HomeMy WebLinkAboutPermit Building 1990-10-15
00 RESIDE~AlALoo.
" APPLICATIONYffRMIT
225 North 5th Street
Spri ng f'i e ld J Oregon 97177
Building Division
7,~G-37 5'3
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SPRINGFIELD
rob Loa:lti::)71: b335" ..0A-/s: '1 # / z ""2-
16::c830r:: Map H /70 2- 3"3 00 Tc;:r Lot II
Yi.bdivision:
0/ 300
::unCI': WAa(b4-) WM V LJ ~k:-A
I 7~/- O~9:2-
4ddress: 5/Irr16 Phone:
City: c:::.,;::;A?/ d R ,?/e( () I'J#< Zip: ~?479./
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Date of IIppZicatien___
:on t rae tors
.:eneral
Receipt .'1
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Describe r\'orl~:
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Address, Lise. n Bidrs
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(.01 ,q-m SLf.)
tJ::,./lti&A._1
) J.ulIlb:i.ng
~leclHlnica.l
~J.t;:c t ci.!;u 1
511peL',..-:tt;;r.l,g Elec t r:ie iLln
----.- -
, Value
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Signed:
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Date:
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It is tho responsibility of the permit hoUder to see that all inIJpections are made at the propep time. that each ~dress is readab!e '
[rom the street, and that the pernrit cal'd is located at the fl'Ont of the property.
~!Jui!di,'1g tr:vi::io~ approl:ed plan s1u;U remain on the Building s.it$ at aZZ times.
[!,70C.<:DU!?E FOR [NSPECTION R::QUEST,:CAll 726-3769 (pecorderJ state your City desi!Jnated job nwr.ber, job address, type of ill3pea~ic/l
l'cque8ced ar.d wherl YOIl will be ready for inspcction. Contractors or OWners name and plwne number. Request8 peceived before 7:00 cr:I
~'ill be made the same day, requests made aft~r 7:00 = LliU bcmade the next :JOrking dny.
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&2aHZ:llcd TnSr1(YJt1:cntl
I sn.~' INSN.Y.."."JON: To be made after
--1 excavatioll, but prieil' to set up of
[m'ms. '
-J ~"'.~F.R~LA,B PU'~\IBING, ELECTR~C,1L &
,,!r.. I. II..L 11 1..i1 L: To be made before any
---- wol.k is ~ov(Jr'ed.
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t'(JI!'l'TNG ~ FOUND.1TTON: To be made
ai't.el' tJ'i::>lU;'CS (H'e excavated and
i'm'",:; QJ'C crectad, bllt prior to
pOZil.'>tltj ccnCI'et.s.
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U!ID~!I(;!IO//;;,D P::UM,'3 [NC, s.<:rff.!?, W,1TF.!/)
li,'!~U.!!!.l(;!~: 1'0 be ",a::1e pJ'ioJ' to Ii l-
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1III/lE.'!."'f.OO!! 1'[,/JI,!!l[,VG ,~ MECHANICAL:
t.' .'hi mll<le pJ"ioJ' to 'irwtallation' of
{I ~".".imJilla t'ion or deeking.
I'O:':'!' :111/) BF.,1,',I: To be made prior to
7~';,Jt;;l/.~ticlI of fZool' i71sl<lation 01'
I "'~l'II"
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.'IO!'{;.'I ,"[,(I,'!lif:'.'C. Er.F:CT.'1!CA:: ,~ MF.ClI-
.,111' r....X!-::'.. ,'ia - :J01'1: 'ia to be <,:o~'ered
;;;~!"Tl'i;lJ{)se 'illspeet1:or:s have beer.
mnde ,ulll apPl'ove.:!.
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,. r1H'I'1 11'''''
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tf!.; C:t)~': (f t::
(:in::.
P['1:or to plaeir.g facing
IlIld be[or'e fJ'(Uning inspec-
-J ,".'1..1.','1:';,,;: ;'!J/::t be reqllBIJted aft;ep
;;;..j;-;~;,'~~I. Dr I'ouah plwr.bing, c:Zectri-
"..zi ..; :::.:.:hllli~a7... Ill! rOOfing
1"'W'i"..1 ,~ <:hi/fmcys, et~. nr.18t be
G(,ll!l!,I.:r.,:/, Nil IJ:Jl'k 'ia to be eOTl-
c.1<':I.../ :<llt,:' /. t:l1l::: 1:1l8pcation has
. lh'l''i -:l.il' ,nl.! appt'ot.'cd.
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Your City DeIJigrnted Job Number Is:
D INSULATION/VAl'OFl BARRIER INSPECTION:
To be made after all insulation a~.d
, required vapor barriers are in place
" "but l;'efore any lath, gypsum board 01'
wZZ covering is applied. and before
any insulation iIJ concealed.
D
DRYWALL INSPECT!ON: Te be made
aftel' aZZ dl'ywaU is in plaoe.
but prior to any taping.
MASONRY: Steel location, bond
beama, grouti7lg 01' vertieals in
aceordallce with U.B.C. Section
2415.
WOODSTOVE: After instalZation is
cempletcd.
DEMOLITION OR gOVED BUILDlilGS
~ Sanitary 8B'.Jer ::apped :It property line
..-J . ", ',I ItI"~ 1",'tl'h"'t~"1f.h~\,.'f":" 1.,1; iki... I~'
:=J Septi~ tank p:imped and [i Had wi th tjl'Cl:Jc l
I Final - m,en above items are ccmpZeted
--1 and when demolition, is complete 01' stn,-'-
ture moved and pr~mi3es ::leaned up.
Mobile lIemes
~'BloCking and Set-up
/ , b . . ---'
:~P~um .ng oannect.ans -- sewer a~ wa~er
"~lcctrical Ccnneotian - Blocking, set-lip
, and plunwing oonnections nr~st ce approved
efopc requestiTl!J elec~rical inspec~io~
=:J Aa::esGory Building
~ Final - After porcr.es.' skirting,
~etc. are completed.
I
decks,
D
D
D
CURB ,~ APPROACH AP.'WN,: Afte~ forms
al'e cre:Jted bl4t pl'iol' to pouring
"on~re te.
~
-
-
D
SIm;rIALK ,~DRIt'Er/!.Y: For all oon-
crete paving within street right-
of-wcy. to be made after all exca-
vating complete & fo~ work & sub-
bane material in plaae.
AU pl'o.fect conditions, :me.': aa tile ~',nstallation of stl'eet treea, "eo,~pleti.on of tne
l'equired lmld::r:r.p1:ng, etr!., rmwt be satisfied before the BUILDINC FINAL aaTl !Ie r~qllelltsd.
FJNIl!. BUnDING: TI1C final Building Inllpeetion nnlOt be requeIJtod after tltC ,~'i'l(!l PlwnbiniJ
Elcctrical, and Mccllar:ielll Inspectio7ls }zqVC beeTl made cj.ul approvad.
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':11.1. f.l.lN/lGU:S ..1Nf) r.U:i1NOIJT:: II/I,".'T m: .1CO:s:;mLP., IID,IUST!!.':N'!' TO BE f./AnE ,~T NO r~ST TO C['!'Y I'r:1~~'~ ' of :!
D
fENCF.: J.'her. compl.>te -- Provide
gates or movable sectionlJ throug~
P.U.E.
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Lot Sq. Ftg.
S af lot Caverag~
,~ of Stories
Total. Height
Topography
Interior
Setbacks
/loUGe ' r.arane
I AaceSll.
,
L-COC;"
Iledroomo: ~""),.
Ener17/f So,wees ~ '/';I/'(!
Heat
Water !lea tel'
Ran(1e
, Firovlacc
Wood:;tove
~
JOB NO. q()/{)5,1
SOLAR ICES S :EQ,-
OccupanclI G : R.~ ~
WT 'TYPE -1 [,at Faces -
I
I P.L.
North
East
South
fvest
Tyve/Coy:st: .
Zone:
Corner
Panhandle
Cul-de-sac
Fees
TTEM
SQ.FTG
/ X
Va lue
Building Value & Permit
This pemit iIJ granted on the exprells condi tion that the :;,!l:,i ,~(lI1" I ,'ilL' I,,:on
shall, in all respccta, confom to the Ordinance adop ted })y d,,) : 'i I I, ',l[
Springfield, incLuding the Zoning Crdinance, regulatill(J the ':<::111;/)';"'/1:':11
and uoe of buildings. and m:;.y be sucpe'lded 01' revoked at r.;I:Y t ;:"1'< 1Ii',}11 I) 1:';-',
lation of any provisions of said Ordinallces.
, ,
Main
I Ga:raGe
Caroort
Accessoru
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Is.D.c.
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State Surcharge
Total Charges
~
, Plan Check Fee:
Date Paid:
Recdpt II:
Sig~ed:
, '
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Buil.ding Permit
lITEM
I Fix,tures
IResidential. (1 bath)
'sanitary SeLJer ,
I Water
1Lf0 ~ '"
NO.
FEE
CHARGE
--
Plumbing, Permit
No person ohall conlJtruct. instal?. at.ter 01' challge allY lleW C/' e;::il;t;i,lI(1
pl.umbing 01' drainage syste.~ in whale 01' in part,' udess Glwh pel'GOII I:'; 1:11,..
legal possessor of a valid plumber's license. except that a perGO'1 mail Ii,;,
plumbing LJork to property which is owned. leased or operated by tho apl'l.I:-
cant. '
Total Charl1es
\ % .00
( 6,bO
l'l~
J~ .rt<:; ..
FEE CHARGE
Electrical Permit
'Plumbing Perr.:i t
State Surcr.arge
, 1 n'M
I Res. So. fto.
I NalJ/Ertend Circuits
I Temporary Ser-vice
I
NO.
Where State LarJ requires tr.at the electrical LJork be done by all E,'lectl'ic,r!.
Contractor. the electrical portion of this permit shall not be vaLid wztiL
the label has been signed by the Electrical CO'ltractor.
El.e~trical Permit
State Sur~har!1e
Total Charges
i A
1T5M
NO.
FSE
C/lARGE
Mechanical Permit
Furnace ETU' S
I E:haus t /lood.
Vent Fan
WXJdstove
Peoot Iasuanc2
Me~hanical Permit
State Surchar17e
Total CharQelJ
-- ENCROACHMENT --
..
SCC'".lritu D2D03it
-'
Plan Exam1.ner
vate
Stora(Je
Total Chal'ges
I ..
,I HAVE CAREFULLY EXAMINED the completed application for permit, and do
hereby certify that aH i~fo~ation hereon is true and corr~ct, alld I
further certify that any ar.d all. work performed shaH be dO;'le in aC::Ol'-
dance with the Ordinances of the city of Springficl.d. and th:: La:.;s of tho
State of Oregan pertaining to the work describcd hel'e-:.n. and that NO OCCI)
PANCY wi LZ be rmde of any structure LJi thout pemis3ion of ti,e Bu i ldinfl Di
visian. I further certify that O:1Zy contractorlJ' a,:d e'77pl"yees wl:o are ill
c~~pliance LJith ORS 701.05S LJill be used on this project
Maintenanl,e
Pcmit
Curbcu~
I Sidm.J.:J. lk
I Ff!"~e
EZectrical Label
-
B'1.:.JS
l 'S. 'IS
I S,A.S
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V ~A/1AJA'
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[1.11,,:
tJ\e\io, . ~_ ,
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I TnTAr. AMOUNT DUE: 4 -
,
SP.FiEL:J
. 'i 'IIi ~_'1!ll.!1.i 1..=:'"6' l
E.Hiscellan~ous (Service/feed~r
-Each installation '
Pump or irrigation
Sign/Outline Lighting
Signal Circuit or
limited energy panel
,,~ . I ",,-
225 FIFTH STREET
SPRINGFIELD" OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1;. LOCATIOJ!, OF ~ALLATION J...L. \ n h '
' ' S6u~' \..)(\~'"M' ~ A.
LE~ DESCRIPTION' , ~~/'\ '
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'(\" JOB DESCRIPT. ~t<?N _ -1\
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Permits arenon~transferable and expire
if vorkis not statted within 180 days
of issuance or if vork is, suspen~ed for
180 days.
2. CONTRACTOR INSTALLATION ONLY
, "
Electrical Contractor
Address
City
Phone
. '
Supervisor License Number
Expiration Date
Constr Contr.Number
Expiration Date .
Signature of SuperviSing Electrician
Ovners Nam~(L--\-\tffi ~Uctn )0.
~ddr.ss 5.")?>..C; tu ~ ~ lzi:
Ci 'y 0\}~\&' Phon. 'l41-{)2Cl Z,
OWER INSTALLATION'
the installation is being made on
' property ,1 ovn vhich is not intended
,for, sale, lease or rent.
Ovners Signature:
~.21fl /Y74~ '/ t! ~f'~
~~~~~----T!)-~T- ,~----------~----
RECEIPT .: ' /~1I1 . I \A i ~-=-o
RECEIVED nY:~/\ )
5'. '
ELECTRICAL PERMIT APPLICATION
City Job Number' qO 1c9b-
3. COMPLETE PEE SCHEDULE BELOV
Nev Residential-Single or '
Hulti-Family per dvelling unit.
Service Included:
Items Cos t
Sum
1500 sq. ft. or less
Each additional 500
sq. ft or portion
thereof '
Each Hanuf'd Home or
Modular Dvelling
Service or Feeder
$,85.00
$ 15.00
\ $ 35.00 ~~
B. Services or Feeders Cio 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
, f
Reconnec t Only ,
$ 35.00
$ 60.00
$ 90.00
$130.00,
$300.00
$ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 35.00
201 amps to 400 amps $ 40.00
Over 401 to'600 amps $ 80.00
Over 600 amps or'lOOO volts see "B" above
Branch Circuits
Nev; ~lteration or Extension Per Panel
One Circuit
Tvo to ten Circuits
Each Addt'l ten or
portion thereof
$ 35.00
$,50.00
$ 15.00
not included)
$ 36.00
$36.00'
SUBTOTAL OF' ABOVE
5% State Surcharge
TOTAL
$ 36.00
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Permit' No:C'.,D \~ CS \ ~""
'Addr~ss: ' h?;?~S ~~' LDAA ~r2Z
Issued bc::1~ Ol) , Date:, }O/''6f1o
/ '
ST A TEM ENT:
,.'INFORMATIONNOTICETOPROPERTY OWNERS
'ABOUT CONSTRUCTION ,RESPONSIBILITIES
Note: Oregon Law; ORS701~055(4), requires residential.buildfngpermit applicants
,'who are not registered with the Construction Contractors Board to sign the
following statement before,the,building permit can,be issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submi,t t~isstateri1ent. This statement,will be filed 'with the permit.
'Fill in the applicable blanks; and initial. box 1 and either box 2A or 2B:,
/
1. I \I I I own, reside in, or will reside in the completed structure.
2. A.I \//, My general contractor is' ~S;,\\.S'~[',..~ _
Contractor registration n~mber ~ \ C\\a4- 4 \ 4ql
~&1s
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
/
B. , ~/ I I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. If I change my mind and (jo hire a general
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 Applicant
Date
CONSTRUCTION CONTRACTORS'SOARD
0244J 10/24/89 ' , ,,' ,"
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E COpy TO ISSUING AGENCY PERMIT FILE
K COPY TO APPLICANT '
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