HomeMy WebLinkAboutPermit Building 1996-03-01SPRII\lGFIELc,
RESIDENTIAL
PERMIT APPLICATION
lnspections:726-3769
Office: 726-3759
LOCATION OF PROPOSED WOFIK:
Qfr,
JOB NUMBER 9t"oTfu
225 Fifth Street
Sprlngfleld, Oregon 97477
-55o Pac-urr<---
ASSESSOHS MAP:I -1 0b ?;T 4r\ *
LOT
-
BLOCK:
TAX LOT:oSoC
SUBDIVISION
()T-1+tPHONE
STATE:
S-
4CITY:
5% P.+<-'Fr <-'
*eo-r r.!<bFv€,,r, Q1+-1
ADDRESS:
OWNER:
NEW. REMODEL ADDITION DEMOLISH OTHER t,,
G * Dei--DESCRIBE WORK:
IB1
CONTBACTOR'S NAME
MECHANICAL:
ELECTRICAL
ADDRESS
141
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
EXPIRES - PHONE
)
RANGE:
r OF BDBMS:
_ OFFICE USE _
LAND USE:
WATER HEATER:
ZONING CODE:
FLOOD PLAIN
I OF UNITS:
QUAD AFIEA:
r OF BLDGST
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspection, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REOUIRED INSPECTIONShRough Mechanlcal - Prior to
cover.
Final Plumbing - When all
plumblng worl< is complete,
Slte lnspectlon - To be made
after excavatlon, but prior to
setting forms.
Rough Electrical - Prior to B
X
V
FInal Electrlcal - When all
electrical work is complete.cover.
Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Final Mechanlcal - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
Final Building - Wherr all
requlred lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.
)4
tt"*,ng - Prlor to cover.
OtherFoundatlon - After forms are
erected but prlor to concrete
placemont.Wall/Celllng lnsulatlon - Prlor to
cover.
Underground Plumbing - Prior
to fllllng trench.
MOBILE HOME INSPECTIONS
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng.Wood Stovo - After lnstallatlon
Post and Beam - Prlor to floor
insulation or decking.lnserl - After f lreplace approvql
and lnstallatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulalion - Prior to
deckl ng.Curbcut & Approaclr - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home lras been connected lo
water and sewer.
Sanitary Sewer - Prlor to filllng
trench.Electrlcal Connection - When
blocking, set-up, and plumblng
lnspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prlor to filling
trench.
Sidewalk & Drlvewav - After
excavation ls complete, forms
and sub.base materlal ln place.
Water Llne - Prlor to filling
trench.
Fence - When completed.
Rough Plumblng - Prlor to
cover.
Street Trees - When all requlred
trees are planted.
Final - After all required
inspectlons are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.
a
I
ulB
S{\lc-qcrEE Ft nqrs
[-l femporary Electrlc
[--l Underslab Plumblng/ Electrical/tJ Mechanlcal - Prlor to cover. I I
E
E
E
tl
tl
E
tl
E
E
tl
tl E
Etl
l--l Drywall - Prlor to taplng.
tl
tl
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type -,
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbac
P,L.HSE GAR ACC
N
S
E
- lS THE PROPOSED WORK tN THE .
HtsToFilcAL DTSTRTCL OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicailon must be slgnedand approved by the Historical
Coordinator prlor to permit issuance.
APPBOVED
BUILDING PERMIT
VALUE
(A)
o dA)
SQ. FT. X $/SQ, FT,
,oo
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Su rcharge
Total Fee
BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT
This permit is granted on the express condltion that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfietd, inctuding theDevelopment Code, regulating the construction and use ofbulldings, and may be suspended or revoked at any tlmeupon violation of any provisions of said ordinances.
Receipt Number:__._
DatePlans Revieweci nt
Date Paid
Received By:
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmcnt Charge is due on all undevelopedproperties wlthin thc City linrits which are being improved.
Resldential Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
N0
FT.
FT.
(c)
Plumbing Permlt
State Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fixtures
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
\6 , at^r
lO rob
3.oO
(D)
0o r rJ FEt-
MECHANICAL PERMIT
No
Mechanical Permit
lssuance
State Surcharge
Total Permit
Furnacc
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I hdve caref ully examlnedthe completed application and do hereby cerilfy that alllnformatlon hereon is lrue anct correct, and I f urther cerilfy
that any and arr work performed shail be done in accordance
wlth the Ordinanccs of the City of Sprlngfield, and the Lawsof the State of Oregon pertainlng to the work described
heroln, and that NO OCCUPANCy will be made of anystructure without perrnission of the Bulldirrg Safety Divislon.I lurther certify that only contractors and employees whoare ln compliance with ORS 7O1.OSS wlll be used on thlsproiect.
I further agree to ensure that all required inspections arerequesied at the proper time, that each address is readable
from the street, that the permit card ls located at the frontof the property, and the approved set of ptans will remaln
ufl
Signature
Date
on the site at all t st ru ct lon.
MISCELLANEOUS PERMITS
State lssuance I
State Surcharge
Sldewalk -- ft
Curbcut
-
ft
Demolition
State Surcharge
Mobile Home
Total Miscellaneous Permils (E)
TOTAL AMOUNT DUE (exctuding dtectrieat)
(A, B, C, D, and E Combtned)
i-r ,11/
vit-toRttott:
FIECEIPT NUMBER G
DATE PAID 4<e\-
AMOUNT RECEIVED 4 ,12
BECEIVED 8Y \evvr
FT.
r!
1 I TGFIELO
The lollowln
roning,.ond
,lvI xcqb
(?-
225 FIFTH STREET
SPRINGFTELD, OREGON 97477
INSPECf,ION REQTIEST: 726-376i9r:: .' ,.' ' ,'*
OFPICE: 726-3759
1 ALLATTON
LEGAI PTI
EI..ECTRICAL PERHIT APPLICATION
City Job Number
3. COHPLETE FEE SCMDULE BELOV
A I'lev Residential-Single orMuIti-Family per dvelling unit.Servi ce f ncl-uded :
I tems Cos t Sum
3 JOBo r \0r 1000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Manuf,d Home or
-
Hodular Dvelling
Service or Feeder
Services or FeedersInstallation, Alterationsor Relocation:
200 amps or less
201 amps to 400 amps
-
401 amps to 600 amps
-
601 amps to 1000 amps-over L000 amps/volts
-
Reconnect Only
s 8s.00
s 15.00
s 40.00
130. 00
300.00
40.00
Permits are non-transferable and expireif vork is not started vithin 1g0 diysof issuance or if vork is suspended ior
1B0 days.
2. COMTRACTOR INSTAITATION ONLY B
Electrical Contractor
Address
Ci ty Phone
Supervisor License Number
Expiration Date
\o
50. 00
60. o0
100.00
s
s
s
s
s
s
C Temporary Services or FeedersInstall-ation, Alteration or RelocationConstr Contr. Number
Expiration Date
Signature of Su pervising Electriciarr
.Z
Ovners Name
Add ress
Ci ty Phone
OVNER T ALLATTON
The ins talla t ion is bei.ng made onproperty.I ovn vhich is not intendedfor sa1e, lease or rent.
Owners Signature:
DATE:
RXCETPT
200 amps''or less $ 40201 amps to 400 amps
-
S 55over 401 to 600 amps
-
S B0Over 600 amps or 1000 voITs see ,
.00
.00
.00
'Bu aEoiE-
D- Branch Circui ts
Nev, Alteration or Extension per panel
One Circui t
Each Add i. t ional
Ci rcui t or vi thor Feeder permi t
Servicn
o\
5
U-
s 3s.00
s 2.00
E. Miscellaneous (Service,/feeder not included )-Each installation
Pump or i rri.ga t ion g
Sign/Outline Lightirg- SLimi ted Energy/Res
-
SLimi ted Energy/Comm S
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL.
00
00
00
00
40
40
20
36
5
RECETVED B
qt
Seef
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