"___
Setbacks
I House I Carage
I
Access.
1--1
II I
F.?es
Building Value & Permit
This permit ia granted on the express condition that the :;,11:,: " 1;,'
shaH, in alll'ecpects, conf.orm to the Ordinw;ce .'Cldoptl',j he; I.i" ',',
SprinafieZd, including the, Zoning Crdinallce, l'p.(!ldati":J Ule e,;","
and use of buildillgs, and In::.y be suspended or revokec. at e,,!!
lation of allY prDvisions of said Ordinances.
'!'lall CI",ck /.'1'>': II.. '~~
Date Paid:
rRecdpt II:
ISig~cd:
Plumbing Perrrdt
No percoll glzDll 'conat!'uct, instaZZ, alter 01' clzan:;" (;JI!I I:C'.) 01' C.::"';'; I, ;
pZwnb-ing OI' drainage syste:n in ;,;hole 01' in pa],t, Wile:;" auclz 1"'C1":0I/ i,: ; I;,
'legal poases,gor of a valid plwnbel" s license, except tl:at c: pC:'SOI! "';,l~' ,:,
pZwnbing wo!'k to l'ropel'ty which ia owned, leward 01' OPCl'c.t,;d ,"u 1,1;,' "i
cant.
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Electrical
Perm it
Where State [,aw requ'ires' that the electrical ;';O]'K be done L':J em ;;l,;.,tl'i,."j
Contracto!', the electrical portion of this permit IJhaU 'lot be VC1Zi.}, ,o:! I:'
the label IUlS been signed by the Electrical :7ontl'C1ctOl'.
~
Mechanical Permit
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r/Xaminer (/'.... /' I
I HAVE CAREFU[,[,Y EXAMINED the completed application for permit, and do
hel'eby certify that an info:,mation hereon is true and correct, an:i I
further cel'tify that any ar.d an work perfol':ned shall be done in acco]'-
dance with the Ordinances of the city of Springfield, and th;:; [,a;.)s of the
~ State of Oregon p<!Jrtaining to the work C.68cI'ibad herein. and that NO OCCU-
PANCY will be made of any structure without permis3ion of the Buildi,zg Di-
vision. I further', certify that o:'-l..y contractors al;d e:npZ.:Jyees wl:o are in
compZiance with ORS 701.055 win be used on this projsct
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225 FIFTH STREET
SPRINGFIELO, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1 ~ LOCATION OF INSTALLATION
5"T' G:0s L.4.. d e...
LEGAL D~SCRIPTION /Y ~ . "
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ELECTRICAL PERMIT APPUCATION
Ci ty Job Number' 9~ '9Pc..>
3. COMPLETE FEE SCHEDULE BELOV '
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is. suspen~ed for
180 days.
2. CONTRACTOR INSTALLATI~N ONLY
Elec trical Con trac tor 8e-rO..v-d Lfec....:\'vtc...
Address ..2 t &j () I ~ I-\. ..I) L c.. 1f: ~6
Ci ty _ ~p -r l d.. . . Phone jL..f /-259 t,
Supervisor License Number ~? (,5'-1.5
Expiration Da'te Jf'1o /C>-/-92.
Constr Contr. Number S1610
Expiration Date /1-/1-10
Items Cost 'Sum
1500 sq. ft. or less )<. $ 85.00 ;;;:'!>~
Each additional 500
sq. ft or portion I- 'Ib--~
thereof ' $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 35.00 '
B. Services or Feeders (10 Branch ,Circuits
included). Installation, Alteratipns
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
Reconnect Only
$ 35.00
$ 60.00
$ 90.00
$130.00
$300.00'
$ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Signature of Supe:rviSing Electrician
/1 ~ J-1.~
Owners Name
Address
City Phone
OVNER INSTALLATION
The installation is being. made on
property .1 own which is not intended
for sale, lease or rent.
Owners Signature:
--------------------------
DATE: /~-::?.9~t:;5
RECEIPT .: ~' i!!$ ~ c ~ ,
RECEIVED BY: . .~~
, , ,,-.
200 amps or less $ 35.00
201 amps to 400 amps $ ,40.00
Over 401 to' 600 amps $ 80.00
Over 600 amps or' 1000 volts see "B"'above
D. Branch Circuits
New, ~lteration or Extension Per Panel
One Circuit
Two to ten Circuits
Each Addt'l ten or
portion thereof
5.
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
E. Miscellaneous (Service/feeder not included)
-Each installation .
Pump or irrigation
Sign/Outline Lighting
Signal Circuit or
limited energy panel
$ 35.00
$.50.00
$ 15.00
$ 36.00
$ 36.00 '
$ 36.00
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