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Home My WebLink AboutPermit Plumbing 1991-12-13 . .' RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 '. SPRINGFIELD LOCATION OF PROPOSED WORK: --1/ '2.19 ASSESSORS MAP' /7-,?r3-":<,? -3/ LOT: BLOCK' 7) r- /? ~ <d!/-JCl ?( ) ADDRESS: / / ~) /fll ';O~ {j I' S. LA ~ ::;:;.. CITY: _ ~~~ J'1h~/r! , -,y ~7 V'II'~~~41'::." OWNER: _Rl<:'l <J DESCRIBE WORK' NEW REMODEL CONTRACTOR'S NAME GENER~ PLUMBING: ?/9(!/~ MECHANICAl' ELECTRICAl' ~ W'- ;-f&n-1 ~ STATE: ADDITION DEMOLISH OTHER . JOB ~UMBER. 9#~55"" 225 Fifth Street Springfield, Oregon 97477 I. ~~~e tJv- TAX LOT: ~"""'~ ~ SUBDIVISION: PHONF' ZIP' ADDRESS .J ~ U/2, 'k.., ( CON ST. . CONTRACTOR' EXPIRES ~ .//~:>1C:-1 ~.2..U)(.~ ~ PHONE REQUIRED INSPECTIONS D Rough Mechanical - Prior to cover. D 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. o Framing - Prior to cover. D Wall/Ceiling Insulation - Prior to cover. .' D Drywall - Prior to taping. o Wood Stove - After Installation. D Insert - After fireplace approval and Installation of unit. D 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. D Street Trees - When all required' trees are p!anted. . - OFFICE USE - QUAD AREA' LAND USF- FLOOD PLAIN' . OF SLOGS: . OF UNITS: ZONING CODE: OCCY GROUP: CONSTR. TYPE: . OF BDRMS: . OF STORIES' HEAT SOURCE: SECONDARY HEAT: WATER HEATER' RANG~' 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. D Final Plumbing - When all plumbing work Is complete. D Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing/Electrical/ Mechanical - Prior to cover. D Footing - After trenches are excavated. . D Masonry - Steel 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 decki ng. o Sanitary Sewer - Prior to fltling trench. o Storm Sewer - Prior to flIl1ng trench. D Water Line - Prior to filling trench. , o Rough Plumbing - Prior to cover. D Final Electrical - When all electrical work is complete. D Final Mechanical - When all mechapical work Is complete. D Final Building - When all required Inspections have been approved and building is completed. DOlher MOBILE HOME INSPECTIONS [LJ Blocking and Set-Up - When all blockIng is complete. I""AI Plumbing Connections - When ~ home has been connected to water and sewer. ~ Electrical Connection - When blocking, set.up, and plumbing inspections have been approved and the home is connected to the service panel. eEl Final - After all required .inspections are approved and porches, skirting, decks, and venting have been installed. . Lot Type .. .THE PROPOSED WORK IN THE \ , Lot faces Setbacks Lot sq. ltg, Interior p.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON I THE HISTORICAL REGISTER? Lot coverage Corner N If yes, this application must be signed Topography Panhandle Is I and approved by the Historical Iw I Coordinator prior to permit Issuance. Total height - Cul-de-sac IE I "- .APPROVED: . ,~ , . BUILDING PERMIT ITEM sa. FT. x $/SO. FT. VALUE Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' Sanitary Sewer FT. Water FT. FT. Storm Sewer Mobile Home A'?H' jkP/J~? '1':"' - t? /;/- I~~ "'>';;:- ~'v jS:'~ Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stovellnsert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS ~~""'e> ~-;?5" ::<~ p-e> Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B. C, 0, and E Combined) /t.~, ...~ 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: Recei pt Number: Received By: Plans Reviewed By 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 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 during construction. -........--.... ,.,...- Signature l\7N:-... ~\~,l\l\.~ -~ 1 - Date _/$ fh--1" /' VALIDATION: ;s ~ /2 /-:2. -,0-0/ AMOUNT RECEIVEn / $'ii". __e.. --z.~ ,//~ RECEIPT NUMBER DATE PAID RECEIVED BY S'-'IINGt-"IEI.D (- 225 FIFTH STREET .' . . " . SPRINGFIELD, OREGON'97477 INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 . city job Number ~//o/'S S- , , 3. COHPuITE FEE SCHEDULE BELOI! , . w . _, 1.. LOCATION OF INSTALLATIwt II~ ./'?3P/ h'0'c.re-" ~ .;;;f 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 theredf ' $ 15.00. Each Manuf'd Home or Modular Dwelling ~ fc? Servi'ceor Feeder $ 40.00 LEGAL DESCRIPTION I 7oy;S3-2-::>:':":7>/ ~6c::;:ri:?' , JOB DESCRIPTION #/#EccCc;-O-.. , 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 B. Services or Feeders Installation, Alterations or Relocation: Electrical Contractor Address $ 50.00 $ 60.00 $100.00 $130,00 $300.00 $ 40.00 200 amps or less, 201 amps to -',DO amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only City Phone Supervisor License Number Expiration Date C. Temporary Services or Feeders Installation, Alteration or Relocation Constr Contr. Number Expiration Date 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" Signature of Supervising Electrician above D. Branch Circuits Owners Name J?pt?" /J:i!?~,,-#~ Address / /4:;:> J59/;;1jI//~~-;;;' Ci ty ~t2;> - Phone New, Alteration or Extension Per Panel $ 35.00 One Ci.rcuit Each Additional Circuit or with Service or Feeder Permit O\INER INSTALLATION $ 2.00 , E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Ovners ~ature: Limi ted Energy/Res )t~ '-k: ~~iinited Energy/Comm ------~-------------~--------~---- 5. SUBTOTAL OF ABOVE DATE: /;2 </?.::j'/,' 5% State Surcharge RECEIPT II: "'::?::?/2. TOTAL RECEIVED BY: .;...-;7~. , r.b"- The installation is being made on property I own which is not intended for sale, lease or rent. not included) $ $ $ $ c/c::>, ~ 2-. -- ~=<- -~ 40.00 40.00 20,00 36.00 . . " . -e t(,5 I ~Mtl/' ~ J ~A'P7 ' ICA~. I 1'1- ~ ~ ~At;~ -z, g ,r ~/ // ' IICJ~ &; 5~//7' - -5?*'? ~-, 1/2~ rA/~ V/c~..} . 1 ~ '" \lit " ( '5 j! '1'/1 . ~