HomeMy WebLinkAboutPermit Building 1999-04-02IESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726€769
Offlce:726.3759
'Qlt q/7
@,
225 Flfth Street
Sprl ng f leld, Oregon 97 477
LOCATION OF PROPOSED WORK:{)o L-
ASSESSORS MAP:TAX LOT
LOT
-
BLOCK:SUBDIVISION: -
f7o
okSTATE:ZIP:77 "77
7oz-
,k oa,s 7g- orOWNER:
ADDRESS:
CITY:
,4.p4DESCRIBE WORK:
ADDITION DEMOLISH OTHERNEW- REMODEL
ADDRESS
t?tQ
EXPIRES .1 PHONECONTRACTOB'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR '|
FLOOD PLAIN:
ZONING CODE: _
, OF BDBMS:
-
SECONDARY HEAT_
SQUARE FOOTAGE: _
-800-3q?EA?s,unce,is1
pcaltlng
--frIifrbET'fortts0re
, OF BLOGS: 009o Ynrr mav obtain cop es by
the center. (Note:
gon UqfrfSknifiEtsfiEn--
EA:
setarerulesoseThecntericationNotifQUADARthro0ffi1dgmmuffi2'oo1-
follow rules adoPted bY the O r us$ls
OCCY GROUP:
r OF STORIES:
FIANGE:
To request an lnspectlon, you
made the same worklng day,
[-_l remporary Etecrrtc
[--l Slte lnspectton - To be madeu after excavatlon, but prlor tos6ttlng forms.
n Understab ptumblng/Electrlcat/
-
Mechanlca! - prlor to cover.
l-l Foottng - After trenches are|J excavated.
l-l tvtasonry - Steet locailon, bond|J beamg, grouilng.
E Foundallon - After forms areerected but prlor to concreteplacemont.
Waler Llne - prlor to fill lng
Plumblng - prlor to
Mechanlcal - Prlor to
ugh Electrlcal - prlor to
Flnal Plumblng - When altplumblng worl( ls complete.
must call 726'3769. Thls ls a24hour recorcllng. All lnspectlons requested before 7:00 a.m. wlI belnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
!RED INSPECTIONS
Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
E
lnal Eleclrlcal - When all
cal work ls complete.
nal Mechanlcal - When allmechanlcal work ls complete.
requl
Bulldlng - When ailred lnspectlons have been
fl Unaerground ptumbtng - prtoru to rllllng trench.
l-l Underttoor ptumblng/Mechantcal
Prlor to lnsulatlon or clecklng.
l-_l post and Beam - prtor to floor
-
lnsulatlon or decklng.
n Floor tnsulallon - prior to.J decklng.
- Prlor to cover.
/Celllng tnsutatlon - prlor tocover.
I - Prlor to taplng.
[-l Wood Srovo - Atter lnstailarton
MOBILE HOME INSPECTIONS
lnsert - After flreplace approvaland tnstallatlon of unlt.
n Blocking and Set.Up - When ail
-
blocklng ls complete.
approved and bulldlng is
completed.
Plumblng Connecllons - Whenhome has been connected towater and sewer.Sanltary Sewer - prlor to fllllng
trench.
Curbcut & Alrproach - Afterforms are erected bUt prior toplacement of concrete.
n :r"nl Sewer - prtor to fililng.J trench.
Sldewalk & Drlveway - Afterexcavatlon ls complete, formsand sub.base materlal in place.
Fence - When coiilpleted.
Eleclrlcal Connectlon - When
p_t9crl19, set-up, and ptumbtnglnspectlons have been approvedand the home ls connected tothe servlce panel.
l-l Streer Trees - When ail requtred
-
trees are planted.
Flnal - After all requlredrnspecilons are approved andporc_hos, sklrtlng, decks, andventlng have been lnstalled.
JOB NUMBEB
PHONE:/
tl
Flreplace - Prlor to faclng
materlals and framing lnsp.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
__
-
lnterlor
-
Corner
.- Panhandle
-
Cul-de-sac
J THE PROPOSED WORK tN THE.
HISTORICAL DISTRICtr. OR ON
THE HISTORICAL REGISTEFI?
-
lf yes, thls appllcatlon must be slgned
and approved by the Hlstorlcal
Coordinator prior to permit lssuance.
APPROVED:
PL.HSE GAR ACC
N
S
E
This pernrit is granted on the express conditlon that the said
construction shall, in all respects, conform to the Ordlnance
adopted by the City of Springfleld, includlng the
Development Code, regulating the constructlon and use of
ouildings, and may be suspended or revoked at any tlme
upon violation of any provlsions of sald ordlnances.
Receipt Number:-
Plans Reviewed By Date
LuE, r
GPE
c ECKHLAN
D N MR IT
Plan Check Fee:
Date Paid
Received By:
BU I LDI NG
AND BUILBUILDING PERMIT
ITEM SO. FT.
Main
Garage
Carport
VALUE
(A)
Ul-
/f
/+
lfoo* -
>7uu
Total Value
Building Permit Fee
State Surcharge
Total Fee
X $/SQ. FT.
Systems Development Charge ls due on all undeveloped
properties withln tlre City llmits which are belng lmproved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
J 5?
,()
(c)()
FT.
Nr
FT.
FT.
_f
,{o
PLUMBING PERMIT
Plumbing Permlt
State Surcharge
Total Charge
57) *
By slgnature, I state and agree, that I have carefully examlned
the completed appllcation and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I lurther certlfy
that any and all work performed shall be done ln accordance
wlth the Ordinanccs of the City of Sprlngfleld, and the Laws
of the State of Oregon perlalnlng to tho work descrlbed
herein, and that NO OCCUPANCY wlll be made of any
structure without permission of the Bulldllrg Safety Divislon'
I further certify that only contractors and employees who
are In compliance with OBS 701'055 wlll be used on thls
proiect.
I further agree to ensure that all requlred lnspections are
reguested at the proper tlme, that oach address ls readable
from the street, that the permlt card ls located at the lront
of the property, and the approved set ol plans wlll remaln
Slgnature
colitructlon.
Date
lJuna
Lt->-11-
on the site at all times durlng
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Total Mlscellaneous Permits (E)
MECHANICAL PERMIT
iov
/0. t,,
qr/ ?t
L(,, Z,o(D)
N0
/{, o"Mechanical Permit
lssuance
State Surcharge
Total Permit
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut _.-- lt
Demolitlon
State Surcharge
Furnace
Exhaust Hood
Vent Fan
073t7
t-
VAI.IDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVF.D
RECEIVED BY
TOTAL AMOUNT DUE (excludlng electrlcal)
(A, B, C, D, and E Comblned)
16.
SPNINGFIELt)
the following
land use
225 FIFTE STRBf,flC U-l-qr ELEGTRICAL PERHIT APPLICATION
SPRINGFIELD. OREGON 97477
INSPECf, ION REdIJHSf !"d ?IE!S?& City Job Nunber {r
LEGAL DESCRIPTIONlafi 2L/ 3
OFPICE: 726-3759
1. LOCATION OF INSTALI.^ATION
o
0
3. COHPLETE FBE SCEEDT'LE BELOV
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home. or
Hodular 'Dvelling
Service or Feeder
s 8s.00
$ 1s.00
s 40.00
/ bYoo
JOB DESCRIPTION/WLn-urn /2,
s s0.00
s 60.00
s100.00
s130.00
s300.00
Sum
10n
aSoTe
- 6,1nllAl
Permits are non-transferable and expire
if vork is not started vithin 1B0 days
of issuance or if vork is suspended for
180 days. it^-'^t:
2. COMRACTOR INSTALltrffdftI
Electrical Contractor
rF+r iF' E.'1 Services or Feeders
j- Installation, Alterationsi I or Relocation:
ll/.r Clt
Address
Ci ty Phone
i tupervi.sor Li e Number
Expiration
200 amps or less
20L amps to 400 amps
-40L amps to 600 amps
-601 amps to 1000 amps_
0ver 1000 amps/voIts
Reconnect 0n s 40.001y
tefollotv rrrles ad un [t, i,
Notification Center. f f-,oi" ruru. *n.&'i,,,F"'
iH tlAR @., gsz-t,i: I.nsCons t r tr.
Expi r ion Da
Signature of
ovners Name ElAka ll4AAcr
Address {zo t tAYtr
CitY ?L{\tD Gcgo Phone I Ll tl-o5Kt
OVNER INSTALI.,ATION
The installation is being made on
property I ovn which is not intendedfor sale, Iease or rent.
Ovners Signature:
6-/4 /***q
DATE:
porary Services or Feeders
tallation, Alteration or Relocat
D. Branch Circuits
E
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
.?0??;,1111?^:?]3'" copies or the rules goo amps'"or ress s 40.00'- leplionet_20l arnps to 400-amps
-
I ss.oo
suBufiFfsjffH$Siffi#.t1#J3,j;i:'''u:'u',&;,-aoi i" ooo .,pq . $ eo.oo
0ver 600 amps or 1000 vofts see rBtr
Ar.tt'=
Nev, Alteration or Extension Per Panel
t''one(Circuit J_ $ 35.00 J I
eacH edditionalCiicuit or with Service,
iMisCellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0uttine Lighting-
Limited Energy/Res
-Limited Energy/Comm
$
$
$
$
3
40.00
40.00
20.00
36.00
0)7
CITV OF OFEGO'U
RECEIVED
-t-l
5
I
I
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