HomeMy WebLinkAboutPermit Building 1999-11-01RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726.3759
LOCATION OF PBOPOSED WORK:
ASSESSORS MAP:
LOT:
SP rlINGFIELE'
? 2t/ao
BLOCK:
JOB NUMBER
225 Fifth Street
Spri rrg f leld, Oregon g7 471
TAX LOT
SUBDIVISION: ---
PHONE:
ZIP:
ss
CITY:STATE:
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHEFI
DESCRIBE WORK:
?26
?zs L 37
ESS v
I?t z*l Nt
fI
EXPIRES .1 PHONE8?
NAMECONTRACTOB
MECHANICAL:
ELECTFIICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
RANGE:
- OFFICE USE -
r OF UNITS:
QUAD AREA:
* OF BLDGS:
SECONDARY HEAT:
SOUARF. FOOTAGE:
# OF BDRMS: _
LAND USE:
OCCY GROUP:
C OF STORIES:
ZONING CODE:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. will bemade the same working day, lnspections requested after 7:00 a,m. will be macle the following work day.
REOUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prior to
cover.
Final Plumbing - When altplumbing worl< is complete.
Site lnspectlon - To be made
after excavatlon, but prlor to
setting forms.X Rough Electrlcal - Prior to Final Electrical - When all
electrical work is complete.cover.
tl Underslab Plumblngl Electrical /
Mechanlcal - Prlor to cover.Electrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Final Mechanical - When all
mechanical work is complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
ffi fi.,at Building - When ail
Tfrrequired lnspections have been- approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.,xX
Framlng - Prior to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Celllng lnsulatlon - Prlor to
cover.
Underground Plqmblng - Prior
to fllllng trench.J--l Orywatl - Prior to taping.
MOBILE HOME INSPE TIONSUnderlloor Plumblng/ Mechanical
- Prior to lnsulatlon or decking.Wood Slovo - After lnstallatlon.
Post and Beam - Prlor to lloor
insulatlon or decklng.lnsert - After flreplace approval
and installation of unlt.
Blocking and Set.Up - When all
blocklng is complete.
Floor lnsulation - Prior to
decking.Curbcut & AJrproach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Stonn Sewer - Prior to filling
trench.
Sidewall< & Drlveway - After
excavation is complete, forms
and sub-base material in place.
Water Llne - Prlor to filling
trench.
Fence - When coinpleted.
$trsst Trees - When all requlred
trees are planted.'
Final - After all required
inspections are approved and
porches, skirting, decks, and
ventlng have been installed.
Rough Plumbing - Prlor to
cover.
FLOOD I]LAIN:
WATER HEATEFI:
tl
E
E
tl
E
E
E
E
tl
E
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-_ Corner
..- Panhandle \'
-
Cul-de-sac
',,1 iii
P,L.HSE GAR ACC
N
S
E
( IS THE PROPOSED WOBK iN THE .' HrsroBtcAl- DlsrRlcT, oR oN
THE HISTORICAL REGISTER?
-
lf yes, this appliCatlon must be slgned
and approved by the Historical
Coordinator prlor to permit issuance,
APPROVED:
BUTLDING PERMIT
VALUESQ. FT.
3€!D3-y/z ?o
z<^
ITEM
Main
Garage
Carport
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
,': :. 'l
BUILDING IALUE, PLAN CHECK
AND BUILDTNG PERMIT
This pernrit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City 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.
Plans Reviewed By Date
Receipt Numbe
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
Nr
FT.
FT
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformation hereon is true and correct, and I f urther cerilfy
that any and all work performed shall be done in accortjance
with the Ordinanccs of the City of Springfir:ld, and the Laws
of the State of Oregon pertaining to the work descrlbed
herein, bnd that NO OCCUPANCY witl be made of any
structure without perrnission of the Builclirrg Safety Divislon.
I furtherpertjfy that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
proiect.
I further agree to ensure that all requlred lnspections are
requested at the proper tlmq that each address ls readable
,,/ Slgnature
Date \\\,\tr
Irom the street, that the
t
of the and
on the si ructlonring
rmlt card ls located at the front
proved set of plans will remaln
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-_-
ft
Demolition
State Surcharge
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
1276r(
(E)
N0
Total Miscellaneous Perrnits
Vent Fan
(D)
MECHANICAL PERMIT
Fu rnace
Exhaust l-lood
Mechanical Permit
lssuance
State Surcharge
Total Permit
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VAI-IDATION:
RECEIPT NUMBER
;.i::
CITY OF OREGON
02/11/9E 1O:22 8SO', 26 3689 SPFD DEY. SER.
The following proiect as submitted has the lollowing
zoning. and does not require specific land use
approval
,
Zoning LD
.8.
L
@ oor
SPFTNGFTELEt
225 E[FT8 SlTEEf,
SPBIilGEIEUT, oRBGoN
NISPBC TOil REQIIBSI:
OPEICE: 726-3759
726-3169
Authorizeci Signature
1 TTOlI INSTALIATION
DESCRTPTION
JOB
Permits are non-transferable expireif rrork ls not started uiof lssuance or if rork is
180 days.
2. CONMACTOR INSf,AIIAEON
Electrical Contractor
Address
Signature of Electrtcian
Nane E.//,
Address e{
cir
PBRHIT
City Job lftrnber 7
3. COHPLSIE PEB SCEBDU.B BBI.OY
A. Nev Residential-Sing1e orllulti-Panily per dvelling unlt.
Service Included:
Items Cost
1000 sq.ft. or less S 85.00
Each additional 500
sq. ft or portionthereof S 15.00
Each Hanuf'd Houe. or
-Hodular 'Dvelling
Sertice or Peeder $ 40.00
Serv.i.ces or FeedersInstallation, Alterations
or Relocation:
to 400 aups
-Over 600 amps or
to 60O a.oDs
rboondl-ts ee "Bn aEZE
Branch Circuits
Nev, Alteration or Extension Per Panel
E.
5. SUBTOTAL OF AEOVE
5Z State Surcharge
3Z Adninistrative Fee
TOTAL
200 amps or less
201'anps to 400 anps
-401 anps to 600-anps
60tr anps to 100O anps_
Over 1000 anps/volts
-Reconnect only
one circuit 4 S 35.00 ),foo
Each Addltional-Circuit or vith Service
or Feeder Pernit"-"-J S 2-oo 2:
Hiscellaneous (Service/feeder not included)
-Each installation
Pumo or irrigation
sigir/outline Ligh t ing-
Limlted EnergY/Bes
Llmited EnergY/Comn .
Sum
Ci ty.mon.3V3l)91
Superv License Number Ailb:
Expiration Date
Constr contr. Nurnber \-l>S>-Temporary Services or FeedersInstallation, Alteration or Relocation
c
Exp iration Date 200 anps'fi less
$ s0.00
s 60.00
$100.0q
s130.00
s300.00s 40.00
2Al
Over
aoPs
401
$
$
$
s
40.o0
5s.00
80.00
00
00
o0
00
Aa
D
The lnstallation is being
property I oun rrhiih is no
for sa1e, lease or rent.
Orners Signature:
DATE:
nade gn
t intended s 40.
s 40.
$ 20.
$ 36.
RECEI\IED
-[
/\n
I
FD-1 6
f|.7"c *z $lal5
?zt*o
- t0 )r tlrtII
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE:ut /zc (r<q
TO:
FROM:
SUBJECT:
Building Department
Springfield F'ire Deparhnent
Structural Damage to Buitding
Address or location of build.ing t4st ?rstu.
Name of or^/ner
Type of building a)t
(Dwel I ng, Sto , lrlarehouse, etc. )
Estimated value of building $l2O.no c
Estimated loss to buildinq
Date of fire
Location of dannge in building -U)all ,;,.t^€1.,^e
(Root, Wa'll ,Ex terior, Interior, etc. )
Structural weakness as a result of the fire
-f hr,,
zo
Burned rafte lSt Beams, Jo'ists, etc.)
Additional pertinent information
Electrical Hazard
U
0utl e , etc. )
1q
cc:
(Wi ri [9'
Signed
)nk / ,,,, ,^'f
s cc,t
Ept(t SIA:EOF
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REMARKS
FIRE SUPPRESSTON EffPRTS CONFINED TC)
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