HomeMy WebLinkAboutPermit Electrical 1998-8-5
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
ASSESSORS MAP'
LOCATION OF PROPOSED WORK' /0 () ~
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ADDRES~' /00 1 idNC- tZ-1 t::J (;-1::
511/1.-00-'1). /),.."J
LOT'
OWNER'
CITY'
DESCRIBE WORK'
<<51Ld
NEW
REMODEL
CONTRACTOR'S NAME
BLOCK:
STATE: OA.
121
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ElI:"2.n( J
ADDITION
DEMOLiSH
.~
JOB NUMBER
1f{0972..
225 Fifth Slreet
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
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PHONF'
)l;{, -3/7 0
OTHER
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A~~ T
ADDRESS
/JW AI cit-
CON ST.
CONTRACTOR'
.:":,
I rll;:' t't:I1MII ::iI1ALL t:XPIRE IF THE wr
--At;THi:;!iiZCiJ VI~IJl:11 I NI::i t"t:HMII IS
- OFFICI1QMMENCED OR IS ABANDONED FOh
QUAD Al\If1f"I\ITI()N:Ore.!lon law requireS y~~~ USE: _ ANY 180 DAY PERIOD,
rules adopted by me uregon
. OF B~B~ -... ~"e€e rilles are seb\9I!1ilJITS:
NotifiCi:lIIOIl "",ng.. , AR 952-001-
OCCY lii~or;?-nn1-001 0 through 0 f(Jj\!'WfI. TYPE:_
U ma obtain caples of the
. OF s9g\l1~~0. y 'er.("-+o"hetelePR!111.11 SOURCE:
call1n91'''' ~g... . .. - ., Notification
WATER IiMliBer lor the Oregon Utlh~344) RANGF'
(',,"tAr is 1.800-;J;j<<- .
GENERA' .
PLUMBING'
MECHANICA' .
ELECTRICAL:
I
/
I
l~vliCc:
EXPIRES
PHONE
(
FLOOD PLAIN:
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 a.m. will be
made the same working day. Inspections requested after 7:00 a.m. will be made the following work day.
!?fTeiftporary Electric
~.
D S InsDectlo~_= ; &.~/j,p., 1
r Rf'J:.!_ (511&7))-----
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o 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 10 floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
D 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 obtnln permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
@mlng - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to laplng.
D Wood Stovo - After Installation.
D Insert - After fireplace approvlll
and Installation of unit.
D Curbcut & Approach - After
(orms are erected but prior to
placement of concrete.
o Sldewall< & Driveway - After
excavation Is compietc, forms
and sub.base material in place.
D Fence - \tVhen completed.
D Slreol Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing w9rl< Is complet.e.
~:Inal Elect Ical - When all
( '---.J. electric ork Is complete.
o Final Mechanical - When all
mechanical work Is complete.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water .1.nd 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 al/ required
Inspections are approved and
porches, skirting, decks, and
ventlng have been installed.
Lot faces
L~I ~ype .
Lol sq. Itg.
InterIor
Lot coverage
Corner
Topography
"
Panhandle'
Total height
Cul-de-sac
BUILDING PERMIT 'i,
'~t
ITEM
SO. FT.
X $/SO. FT. -
Main
Garage
Carport
Total Val ue
Building Permit Fee
Stale Surcharge
Total Fcc
(A)
I PL.
IN
Is
w
E
VALUE
"
'2,()() .:>
3.2.. s-v
35. I (
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Tot~1 Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
. yent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge I
I:::-z. EZ TJt..<."'-'
Total Miscellaneous I"ermlls
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
.sr.sz...
','.'
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. (. THE PROPOSED WORK tN THE _
"HISTOI;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
afld approved by the Historical
Coordinator prior to permit Issuance.
, .:.
Setbacks
HSE GAR ACC'
APPROVED:
, ., .' .,
BUILDING VALI:1E, 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 Clty.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'
'J.-l /3
Date Paid:
Receipt Number'
Receive~J iJ ~i
Plans Reviewed By
?/,/n.-
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 J have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and cC?rrect, and I further certify
that any and all work performed shall be done in accordance
with the Ordinancljs of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thai NO OCGUPANCY 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 .Inspectlons 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.
Slgnatur~
Date
VALIDATION:
RECEIPT NUMBER
DATE PAin
AMOUNT RECEIVEr>
RECEIVED BY