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Home My WebLink AboutPermit Building 1991-12-23 u ~~ 15 .. RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726-3759 . SPRINGFIELD . JOB NUMBER 9//y~ 225 Fiflh Streel Springfield. Oregon 97477 LOCATION OF PROPOSED WORK: ?"'9"":?"7 ASSESSORS MAP: /?~-:;;;-27- V / ~ 9'. ?'I'E fr?1/?'Z- J0..:> TAX LOT: ~ <>~~ SUBDIVISION' LOT: OWNER' /A#~ #":!!>L~ -5,r'uL ?;P~ '-D_ / Ad,9 " \-:. u\'\ ADDRESS: CITY: DESCRIBE WORK' NEW REMODEL~ ADDITION CONTRACTOR'S NAME GENERAI'~ PLUMBING: MECHANICAl' ELECTRICAl' QUAD AREA: SR~)lA . OF BLDGS' OCCY GROUP: . OF STORIES: WATER HEATER: BLOCK' STAT'" Ai'n. PHONF' ?C/&::-c:>3'/ T" ZIP' &7') '9";;>"/ ADDRESS CONST. CONTRACTOR' PHONE REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. rvl Rough Electrical - Prior to ~ cover. D Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framIng Insp. zl >( ~(JrhfL EXPIRES FLOOD PLAIN- ZONING CODE: . OF BDRMS: SECONDARY HEAT: SQUARE FOOTAGE: _' ln9. To request an l~spectlon, you must call 726.3769. This Is a 24 hour recordIng. AI/Inspections requested before 7:00 a.m. will be made the same working day. Inspectlons requested after 7:00 a.m. will be made the following work day. D Temporary Electric lKJ Site Inspection - To be made after excavatIon, but prior to setting forms. ~i'f... ;>/H~,IfI . ";'r'1' VPiYff~/~...."..' D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. [K] Footing - After trenches are excavated. D Masonry - Steel location, bond beams, grouting. C29 Foundation - After forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. D Underfloor Plumbing I Mechanical - Prior to Insulation or decking. o Post and "Beam - Prior to floor insulation or decking. [K] Floor Insulation - Prior to decking. D Sanitary Sewer - Prior to filling trench. " D Storm Sewer - Prior to filling trench. D Water Line - Prior to filling trench. . [EJ Rough Plumbing - Prior to cover. DEMOLISH OTHER - OFFICE USE - LAND USE: III I . . OF UNITS: CONSTR. TYPE: HEAT SOURCE: RANGE: IZJ Framing - Prior to cover. 121 Wall/Ceiling Insulation - Prior to cover. G{] Drywall - Prior to taping. D Wood Stove - After"installation. D Insert - Atter fireplace approval and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation is complete, forms and sub.base material in place. D Fence - When completed. o Street Trees - When all req"ui'red trees are planted. ".. . IZJ Final Plumbing - When all plumblngwo~iscompleta ~ Final Electrical - When all electrical work I:;> complete. D Final Mechanical - When all mechanical work is complete. IX] Final Building - When all required inspections have been approved and building is completed. DOther MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking is complete. D 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. D Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. J - Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type. Interior Corner Panhandle C u I-d e-sac BUILDING PERMIT ITEM SO. FT. X $/SO_ FT. Main Garage Carport .1.P? 1~8 If/''r?te:>I?CZ Total Value Building Permit Fee State Surcharge Total Fee (A) .. " ~ . THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by Ihe Historical Coordinator prior to permit issuance. I PL. IN Is Iw IE Setbacks 'HSE GAR'ACCI I I I I VALUE ~-9'.~6 ;z,~Y'P ~ - 7'1, S-,o ;;;.73 7E.2? SYSTEMS DEVELOPMENT CHARGE (SDC) 1/.1' . PLUMBING.PERMIT ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan (B) / N' FT. FT. FT. /?? //o/- (C) Dryer Vent Wood Stove/lnsert/Flreplace Unit N' Mechanical Permit Issuance State Surcharge Total Permit Mobile Home MISCELLANEOUS PERMITS (D) State Issuance State Surcharge Sidewalk It Curbcut ft Demolition State Surcharge Total Miscellaneous Permits (E) FEE /&7.<>':> /5.-= _77 /5: ::;::>,,5" TOTAL AMOUNT DUE (excluding electrical) (A, B. C, D, and E Combined) 9::3.7~ 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. 'Ie. 7'~ /2/'6'''/, Recelpl Number' "'??7/ ./??..f"~~ Plan Check Fee: Date Paid: ReceIved By: , ~ ~/. '- ~-- '-- ~ ~ ns Reviewed E!y r /:2-"<<:::>-9/ Date Systems Development Charge is due on all undeveloped properties within the City limIts which are being improved. ADDITIONAL COMMENTS 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 pertaining to the work described herein, and Ihat 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 t~~structi~. ~ Signature ..y~~~~~ J Date~-'2-3~/ VALIDATION: -:? -;;? B' 2.. DATE PAin 1'2-<"7-9/ AMOUNT RECEIVED /"3L/ .'1'''3 ~~ -~.~..'? '// --, RECEIPT NUMBER RECEIVED BY ~ ~f 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION ?Q'37 ~~/"';';;:~'u, ,lfz::> LEGAL DESCRIPTION 1'7 -&'~-'2 ~- 'T / _ c:>5'~c> , JOB DESCRIPTION JP;;#i'/~ ~. 4zJZ>/7'"/~~) 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 Address City Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date ". )( s#~rv~Zian ~rs Name_[~H""" l~L ~' Address '29'37 4?#-,,"e&-~~. Ci ty .c:;;~_n:r. Phone 7.yt:~&P?/'3 OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: DATE: /';?~::z ~_ '7 / RECEIPT II: '33B'2-. RECEIVED. BY: ~~....c;__ = 'F ,. /" S'.'IINGFII.::LD City Job Number 4//7'5"9 3. COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cost Sum 1000 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 Feeder $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. 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 volts $ 40.00 $ 55.00 $ 80.00 see "B" above D. Branch Ci rcui ts New, Alteration or Extension Per Panel One Circuit , Each Additional Circuit or with Service or Feeder Permit ~ $ 35.00 ~~~ $ 2.00 '-/. c- E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE 5% State Surcharge TOTAL ~"7. _b t . "t-f? 4".0."9<;'