HomeMy WebLinkAboutPermit Electrical 1992-10-16
S"'lINCFI~LO
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225 FIFTH STREET r:'~ ,;.""I,.'.:';;1[~J5~~J6'st ~~ ~iJ,l;lml!ted, ~asB~~AL P'ERHIT APPLICATION
SPRINGFIELD, OREGON 97477 8:: ,.: ~:;.i'l{l C~\v_ nGi r9tjW((~ specifiC land use
INSPECTION REQUEST: 726-3769 ~_. .~ll \ ,City Job Number
OFFICE: 726-3759 ;:;~fJI~@~" - ;\\I\~,
, 5eie..:J.~..:JI).. COMPLETE FEE SCHEDULE BELOV
1. k,:~~~ ~;lNSIT,~~~uHicfii9a ~gf\a\".~ '-+.'
~~~ ~ J) / ~ 1 ) w~ ~cw r.e3ideRt~l-Single or
Multi-Family per dwelling unit.
Service Included:
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
~ ("")
Permits are n-trans
if work is not
of issuance or if
'180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Heritaqe El ect
Address 855 West 24th Avenue
City
Euqene
Phone 344-1500
Supervisor License Number
9455 '
Expiration Date
10/1/'15
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling ;Q
Service or Feeder (~
Items
Cost
Sum
$ 85.00
$ 15.00
$ 40.00 BJ
Constr Contr. Number 63137,
C.Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
12/27/C(IJ.
Signature of Supervising Electrician
./J~ /~',~ 91/6-5
Owners Name ~ /1~h 1 ) ~ .
Address efn ym In 1 fl)
, City __ Phone . J Y
OVNER IN TALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners Signature:
--------------~
DATE:
, RECEr'i? r' i: t
RECEIVED BY:
-~\l()~~f)--~----
A .. Cl. I
lJ l' l /
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200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
One Circuit
Each Additional
Circuit or with servici'
or Feeder Permit
E.
5. . SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL '
$ 35.00
$ 2.00!J
not included) .
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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nto .If )
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RESIDENTIAL
PERMIT APPLICATION
. ,
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED~RRA
ASSESSORS MAP: \fl ( Ht}~,
LOT'
~~';:'~:~::5il""~ .~OB NY~1B,.R
. -"f"Jt.',M-!. ' ',.'
..'.,r,.." 't :WI' ~ V{j 225 Fifth Street
'.I~l..~~r .~, \ . .
'" ',':" ~..rp;:< Springfield, Oregon 97477
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SUBDIVI$iON:\\\ :.:l1 \m~,
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BLOCK:
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OWNER .rrrt\ -f_D cl,.- ~\ Q.9J\ ~~q~) PHONE, IQjO.~-nJ
ADDRESS: ' . ,S~;4 \"\"{\J. (\ &\\Q.s22,,\ -- ..~' ~
CITY_ \ \JJ~ STATE' t\)^O~ ZIP' 414 7't~
:::RIBE wo=;~o~~J\\ I:~,~Q D::SH~
CONTRACT
GENERAL:
PLUMBING:
MECHANICAL: --
ELECTRICA,I,. ~W ~ b ~lfl
QUAD AREA: 2>?~
# OF BLDGS: c:Q.
i OCCY GROUP: 't-Z'?1\ -\ N\
# OF STORIES:
r)
WATER HEATER:
,)
CONST.
CONTRACTOR #
~ (\ )
- OFFICE USE -
~:FDU~~~~' \ 'fDj
CONSTR. TYPE: \UV
HEAT SOUR~E: t=G
f..;;
RANG E'
EXPIRES
PHONE
f\~\n~~1
f\~h ~&l
AD B. S
o l~StJ9~ ~
tG~~u/lL\~~ ~\2Jru!l.8!J3{l ,arl4~I~
FLOOD PLAIN:
ZONING CODE:
we)
~
# OF BDRMC:'
-
SECONDARY HEAT:
SQUARE FOOTAGE:
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 made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
~ setting forms, .--::: """J
l:Jmler6Ia~ DI'U;...hl.Q / Electrical/
1\II..,.h"'Rk:al - Prior
'1'V'1 Footing - After trenches are
~ excavated,
o Masonry - Steel location, bond
beams, groutl ng.
rQ Foundation - After forms are
~erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
o Underfloor Plumbing/Mechanical
-, Prior to Insulation or decking,
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking, _
I':7i Sanitary Sewer - Prior to filling
!,b.J trench,
~ Storm Sewer - Prior to filling
trench: '
/,'
i4water,Llne,.;... Prior to filling
trench,
" .
. '
,,'
.. ," . "
,} ',":,:0", ',R~.~ij~;ip'l~~~b.lng '+ ~rlor)<?:
"'\ . cover' I '", ,'. , '
. .' .... . . , ! . '. : . ~ ,'1 J
I .... ~" '. i "r'. . .
"~.,:~ '~f~~!k;'~/a~~:'Set.uP - W~en 'all
. I()cklng ,I~complete., '
," , .: ,: "" - '. .
: l'~;.'.~m, '.:~I~'Q. q~.~'ne,Ctl9nS '-: When,
, ': "home;;hal;l~ ,QflEfn qonnecteo to
. ,., ...f.: ,-4.......1.
. .,:: ,wateri,a!1'r',!:Il~~er\," . :'. ,'\, " ,
,.; >, ,,\,{'<~':' ;:~"" : ,:. , ,.,
~t:lec'rlcal Connection - When
. , locklng;;setilJP. .and ,plumbing
, ',....lnSR~(itl()ns.',have;'b'Ele'nlapprbvea
. ,:..: and ,th'e',home.ls"connected t6 .
. ~. ' "'." -.. " -. -
: the service panel. -: . ' ,
. . ' . .~ ~. '
O Fence When completed" " ,..,' ".,11 ' ", ';"0'" ,", '
- . ,-.C'..;. ,Iii:" .~. '. ,'''i-.....,,}, ~ "'>1" \.f.'~ " '!'. ,.,', , I
.. '~", I i:r )\, Ci '.., . ,....",;q). ~ r" II '<'~ I.. '"
". I. . '.;; . ..t.~.. <'I 't~tt. t-' "'{~J,I~;t "'~'\l)" I ~!. . ,t, I' .'.' .~. I '.
"", ",- 'I, ",,' >:,.:", " :;,; ::.: . '" 'F.lna' 1~.1;Wr'''^''f~'''e'r''''a~II't'eq' ul'r~d,r i, ,,',,': ," "
..~' . I.. ,_ ,I -:...~'~ ~""l , . _''''''11,' i ::\.~,. l"~.'" .1 ,....... I
. . \ jli' .,. . 't' '(' ~11''''''~ .. 'Iii ~u'" &tJ~,,-.(,"V!!.~t..~0ol"""'o-/. ,'rt' '.11' d' J..1i';d' ,j,~l'f
_ '" .t....;~:".f,t~~~. :. .t~. \1~'1' :.,:..,.... "'~.;.,:'",.!;.l.,.. ,.... \. S e 0 s ar..a rove 'art '~.tli'.'" '. '
[2]' s' '~l...~t' Tr"""" ,~\ J'IW' 'ti",.J,;.i~!lIijrL,..tJ;""'''I-' ';./.~. ...~ l't.f ,: g')~t' ".[l. '~..!~~P"""'"'''' 1\:1: -.'\'1,1 '~f.." 'I ,"
'. \' rea" ae8,~ en:a lIre u rey, '~,,"'.\:,t( ',~ 0 ,,~. ~. ">, ' '!',I' ~ " . ;
, ",. 'tr~~s'l81re~'p" fan't~fiC1.::':S:K<'~fc..,;ltiJ:f..~~ ';Iti'i'~;;~.~'';::~~,~ 5~eefl~Jd~ii:~f}~r..~tn91~~~t'~i~:..~~~k~:V ..!A' , d, :'
. ., ~ . ';:.~-l~l;1"~'~"", "!:~~:'1~1.-\;),lr.'.~~ '. t:'r~~~... \,l 's'.r.VI4 ~ - '~~l':l""',. i'i..~~ ~ "\~ .. '~"I.~' f.:.,!. ~,'
. p_ ." , "~"'l' ',h~"".\ ...:'{'>If"t!....~:.'''..:'tt\4l..I\.'..1 ,'1,. l';;':" 'o't, ,I;... '("1", '
. . .. ~ -I ~'. '.I' ..""' ... I ~ 1 I ~\ "I . . .
o Rough Mechanical - Prior to
cover,
k--7f Rough Electrical - Prior to
lAlcover. to qaA~
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp,
~ F,.mlng qM~
o Wail/Ceiling Insulallon - Prior to
cover. .
o Drywall - Prior to taping,
D Wood Stove - After l~stallat'lon,
o Insert - After, fireplace approval'
and Installation of unit. '
::., " '. .' ':,~: . ; " ,...:. I;:,; . .
I~ Curbcut & Approach - After ','; ,
~ forms ar~ erected but prior to .'
placement ,()f Qoncrete,
..
.. . .'.f T
o Sldewalk:&: Driveway,.... After
excavatldrHs Qomplete, forms'
and sub,base material I~,place.',
j'
o
Final Plumbing - When all
plumbing work Is complete,
D Final Electrical - When all
electrical work Is co pi
, ~
o Final Mechanical - When all
" ,mechanical 'work Is complete.
~' ,
Final Blilldlng - When all
requlr~d Inspections have been
approved and building Is
, completed. q
o Other
MOBILE HOME INSPECTIONS
. ...~ "
. : .,'. ..
10
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-
Lot Ty,pe . '
.. "~ ., ...'r '.~ ,: r :;;.:' ;'. . ~', " ~:>~'q'!;. 'I p. 'L-'~"
J'1'~')" 't ... ~~. " .' '. '.. 1:\1,," '. ~ . .' ..
",". ....':Ir\tE3rlorl,o ~ '~",,'c ,'"
. - ..', :"...... ~ .",", ',:', ..;. ~.~;:l~~~' ,"l." ~..; I, ':"';;!!~iiY I ~f'
. " , '!{,' :.,"'::. ';\(~t: ':N'" " ' ,. . , ..:'
" " Corner" :c('., . . .'
.~... '.'~li~~,I}.,~,.;.:: ,~I~; .'..,.. . .':-~:' ','
'Panhandle S
.:-:'~\ .:1 I
' ..- W
~ Cul.de.sac
IE
If>/' _.
(& THE PROPOSED WORK IN THE
'~IISTORICAL DISrRICT. OR ON
THE HISTORicAL REGISTER?
Lot' faces
l . ~~i.,"",~~}~ I ".""~ ~~~.':_:~.
Lot, sq'" ftg.. '.' ';' .
" ',,'. ;1.:_,(,',",:,
Lot coverage
',1
Setbacks
HSE ;GAR: ,ACC I,
I
I
Topograp~y
Total height
, , ,
.'
,_ I.t
,.
BUilDING' PERMIT'
ITEM SQ, FT: '
" '.
Main
{1){ 0
<f '
Garage
,C rpo~~ I
Total Value
Building Permit Fee
~r(84)
State Surcharge
Total Fee
(A)
1
SYSTEMS DEVELOPMENT CHARGE (SDC) ~
, " , (B) ~ \ ~y.~~..L
FEE
..rx,.CD
f ~.CXJ
r;:) ,c;b
Plumbing Permit
State Surcharge
f]c:=) ,00
'l~.f)5
f)~. 'f5
Total Charge
(C)
, ~ : . .. ;,... ~ ,.. :.......' ~;:., ",,:,.j -
MECHANI'CAL:~"PERMIT .
, ,
,Furnace
Exhaust Hood
Vent Fan
NO,
Wood Stove/Insert/Fireplace Unit
Dryer Vent
. ',"
Mechanical Permit,
. '
Issuance
State Surcharge
Total Permit ' '
" . " '(D)
". I'. ,',
MISCELLANEOUS PERMITS
. , l' ,'.
.
\05.00
rYO.oO
,~
1/3.'+5
Mob)leHom,e',
,.
State Issuance
State Surcharge
, "
Sidewalk ,'It
Curbcut &..B..- It
Demolition
State Surcharge
".~ . eO, ,
Total Miscellaneous Permits I (E):
TOTAL'AMOUNT DUE (excluding e/e:ctrlcal~ L.f1
(A, B, C, D, and E Combined)
, t~
: ;'~~f)
t:
:'~"
'"
I~'l
~,
,',
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance,
- I
APPROVED:
" .
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: ~
Date Paid: -~-t\1I- ~_/
Receipt Num er,., \~
, \
~s Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
~+T:
- ~
3, 500
\~ l)Tto~ \V\~QU
o0tlf-UG GCX'Xct (lQ.rtl'\
-
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify tllat 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 pertaining to the work described
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 time; 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 site at all times dUringY7stru on,
Signature I -'// /: :::3" L.
CJ --
Date /0 - /~ -q Z.
.
VALIDATION: ~C;
RECEIPT NUMBER l () ,
11 J I
DATE PAID ,~~.
AMOUNT RECEf::f, ~~!)"/3..
RECEIVED BY ~,xL-l
.
. '-...
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SPRlttFIELD
DEVELOPMENT SERVICES
PUBLIC WORKS
METROPOLITAN WASTEWATER MANAGEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726-3753
MANUFACTURED HOME SET-UP AGREEMENT
As required by the City of Springfield Development Code, I understand and agree
that with the approval of the attached1\~~~ts,~~e'~f t~llowing
manufac tured homes will be placed at _ ~ :-'f-t U llill ~ ~\ ^ 0 rr+ 'l
Springfield, Oregon, Ci ty Job Number .~~4,;J.Q . -
'" Ty~e I Manufactured Home. A multi-sectional (double wide or wider)
unlt with an enclosed floor area of not less than 1,000 square feet,
that has a nominal roof pitch of 3 feet in height for each 12 feet in
width, that has no bare metal siding or roofing, and that has been
certified by the manufacturer to have an exterior thermal envelope
meeting performance standards which reduce heat loss to levels
equivalent to the performance standards required of single family
dwellings constructed under the State Specialty Codes.
Type II Manufactured Home. A unit of not less than 12 feet in width
with an entlosed floor area of not less than 500 square feet, that has
a nominal roof pitch of 2 feet in height for each 12 feet in width and
that has no bare metal siding or roofing.
I further state, by my signature below, that I have been provided with the
following information:
- Manufactured Home blocking
- Yater line connection
- Street tree standards
- Sanitary sewer connection
- Electrical connection
- Minimum requirements for permanent steps
I also understand that if I am installing a Type I Manufactured Home, the home
shall be enclosed at the perimeter with stone, brick or other masonry materials,
and with no more than 12 inches of the enclosing material exposed above grade.
"" _p_ /' ,e:
~nature
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/0 -/?" -qz..-
Date