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Home My WebLink AboutPermit Building 1995-02-09B P ESIDENTIAL ERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 IELI) Rough Mechanlcal - Prlor to cover. Rough Electrlcal - Prlor to cover. Electrlcal Servlce - Must be approved to obtaln permanent olectrlcal power. Flreptace - Prlor to faclng materlals and framlng lnsp. Framlng - Prlor to cover. Watl/Celllng lnsutatton - Prlor to cover. Curbcut & Approach - After forms are erected but prlor to placement of concrete. Sldewalk & Drlveway - After excavatlon ls completo, forms and sub-base materlal ln place. Fence - When completed. Trees - When all requlred JOB NUMBER 225 Flfth Street Sprlngfleld, Oregon 97477 AccESS ts - SARA k+obs A&4/ tu /s oNE . MOBILE HOME INSPECTIONS LOCAT]ON OF PROPOSE ASSESSORS MAP:TAX LOT: SiJBDIVISIoN:- To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All. lnspecilons requested before 7:oo a.m. wlll bemade the same worklng day, lnspectlons requested after 7:00 alm. wlll be madei the followlng work day. REQUIRED INSPECTIONS Nd ,"-oorary EtectrtcF X Slte lnspectlon - To be made after excavatlon, but prlor to settlng forms. Underslab Plumblng/ Electrlcal / Mechanlcal - Prlor to cover. Footlng - After trenches are excavated. Masonry - Steel locatlon, bond beams, groutlng. Sanltary Sewer - Prlor to fllllng trench. Storm Sewer - Prlor to fllllng trench. Water Llne - Prlor to fllllng trench. X ,< ,X E X ,K Flnal Plumblng - When allplumblng work ls complete. pl ftnat Electrlcal - \ruhen ailAelectrlcal work ls complete.c ffi flnat Mechanlcal - When altHmechanical work ls complete. ffiflnat Bultdtng - When a[ flrequlred lnspectlons have been approved and bulldlng ls completed. K Other iloAo Au PEililrs a/yr/t f] ,'Jffii:l3l,ll"ln'."orns - Prror ,{oo*"n - prror to taprns. filfornaatton - After forms are.H,lerected but prlor to concrete placem€nt. pf Unaerttoor Plumbtng/ Mechanlcat a- Prlor to lnsulatlon or decklng. ffino"t and Beam - prtor to ftoor.fllnsulatlon or decklng. X::""r;gsuratron - Prror to ,K, ,K X n Wood Stove - Afti:r lnstailatlon: :. l-l lnsert - After flreptace approval'- and lnstallatlon of unlt. [--l glocklng and Set.Up - Whep ail - blocklng ls complete. Plumblng Connectlons - When horhe has been connected to water and sewer.t Electrical Conndction - When blocklng, set-up, and plurgblng lnspectlons have been approved and the home ls connected to the servlce panel. Final - After all required lnspectlons are approved andporches, sklrtlng, decks, and ventlng have been lnstalled. OWNER: ADDRESS: CITY:STATE: PHONE: ZIP: ADDITION MOLISH OTHER DESCRIBE WORK: NEW y' BEMoDEL R'S NAME EXPIR PHONEA I t ELECTRICAL: CONT GENERAL: PLUMBING: MECHANI CONS.T. CONTRAfiOR # FLOOD PLAIN: zoNrNG coDE: IDX-/ 5Q{\)IJ - OFFICE USE - OCCY GROUP:* OF BDRMS: FIANGE: r OF UNITS: LAND USE: WATEB HEATER: r OF STORIES: QUAD AREA: * OF BLDGS; SECONDARY HEAT: SQUARE FOOTAGE: CONSTR. TYPE: HEAT SOURCE: M Rough Plumbing - Prlor to ffi{cover.rees are planted. tl E I I P.L.HSE GAR ACC N /4 S 5 E 4t Lot faces Lot sq. ftg. Lot coverage Topography Total ht Lot Typ€ -Y rntuX, -. Corner - Panhandle - Cul'de-sac Setbacks S THE PROPOSED WOBK TN THE.- HISTOBICAL DISTRI T, OR ON THE HISTORICAL REGISTER? - lf yes, thls applicatlon must be slgned and approved by the H lstorlcal Coordinator prlor to permit isSuance. APPROVED: ADDITIONAL COMMENTS 42q J55' *T / 7.?ot/o,?( W (A)39 X $/SQ. FT. b.64 3_5be "-b94 Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. IvJaln Galage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordlnance adopted by the City of Springfleld, including the Development Code, regulating the constructlon and use of buildings, and may be suspended or revoked at any tlme iewed ByP Plan Check Fee: Recelved upon violation of any sions of sald ordlnances, Date Paid: Beceipt Nu SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge ls duo on all undeveloped properties wlthln the City limlts which are belng lmproved. ITEM Flxtures, Besldenttai Bath(s) Sanltary Sewer Water Storm Sevyer Moblle Home -/ad" ** ?+Po FEE -=--_l (c) PLUMBING PERMIT /7290 2go Plumblng Permlt State. Surcharge Iotal Charge Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent Mechanical Permit lssuahce State:surcharge ,?b f ,5f Total Permit (D) @ N Vent Fan €o f,7 MECHANICAL PERMIT Furnace Exhaust Hood Noz 10:? zt 07 6e2.ro By slgnature, I state and agree, that I have caref ully examlned lhe completed appllcailon and do hereby certlfy that all lnformatlon hereon is true and correct, and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordlnances of the Clty of Sprlngf ield, and the Laws of the State of Oregon pertalnlng to the work descrlbed hereln, and that NO OCCUPANCy wlll be made of any structure wlthout permission of the Buildlng Safety Divislon. I further certlfy that only contractors and employees who are In compliance with OBS 701.0S5 wlll be used on thls proJect. I further agree to ensure that all requlred lns per tlme, that each address ls readable pections are c Date requested from the at the frontthe permlt card ls I of the d the plans wlll remaln on the slte times on. / Slgnature MISCELLANEOUS PERMTTS Mobile Home State lssuance State Surcharge Sldewalk - f t Curbcut - f t Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (exctuding electricat) (A, B, C, D, and E Comblned) 5?c€/7/ VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY { l1c;<zz. ,- 4,- *i NOZ FT. FT. FT. /g SPfIINGFIELO zoning, and nct require specilio i % SPRINGFIELD, OREGON 97477 _ ./ /(t -e._fNSPECTI0N REQUESTT 7264?89 u ' 't !- aooroval. zonins UD{L- -225 FIFTB SIREET 0FFICE: 726-3759 1 0 --T n,Permits are non-transferable ahd expire if vork is not started vithin 1B0 days of issuance or if.vork is suspen-ded for 180 days. CONTRACTOR INSTALLATTON ONLY E1 EC cal Contractor Address Ci ty ELBCTRICAL PERHIT APPLICATTON Ci ty Job Nunber q, 3. COHPLETE FEE SCMDULE BELOII Nev Residential-Single or MuIti-FamiLy per dvelling unit. Service fncluded: I tems Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or -Modular Dvelling Service or Feeder $ 85.00 s 15.00 s 40.00 B. Services or FeedersInstallation, Alterationsor Relocation: Authorized Sig A PTT Sum +0,{fl'ri"ffii\r- Onl^) 200 amps or less 201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps- Over L000 amps/volts -Reconnect OnIy Supervisor Li Expiration Date Constr Contr mber Expi ra t i Da te S Name Address r $ s0.00 s 60.00 s 100. 00 $130.00 $300.00s 40.00 of Supervising EIec clan C D. Branch Circuits New, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit S 2.00 Temporary Services or Feeders Installation, Alteration or Relocation 2oo amps or ress I S 4o.oo $jO20L amps to 400 amps .* S 55.00 T- over 401 to 600 amps - S 80.00 0ver 600 amps or 1000-voEs see rrgtt uffiii[ Ci ty erlqmp-3AS3F?Phone ,$rrnr*rro*OVNER The j.nstallation is being made on pro ty I or.,n vhich is not intended Miscell-aneous (Service/feeder -Each installation Pump or irrigation S Sign/0ut1ine t ighting- S Limi ted Energy/Res $ Limited [nergy/Comm $ E.not included) 40.00 40. o0 20.00 r f.e, lease or ren Signa DA 5 7 SUBTOTAL OF ABOVE 52 State Surcharge 32 Administrative Fee 'r0TAL Phon e RECEIVI]D I} a I CITY OF SPB'A'GFIELD, OREGON ISPBIilGFIELE The.lcllowing preject as submiled has tha 225 PTmfl SltsEET sPRrNGrrELD, oREGON 97477 INSPBCTI0N REQTEST2 726-3 0FFICE: 726-3759 zoning, and cioes approval. Authorized Signatu 1.OP TNSTALI,ATION I,EGAL DESCRIPTION/va3 2€ 2,/ 13 6fl JOB DESCRIPTION<'rc' '447' Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. COMRACTOR INSTALI,ATION ONLY Electri car contrac totf-ol'z-c\ Address ?a do--s .'2.d Ci ty JbFtd Phone -2f?( Supervisor License Number Expiration Date '6^l-?s Constr Contr. Number Strls Expiration oare l-10 '7\ Signature of Supervising Electrician iiic latir: t,ue EI,ECTRICAL PERI{IT APPLICATION Ci ty Job Nunber FEE SCEEDUI,E BEtOg Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost not requiro sp*r. i-D0- A C Sum B Temporary Services or Feeders Installation, Alteration or Relocation 1-000 sq. f t. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Sertice or Feeder Services or Feeders Installation, Alterations or Relocation: 200 amps or less 20L amps to 400 amps -40L amps to 600 amps _ 601 amps to 1000 amps_ 0ver 1000 amps/volts Reconnect Oniy 200 201 0ver 0ver SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTA.L u $ 8s.oo 25 ?2 Z S 1s.oo -\2.* $ 40.00 not included) 40.00 40.00 20.00 s s0.00 $ 60.00 s 100. 00 $130.00 $300.00s 40.00 amps or less $ 40.00 +bt to 600 amls - $ 80.00 600 amps or rbOO vol-fs see uB" aEE- Owners Name Address Ci ty Phone OIINER INSTALLATION The installation is being made on property I ovn vhich is not intended for sa1e, lease or rent. Omers Signature: DATE: D. Branch Circuits Nev, Alteration or Extension Per Pane1 One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E 5 Miseellaneous ( Service/feeder -Each installation Pump or irrigation $ sign/outline Lighting- S Limited Energy/Res $ Limited Energy/Comm $ BRECEIVED 'oo' < ,7-r -?7v?--v-%13e- Willamalane Park & Recreation District fob No. SYSTEMS DEVELOPMENT CHARCE WORKSHEET PHONE: 1 NAME: ADDRESS: LOCATION OF FROPOSED DINC S Stred Address if Known: SrArE:WrP9ILU Manufactured home not in a Park $ oox $400 PER UNlr; X $370 PER UNIT =$ X $277 PER UNIT =$ X $280 PER UNIT =$ ts b9 A. Single Family - Detached I Single FamilY home-------t- v NO OF UNITS B. Single Family - Attached NO OF UNITS C. Multi-Family APartment NO OF UNITS D. Manufactured Home Park NO OF UNITS Community Services Platt Name:Tax Lot Number: DEVELOPMENT TYPE (Check appropriate dwellingG). SDC Calculations and dwelling type definitions are on the back.) WPRD SDC 2. SDC CREDIT (lf applicable) sDC-payer must furnish proof of WPRD credit approval. See SDC Credit Workshet' 3. TOTAL WPRD NET SDC ASSESSED (lf SDC reduced for credit) 'i $ $ oo d z /-,t. , ^t C^.: ^^F; ^l.l Date ?, llCaQsP/ /(9t 00 I $4DD.cq