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Home My WebLink AboutPermit Plumbing 1992-4-14 ., RESIDENTIAL PERMIT APPLICATION . Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK' ::J \ M ASSESSORS MAP- tlT'\Sf.\-~ \L"" OWNER: _(~Jll n -t t ~ \9 .fl Q%D ADDRESS _~~4 me) ~S\ ~J' n-, rv, . CITY: ~~N . - STATE:~ DESCRlrY)RK:~ ~ 'Q~ \'\ '{L{\u). . ~o NEW _y REMODEL - - ADDITION DEMOLlSU OTHER I ~~ CONTF#\CTOt.!. NAME l... \ ,"\ n i\\~RESS c::::.rY)." .A ~~T~CTOR . EXPIR~~-.., I P'~~lE11 GENERAL: _L.A~X' q _ ~ f( r\ (. U,L'-" \ \ \.,.11 U \ rL-ln (.J\ PLUMBING' \. \ \ '\ \ MECHANICAL' .. .r-- -: " ........lL - . 1'1\. \ ELECTRICAL: -~- ~. ~~'-~ ~~n C-).illQU) I J- 12J$:ffbJ2Iy~) OUAD AREA \ Q \\u) . OF BLDGS: \.- OCCY GROupL ~ . OF STORIES: r WATER HEATER: _7 / LOT: BLOCK' - OFrlCE USE - LAND USE: \ \ ~ . OF UNITS' CONSTR. TYPE: HEAT SOURCE: ~ f~ RANG'" C(-..--/ . JOB NUMBER q fJDs1f- 225 Fifth Street Springfiel<l, Oregon 97477 TAX LOT' SUBDIVISION: V~'l) PHONE: IR lo~Al.1 1-/ ZIP: UJ1~b )~ FLOOD PLAIN: lDr ~ ZONING CODE: . OF BDRMS: - 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 3.m. will be made the same working day, Inspections requested after 7:00 8.m. will be made the following work day. o Temporary Electric D SlIe Inspection - To be made alter excavation, but prior to selling forms, o Underslab PlumbingJ ElectrlcalJ Mechanical - Prior to cover. o Footing - After trenches are excavated. o Masonry - Steel location, bond beams, grouting. o Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. o Underlloor Plumbing/Mechanical _ Prior 10 Insulation or decking. o Post and Boam - Prior to floor Insulation or decking. o Floor Insulallon - Prior to decking. o Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling Irench. o Water Line - Prior to filling trench. o Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS o Rough Mechanical - Prior to cover. D Rough Electrical - PrIor to cover. o Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. o Framing - Prior to cover. o Wail/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. o Wood Stove - After Installation. o Insert - After fireplace approval and Installation of unl t. o Curbcul & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub.base material in place. o Fence - When completed. o Street Trees - Wh~n all mquired trees are planted. o Final Plumbing - When all plumbing worl< is complete. D Final Eleclrlcal - When all electrical work is complete. o Final Mechanical - When all mechanical work Is complete. o Final Building - When all requIred inspections have been approved and building Is completed. o Other MOBILE HOME INSPECTIONS ~OCklng and Sel.Up - Wilen all I (' ~IOCklng Is complete, ~lumblng Connections - When orne has been connecled to water and sewer. ~ctrical Connection - When locking, set-up, and plumbing inspections have been approved and the home Is connected to the service panel. ~'nal - After all required inspections are approved and porches, skirting, decks, anel venting have been Installed. Lot fades Lot sq. ltg. Lot coverage Topography Total heighl BUILDING PERMIT ITEM SO" FT, Main Garage Carport Total Value Building Permi t Fee State Surcharge Tolal Fce Lot Type. Interior Corner Panhandle Cul-de-sac X $/SO. FT. (A) " r . THE PROPOSED WORK IN THE -. HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be slgnod and approved by the Historlcal C,oordinator prior to permit issuance. Sot backs I PL HSE GAR ACC IN Is Iw IE VALUE SYSTEMS DEVELOPMENT CI:lARGE (SDC) (B) PLUMBING PERMIT ITEM Fixtures Resldontial Bath(s), Sanitary Sewer Waler Storm Sewer Mobile Home Plumbing Permit Stale Surcharge Total Chmgc MECHANICAL PERMIT Furnace Exhaust Hood Ven I Fan N' FT. FT. FT. N' (C) Dryer Vent Wood SlovellnsertlFlreplace Unit Mechanical Permit Issuance State Surcharge Total Permit Mobile Home MISCELLANEOUS PERMITS (D) Stale Issuance Slate Surcharge Sidewalk lt Curbcul lt Demolition Stale Surcharge Total Miscellaneous Permits (E) FEE . uJ. IS. l_c;,~ . I J~. )ry=)cD ~n.CO l ~ ca<; TOTAL AMOUNT DUE (excluding oloctrical) (A, B. C, D, and E Combined) APPROVED' BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granled on Ihe express condition lhallhe saId construction shall, in all respecls, conform to the Ordinance adopted by the Cily of Springfield, including the Development Code. regulaling the construction and use of buildings, and may be suspended or revol<ed at any time upon violation of any provisions of said ordinances. Plan Check Fcc: Date Paid: Receipt Number. Received By: Plans Reviewed By Dale Systems Development Charge Is due on all undeveloped properties wilhin the City limits which are being improved. ADDITIONAL COMMENTS By signature, I stalc and agree, that I have carefully examined the completed application and do hereby cerlify 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 will be made of any structure witho~t permission of the Building Safety Division. I further cerllfy that only contractors and employees who are In compliance willl ORS 701.055 will be used on this project. I further agree to ensure thai all required Inspections are requested at the proper time, that each address is readable from the street, that 010 permil card is located at the front of the property, and the approved set of plans will remain Athe site~e~ during con4"n. inalure~a ~~ Date '-1- /'-/ - 9:;1... VALIDATION: 4r:2.Q.O RECEIPT NUMBjR ~<-;' DATE PAID 4. \4 .q. - AMOUNT REC~. . \ ~ RECEIVED S'" .:.;;t\ I ~ I I I I I I 1 I I I ___ J"" '\ PA ~.~~ ~ I I I I I I I I I I I I 1 1 I I I I I I I I I I I r--~ / I _?o"L'~-Tf --"7U / M, .. I "'-"'FA~~ 'I Ik 4, - I/Il,<;, I, I '~ I , , I ..~',j --'--- -- ~--- . r' ~ " p V R -r 1 , .\ ' i ...:k.. , , , I ' , , I ----,---- . I -----------((-~--- II ~ jIY::::'=~ r(~~( c...\ ,./b,-t. \;1 -~~R (A--- \J '1\ ~~ ~1OfOJ':.-L1bIA -. PI~R::. c<:'ON'~ .:;Ik'J~'" .1 V) ... , I I / I I I A I 1 I , I ~-1 , I I I '--l I I I I I I I I I I I I I I I I I I I I I ......... 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 \ 4fRf1)~#m \ -1fl)~~t) 044rY) m~uE~~or-tarO 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 (-1. J\ Qf\ t-~')OJtQ~ D. Address ~"'\ \f't\..1 f\..., Ci ty ~f- I~ Phone =r:J frT~ { 7/ OWER IN ALLATION The installation is being made on property I own which is not intended for sale, lease or rent. rs Si ature: ~ (j~~ :~:~:-:;4-~]~~~P--~~;~l RECEIVED BY: l / )~ . S.".IING':II.:.LU City Job Number 3. COI1PLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling uni t. 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 \ 4f) Service or Feeder $ 40.00 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 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 $ 40.00 $ 55.00 $ 80.00' volts see "B" above Branch Circuits New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) $ 40.00 $ 40.00 $ 20.00 $ 36.00 5. ~~ SUBTOTAL OF ABOVE 5% State Surcharge TOTAL