HomeMy WebLinkAboutPermit Building 1994-09-08\b
RESIDENTIAL
PERMIT APPLTCATION
lnspections: 726.3769
Office: 726-3759
LOCATION OF PFOPOSED WORK:
ASSESSORS MAP:*oz OJ OtC
225 Fi(t
Springfleld, Oregon gl 4ZZ
TAX LOT:
LOT: BLOCK:
To request an lnspectlon,
made the same worklng ,
[-_| femporary Etecrrtc
Slte lnspectlon - To be madeafter excavatlon, but prlor tosettlng forms.
lffnoerstab ptumblndt rtecrrlcai
-
Mechanlcal - prtor\gyg>
N4ootlng - After trenches are'*-excavated.
'you must call 726'3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.mday, lnspectlons requested after 7:00 a.m. wlll be made the foilowrng work day.
REOUIRED INSPECTIONS
SUBDIVISION
wlll be
x3g?i#tm
ffi'Rost and Eeam - prtor to floorqlnsulatlon or decklng.
ffi ftoor tnsulatlon - prior toHecklng.
ffi Sanltary Sewer - Prior to fliltngf-rtrench.
ffi'Storm Sewer - Prlor to flillng,atrench.
ffi water Llne - prlor to fillingjA(-lrench.
ffi nough Plumbing - prior to!4eover.
Sidewalk & Drlveway - After
excavation is complete, forms
and sub-base materlal ln place.
Fence - When completed.
Trees - When all requlred
fi finat - After ail requtred}- \inspectlons are approved and
Final Plumbing - When allplumblng work ls complete.
Flnal Electrlcal - When allelectrical work is complete.t
Other
Plumbing Connectlons - When
home has been connected towater and sewer.
Electrical Connection - Whenolocking, set-up, and plurpblng
lnspections have been approved
and the home ls connected tothe servlce panel.
porches, skirting, decks, andventlng have been lnstalled.
ffi norgt Mechanlcal - prlor to
--\cover.
lVi Rough Etecrrtcat - prtor to'qcover.
E
,x
Masonry - Steel locatlon, bondbeams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - prior
to fllllng trench.
ffiElectrlcal Servlce - Must be lJJf rlnal Mechanlcal - When auH-approved to obtaln permanent .5{ mechanical work is complete.
electrlcal power.
Flreplace - Prlor to faclng
materlals and lramlng lnsp.
flf'flnat Buitding - When ail
,2++equired lnspecUons have beenapproved and building iscompleted.
XL Framlng - Prlor to cover.
FLWrlltCeiltng tnsulatlon - prtor to
-
cover.
f,f orVwalt - prtor to taptng.
MOBILE HOME INSPECTIONS
Wood Slove - After lnstallatlon
tnserl - After flreplace approval
and lnstallatlon of unlt.
''-'Blocking and Set.Up - Whep all
-
.blocklng ls complete.
Curbcut & Approach - After
forms are erected bUt prlor toplacemont of concrete.
L-t
l......-
NUMBE
.)tSTATE:CITY:
ADDRESS:
OWNER:
NEW
-
FEMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ADDRESS EXPIRES PHONE
a(
tl
yl
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
Ksttri zE,=lr>
^ icWATER HEATER:
- OFFICE USE -
* OF BDRMS:
ZONING CODE:* OF UNITS:
LAND USE:
SECONDAFIY HEA'I:
SOUARE FOOTAGE:
OCCY GROUP:
C OF STORIES:
QUAD AREA:
* OF BLDGS:
RANGE:
- E
FLOOD PLAIN:
CONSTR. TYPE:
HEAT SOURCE:
trees are planted
E
PHoNE: 72o-a3t ^
zre, 7Z/76
_zD<_
.,R
Lot faces
Lot sq. ftg. i
Lot coverage
Topography
Total fiplght
Lot Type
-1-lnterior
-
Panhandle
-
Cul-de-sac
acks i -,S THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and apProved bY the H istorlcal
Coordinator prlor to permit issuance.
APPROVED
?^ri
PL.HSE GAR ACC
N w t
S
W
E 25
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express conditlon that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City o( Springfield, including the
Development Code, regulating the construction and use of
bulldings, and may be suspended or revoked at any time
f any provisions of sald ordinances'
ewed By
upon violation o
Plan Check Fee:C7?
Date Paid
Receipt Number:
Received
BUILDING PERMIT
SQ. FT.
2a/Z
/o< z-
to
/o1
ITEM
Main
Garage
Carport
60
zb
VALUE
//5e52
/r 17-
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
V%,W/t){-tfr\ ?7
X $/SQ. FT.
z.r 20
- -tV.
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
S DEVELOPMENf 6iiNN
(B)U6BSYSTEM
ADDITIONAL COMMENTS
ITEM
Fixfures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
-'4><E
3%nba/O,--Jfu(c) 3E4P
FEE
15::30e
,r./6e'
FT.
oO
No ?-
Fr. 2_-30
PLUMBING PERMIT
Plumblng Permlt
State_ Surcharge
Total Charge
-4A90
Wood Stove/ lnsert/ Fl replace Unit
Dryer Vent
4f"
,3.N
,/o,*
oo
o-D\.Gnt Fan
Mechanlcal Permit
lssuahce
State Surcharge
Total Permit
4s3%,+W4"---$r,-(D) 7?97
MECHANICAL PERMIT
Furnace
Exhaust Hood
Noz
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true and correct, and I f urther certi(y
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Buildlng Safety Division.
I further certlfy that only contractors and employees who
are ln compllance with ORS 701.055 wlll be used on thls
project.
I further agree to ensure that all required lnspections are
.K,,
Date T ,-7
e, that each addressrequesled at the pro
from the street, th permlt card ls located
of the property,approved set
on the site at tlon.urlng co
ls readable
at the front
will remain
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
1z;.*
?,1e1s:4.
Cro--r--7DATE PAID
AMOUNT FIECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBEB
TOTAL AMOUNT DUE (excluding electrlcal)
(A, B, q D, and E Comblned)
-w:
qg?:4 0
i, - i;i?.11
7'#xi)
a
7b7
" C-' ' (f'zaz c-)
C'TY OF
4\-.
The follcwing proiect as submittod has the
zoning, and does not require specilic land
I
-oseRrrcrreio
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home o
Modular Dvelling
Service or Feeder
225 FTFTE STREET
SPRINGFIELD, OREGON
TNSPECTION REQTIEST:
OFFICE: 726-3759
approval.
97 477
1 LOCATION OF INST
JOB DESCRIPTION T<{T /t
U,/ CE
7ePermi
Zz 7-t
nsferablents 2c){rts are non-tra
ELECTRICAL PERHIT APPLICATION
u
BELOV
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cost
I
expi re
t_
t^
$ 8s.00
$ 1s.00
$ 40.00
Sum&band
if vork is not started vithin 180 days
of issuance or if vork is suspented for
180 days.
2. CONTRACTOR INSTALL.I\TTON ONLY
Erectricar contractor 'o 'o/-f /arc-'
Address ffzZ ,rr_2n/F
Ci.ty ,uzo Phone 7)( /2o /
Supervisor License Number ?az3 f
Exp iration Date 75
Constr Contr. Number 70 7.c
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps _401 amps to 600 amps
60L amps to 1000 amps-
Over 1000 amps/voIts
Reconnect 0n1y
Temporary Services or Feeders
Installation, Alteration or Relocati
r
B
c
D
s s0.00
s 60.00
s100.00
s130.00
s300.00
s 40.00
Expirat ioo oarc z a /Z /? -f
-
Signature of Supervising Electrician
200 amps or less I S
20L amps to 4OO amps -...*_ S
over 401 to 600 amps
-
S
Over 600 amps or 1000-T6TEs s
Branch Circuits
40.00
55.00
80.00
onI
L
-rr
Z1 ee rBr a56F
0vners Name
Address
Ci Phone
OgNER
The installation is being made on
property I own vhich is not intended
for sale, lease or rent.
t
0vners Signature:
DATE:
RECETPT
Nev, Alteration or Extension Per Pane1
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. MisceLlaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/ou tline Light ing-
Limi ted Energy/Res
-Limited Energy/Comm
$ 40.00
s 40.00
$ 20.00
s 36.00
SUBTOTAL OF ABOVB
5Z State Surcharge
3Z Administrative Fee
TOTALRECEIVED B
5
REOEIVHN ST lo ucB
x7f/?qPERMIT #
SINGTE FAMILY DUTETLTNG A*ilror,...*.
.A
BEOUEST
FOR:
18
726-8317
97478 726-8317
RES YES ViELL
NO OF SEDFOCiliS
PREGEDWOBX
CCI{STRIJCTIOT\ OF SINGLE FA}4ILY DdELL]NG
DR]\EWAY OI{ RTGFrI ( sCIJTlr) srDE.
MAIN
NAtt E
C,ORDOT{ TRIPP, 36676 BRAND
OWNERS ADORESS
SCIJTTI TO 57TI{ STREET & MT. VERNO{ ROAD ; EAST TO LAST
TO SITE FRd
EAST SPRINGFIELD TO 58TI] STREET;
E AODRESS
S RD., SPRINGFIELD 97478
BURNED - MH PLACED ]N SAIqE SITE HAS BEEN REMOVED)
CORDON] TR]PP
C,ORDOD{ TRfPP,
501
36676 BRAND S RD., SPR]NGF]ELD
02 03
MI. VERNOI{ RD., SPRINGFIELD 97478
FEES DUE: $APPROVED BY DATE
CALL FOR TNSPECTTONS (SEE
SEPTIC permlts are good tor one year. AL
BACK OF FORM FOB
'ATSTBUCT|ONS)
687-4065
L other permits expire atter 180 days unless lnspections are current.
LMD 040 Rev. 6/92
true and correctC,ORDCX{ TRIPP
of and allcertify
o-ffi--
8ail (ll$tqtz
\-' vroLAfioNs U \-/
SBTBACKS AND OTHER, CoNDIIIONS OP APPROYAL MUST EB $TrcILY OBSERVD' VDI'ATION CAI{ BEST'LT IN RBVOCATION OF TIITS PBRMIT'
crrATroNs MAy BE
^srJD
TTNDER TuB T*ovBroNs a ilft-ccitrrit nm.lcrpr monrene rnoron orsm RBll@IEli AIr.owED BY LAw'
A MINIMUM OF AT LEAST % HOI.'RS ADVAI{CE NOTICE MUST BE GIVEN FOR INSPECTION REQIJESTS
Ilave the foffowin' rn;;ation readv whel you call: '6874065
permit number - Job address - TyPe of inspection required - when it will be ready
Yournameandphonenumber-Anyspecialdirectiorrstothesite
SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELDFrom: Interior property lines l0' iO;--
Edge of road right-of-way 10'
Building foundation 5'
Wells or other water sources 50,
PTJALTC OFT'ICIAL RIGIIT TO TRESPASS ON PRIVA'IE PROPEnTY ORS 215'080
POWER TO BNTER I'PON LAND' THE COMMISSION, AND AITIY OF rTS MBMBERS, OFFICERS AND EMPT'YBS, IN THB PERFORMANCE OF THBIRFT'NCTIONS. MAY
ENTERUPON ANYLAND AND MAXEEXAMINATIONS A!'ID SIJRVEYS AND PLACB AND MAINTAIN THE NBCBSSARY MONUMENTS AND MARXERS THERFON'
REQI,IIRBD INSPECTIONS
FOT]NDATION INSPECTION:To be made after excavations for footings are complete and any required reinforcing steel is in place'
I.INDERGROUND PIPING INSPECTIONI To be made after all underground piping has been irstalled, pnor to any backfill.
CONCRETE SLAB OR I.]NDER-FLOOR INSPECTION:To be made after all in-slab or under-floor building service equipment, conduit,prPmS
accessories and other ancillary equipment items are in place but before any concrete is Placed or floor sheathing instaUed, including the subfloor'
ROUGH MECHANICAL INSPECTION: To be made after all ducting and gas PiPing has been installed and prior to being covered.
ROUGH PLUMBING INSPECTION: To be made after all plumbing rough-in is in place, prior to being covered.
chimneys and vents are comPlete
FRAMING INSPECTION: To be made after the all framing, freblockhg'b,racing and roof are in place and all PiPes'
and the rough electrical, plumbing'and mechanical inspections have been made and approved.
INSULATION INSPECTION: TO be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all la0ting and gypsum board, interior and exterior, is in place but before anY
plastering is applied orbefore gypsum boardjoints and fasteners are taped and finished'
ADDI.TIONAI, INSPECTIONS MAY BE REQLIIRED, such as but not limited to;
BLOCK WALL:' To be made after reinforcing is in place'but before any Srout is Poured.The inspection is required for each bond beam pour' There
will be no approval until the plumbing and electrical inspections have been made and aPProved.
FINALMECHANICAL INSPECTION: To be made just Prior to the structure or remodeled area being occupied and prior to operating any equipment.
FINAL PLUMBING INSPECTION: To be made just prior to the building,structr[e or remodeled area being occupied.
FINAL BTIILDING INSPECTION: To be made after finish grading and the building, structure or remodeled area is completed ard ready for occupancy.
MOBILEMANUFACTURED HOMES: An inspection is required after the mobile home is cormected to an approved sewer or septic
system, prior to covering sewer or water lines, for setback requirements, blocking'tiedowrs and plumbing cormections.
Footings and piers to comply with State formdation requirernents for mobile homes or as recommended by the manufacturer'
Minimum finished floor elevation shall be certified when required by Floodplain Management
Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy.Tiedowns shall be installed per enclosure.
APPROVAL REQIIIRED
No work shall be done on any part of the building or structure beyond tlre point indicated in each successive inspection without first obtaining the
approval of the building omiciar. such approval shall be giren only after an inspection shall have been made of each successive step in the construction
as indicated by each of the irspectiors required.
THIS PERMT WILL E)(PIRE IF WORK DOES NOT BEGIN WTITIIN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE T}IAN 180 DAYS'
SUSPENSION OR REVOCATION MAY OCC1JR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION'
ANYONE PROCEEDING PAST THB POINT OI'REQLIIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
your signarure on the fronr of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS CoMPLETED APPLICATIoN, and do
[o"Uy !"rtify that all information hereon is true and correct,-and that I have a legal interest in the property as owner of record or authorized agent' I
further certify rhat any and ali work performed shall be done in accordance with the ordinances of Lane county *9 4" !1| lf the statB of oregon per-
i^irlrrg to the work A".omJ t o"in. I furtlrer certify that if I am not the owner of the proprly, my regisuation with the Builders Board is in full force
*a "fi".t as required by ORS 701.055, and that if eiempt the basis for the exemption is noted hereon, and that only subcontractors and employees who
,\
record
to the permit
certificate of completion
l0'
10'
100'
before a
and this rule.
Land
with all a
and all corrections
constitutes a violation of ORS
'!
(
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l-.AN[: L:Ui.]t'l'fT I]t:[i1' HNV t'lf,1' F(HilEIl"T {: i:!'?*(t?4 DAT'E 0$?394
IORDON ADDR 3667& T'RAND .S RD., SI}RINGFIELD, ORT-
SIJBDIU I.OT BLK
U.lE H ETDRHS $ UN.ITS 00{ .ST0RIES +I|LDGS 001 FI{0NE ?26 S31
G0ftDtlN ADnft 36&7$ [{EAN$ S ED . , ,Sl-'R I NGF I ELD , ,,.ilRE--
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STATE SURCHAIIGE
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