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Home My WebLink AboutPermit Building 1991-8-7 ~~ LOCATION OF PROPOSED WORK' 3"7-7 ~ c.~~;P~ I-f(-A,-;Z -~~ . 15 ~~.#€~ If/lE-L f ,(,7'//? 1?/c..HL~.Hb. &::;%47 :D_ _ :,r,' ~ I' DESCRIBE WORK: U.fl'7~r~ ~.E ~.h-f~.cY. .b~~'7?~/1 er~/~). REMODEL ADDITION DEMOLISH OTHER ~l , " RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726:3759 ASSESSORS MAP: . , LOT: OWNER: ADDRESS' CITY: NEW CONTRACTOR'S NAME GENERAL: ~~~~ PLUMBING:. . MECHANICAl' ELECTRICAL: ~.-v.N:~ . .. 9/~/=1' SPRINGFIELD }fr:> BLOCK"" STATE: /p)? . JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 . TAX LOT:. O~?~ SUBDIVISION' PHONE: ?7r-::;-/?-:$#!Y w- ? ~tt:.c;"':? Y' ZIP' ~C7/~ ADDRESS CON ST. CONTRACTOR # PHONE EXPIRES - OFFICE USE - QUAD AREA: LAND USE: FLOOD PLAIN' # OF BLDGS: # OF UNITf' ZONING CODE: OCCY GROUP' CONSTR. TYPE: # OF BDRMS: # OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER' RANGE: 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. o Temporary Electric D Site Inspection - T9 be made after excavation, but prior to setting forms. o Underslab Plumbing/Electrical I Mechanical - Prior to cover. D Footing - After trenches are excavated. D Masonry - Steet location, bond beams, grouting. D Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. D Underlloor Plumbing/Mechanical - Prior to insulation or decking. D Post and Beam - Prior to floor insulation or decking. ~ D Floor Insulation.- Prior to decking. D Sanitary Sewer - Prior to filling trench, D Storm Sewer - Prior to filling trench. D Water Line -'Prlor to filling trench. D Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. rVJ Rough Electrical - Prior to ~ cover. o Electrical Service - Must be approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ILl Framing - Prior to cover. o Wall/Ceiling Insulation - Prior to cover. D Dry~all - Prior to taping. D WO~d Stove - Aft~r Install~tlon.. . D Insert :...... After fireplace approval and installation of unit. D Curbcut & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms. al)d sub-base materIal in place. D Fence - When completed. o Street Trees - When all re~qLljred trees are planted. . - . D Final Plumbing - When all plumbIng work Is complete. [K) Final Electrical - When all electrIcal work is complete. D Final Mechanical - When all mechanical work Is complete. ~ Final Building - When all required .Inspections have been approved and building Is - completed. DOther MOBILE HOME INSPECTIONS D Blocking and Set-Up - When all blocking Is complete. D Plumbing Conn~ctions.- 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. D Final - After all required . inspections are approved and porches, skirting, decks, 'and venting-have been Installed. j Lot faces Lot Type. Setbacks . THE PROPOSED WORK IN THE , Lot sq. ltg. Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT. OR ON IN I THE HISTORICAL REGISTER? \ \ Lot coverage Corner Is I If yes, this application must be signed and approved by the Historical Topography Panhandle Iw I Coordinator prior to permit issuance. Total height Cul-de-sac IE I APPROVED: BUILDING PERMIT ITEM SO. FT. X $/SO. FT VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT , This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Main Garage4n"'.'~',_ ~2...p t2_S)iS. y~ Carport Plan Check Fee: Date Paid: Total Value ~$!l.;57::>' t./..q., jO':? 7""5 SYSTEMS DEVELOPMENT CHARGE (SDC) Receipt Number: Building Permit Fee Received By: State Surcharge Total Fee (A) Plans Reviewed By Date (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being Improved. PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Fu mace Vent Fan N' 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 that NO OCCUPANCY wi/I be made of any structure without permissIon of the Bul/ding Safety Division. I further certify that only contractors and employees who are in compliance with GRS 701.055 witl be used on this project. Exhaust Hood Wood Stovellnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) 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 ~s during construction. . Slgnatur.{'}~ /J ~ ~- / / Date tr- 7 - q/f MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk lt Curbcut lt Demolition State Surcharge frNC~ (/~OC),G>-6J VALIDATION: -6:. C:>,;J' ~c>? 7 ~ DATE PAID r:?~ '-<7 ,/ AMOUNT RECEIVEfl ' / .6 "2 :;2..'3 /2?- RECEIVED BY RECEIPT NUMBER Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) /.08. 93 .. , ) 225 FIITH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 City Job Number ~~~~~ OFFICE: 726-3759 1. LOCATION OF ,INSTALLATION "'3??~ /~Z>E;Z;> If>z:> LEGAL DESCRIPTION /,z-,-;>::!. -~,:;, - ~ C>'9?_t:> / JOB DESCRIPTION /;0 7-?/kc;. /..6 4A??~~ 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 Signature of Supervising Electrician Owners Name )'?cS7:?#E.ir ,1P/~C. Address -;;;?/t:> jq/c#?.R-"Y.D Ci ty <jz,rL-;r;> Phone 72~-/ /#~ " OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Ma~e~ - ~- ..L. . - --- --- - ---~---- DATE:~/-9/ RECEIPT II: -::2~ 3" ~ RECEIVED. BY: / ~ ~r-' ' 3. COHPLETE FEE SCHEDULE BELOV A. New Residential-Single or Hulti-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 --- $ 50.00 ..$i2. ~ 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 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 40.00 201 amps to 400 amps $ 55.00 Over 401 to.600 amps $ 80.00 Over 600 amps or 1000 volts see "B" above D. Branch Circuits New, Alteration or Extension Per Panel. One Circuit Each Addit ional Circuit or with Service or Feeder Permit ~ $ 35.00 $ 2.90 6- _ crl> E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lightin~ Limited Energy/Res Limited Energy/Comm not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 5. .::) ~. -.... . '2_~.:s ~9_ !:tC> SUBTOTAL OF ABOVE 5% State Surcharge TOTAL .' . . ( -, .. Permit No: '9/69-/<::3 Address: }:7? ri C!A<PE..:? ~ ~ Issued. by: /7 /. P. Date: ~.~/ .' ,/ / STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law,ORS 701.055(4), requires residential building permit 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 submit this statement.This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 2B: 1. l';L..J I own, reside in, or will reside in the completed structure. 2. A. L-.J My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. L-.J 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 00 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. s~~er~A~/ K~?-Cf/ Date '\ "". 'i ~1_. CONSTRUCTION CONTRACTORS BOARD. 0244J 10/24/89 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT ~,.