HomeMy WebLinkAboutPermit Electrical 1991-5-28 (2)
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RESIDENTIAL
PERMIT APPLICATION
Inspections; 726.3769
Office; 726-3759
LOT;
.
.
SPRINGFIELD
.
CJ I~S)
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
BLOCK;
\
TAX LOT: 'fil ~
'.-'SUBDI~ISION;CL} ,11m;p J1!) ,
OWNER: H\f){1[y) J ,.(JIJ" \ 1lI Jrtr\Q.A:)
ADDRES~ 1\ .-' T .1X'n.j;
CITY: C;:.1 ~5L\\ CL (j STATE; l\).l;) ~ ZIP:, qt"\OQ-.>
DESCRIBE WORK; JRx~!L 0JJ\J'\~o .ffinhiLg) IT\,\:i ~Q ,',::J..I}fl6
NEW REMODEL ADDITION DEMOLISH OTHER \ ~', ~;.Ll.cp
PHON'"
lo~~. C\, tL:~
CONST,
CONTRACTOR'S NAME t ADDRESS . CONTRACTOR'
GENERAL: M.I\Q{) \wdun <~4. ffiO ~ 1'\ 4\<t!l2-
PLUMBING: (-c1J\.Q1l . li'lQffi \1'\..; ~'2:\.. ~ 4. \ n~ 1 fJ-.
MECHANICAl'
ELECTRICAL: ~ ~~
QUAD AREA;
. OF BLDGS'
I R. ^J \A.J
I
R3
J
'T
OCCY GROUP'
. OF STORIES:
WATER HEATER:
EXPIRES
\\1\2.~1
1\ !JZ,!C:t \
PHONE
r\lLl" ~ 111 I
f\M\f\\.
'Bt:fJca I...L:> Q.4.'*"l. l o~Y~'l \ '2.\1.. f\ -r \ .~-\Cf{\"
~ OFFICE USE -
LAND USE: I.Jf,D FLOOD PLAIN;
. OF UNITS: I ZONING CODE: UJR.
CONSTR, TYP'" . OF BDRMS' ?,
HEAT SOURCE: F:;;-~ SECONDARY HEAT;
RANG~' '7 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. wilt 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 - To be made
after excavation, but prior to
setting forms.
o Underslsb Plumbing/Electrical/
Mechanical - Prior to cover.
[2(]' Footing - After trenches are
excavated.
D
Masonry - Steel 'location, bond
.beams, grouting.
D
Foundation - Aft'er forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
D
Underlloor Plumbing/Mechanical
- Prior to Insulat"lon or decking.
D
Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - ,Prior to
decking. .
BSanitary Sewer - Prior to filling
trench.
~ Storm Sewer - Prior to filling
trench.
~Water Line - Prior to filling
trench.
o Rough Plu,mbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o 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.
o Framing - Prior to cover.
o 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.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
[2(t Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material in place.
o "Fence - "When completed.
o Street Trees - When all requrred'
trees are planted. ,
D
Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed,
o Other
MOBILE HOME INSPECTIONS
~Blockln9 and Set.Up - When all
blocking is complete.
~Iumbing 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.
~ Final - After all required
- inspections are approved and
. porches', skirting, decks, and'
venting have been,instaJled,
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SYSTEMS DEVELOPMENT CHARGE (SDC)
~"2..I.~
Lot faces
L~JYpe.
~ Interior
Lot sq, ltg,
Lot coverage
Corner
Topography
, Total height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
JY\14
f'.\ , ~JrrvP,
Total vQe
Bullding Permit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer
FT,
FT,
FT,
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
,
Furnace
j
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFlreprace Unit
Dryer Vent.
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
bB
It
Sidewalk
Curbcut
lt
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
Setbacks
I P.L. HSE GAR ACC
IN
Is
Iw
IE
VALUE
FEE
dE, Dl:>
;::;)~r;:lO
;::;)s, Of)
I';, ,m
3./5
1~,7S
~ ,;;} S
IS./S
S~S
10,00
1ri.C1 ,d~
c.. c..r;; ,?:f-/
J
I
. THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER
If yes, this application mu b igned
and approved by the storlcal
Coordinator prior to per t
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition th the said
construction shall, in all respects, conform to t Ordinance
adopted by the City of Springfield, eluding the
Development Code, regulating the cons ction and use of
buildings, and may l(a "'..~ ended 0 evoked at any time
upon violation of any provis ns said ordinances.
Plan Check Fee: ~{'}.
Date Paid: \~~
/'Pians 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 t street, that the permit card is located at the front
of th p perty, and the approved set of plans will remain
e at I times during construction.
~~~
1::- )..J(- '7 I
D te
VALIDATION: .1") / ( 7\
RECEIPT NUMBER OI() au
DATE PAID /'S .2..R. C1/
A,MOUNT RECEIVl=~'1J I
RECEIVED BY (_ . -.
L~ -
__..' J.
.
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
that with the approval of the attached
manufactured homes will be placed at
Springfield, Oregon, City Job Number
Development Code, I understand
permits, one of the'following
&:,9n 'rR.()r~C<ALP~
~ 1l)<;:,S{) .
and agree
g
Class A Manufactured Home. A manufactured home of not less than 24
feet in width and 16% (not less than 2:12) roof pitch, with exterior
dimensions enclosing a space of at least 960 square feet, with roofing
and siding materials that are commonly used or compatible wi,th si te
built homes. /
o
Class B Manufactured Home. A manufactured home of not less than 12
feet in width and 16% roof pitch, with exterior dimensions enclosing a
space of not less than 500 square feet, with roofing and siding
materials that are commonly used or compatible with site built homes.
I further state, by my signature below, that I have been provided with the
following information:
- Mobile home blocking
- Sanitary sewer' connection
- Yater line connection
- Electrical connection
- Street tree standards
- Minimum requirements for permanent steps
X' ~ujg t'.~
Sig ture ' , I
6- 'J-'t-9./
Date