HomeMy WebLinkAboutPermit Building 1992-06-25ST'fl!^.(;FIELr)
RESIDENTIAL
PERMIT APPLICATION
lnspections: i :'0'3769
Of lice : 72(:\-li"')
-:
-i
JOi-} NUMBEFI I -:'
h,225 Filth Street
Springf iel(1, Oreg<trt 9747 /
rAX.Lor: -1-?399
LocA.oN or pRoposr D worK: l5-8t1?t94)G--
ASSESSotIs t,rAP:-- J)43 <-S53
BLOCK:SUBDIVISIONLOT: - -
PHoNE:
'>za - ?7 a?
zrP,ll!R?STATE:
--
a<
OWNFN
crrv, _- !q.!'Sfrh3=D
ADDRESS: i
DESCRTBE_ w()RK: _$pU I o'1".*.-,t.,-
NEW --- RF:MoDEL
-
ADDITION Y -
t
DEMOLISH OTHER
6D'NR Lc>--y':- 9?rtg Lttuoa l,l loNIN DDREI;S 18"'6roo
EXPIRES;
I"lqs
COr.l I IIACI(jli '; NAMt
CONST.
CONTRACTOFI #
MECIIN NIC:AI
ELt:Cl R|CAL,:
(]I'NI I:iAL
t'tt,tltllr'l(;
ouAD^-.CR!D[r)
, OF BLDGS, T
OCCY GR(-'U,, fu3
- ot'l-
I AND USE:
, OF I]NITS:
ooNl,; I R. TYt't,:
IlEAT l;OURCII,
RAI',lC[: ,-
t &qD
ZONINO CODE
FLOOD PLAIN
c OF BDRMS:
ICE USE -tIt_
UlO-
Na:e SECONDARY lltiAT:
SOUARE FOO'IAGE:
, OF tlTOIllt ,
WAtf:t] llt:Ali ,ll
t_l
[j
To request.rr ins;peclion, you rnust call 126.376g. This is a24 haur recording. All inspections recluested bt:fore 7:o0;-r.trl. will l)u
macle th(..:;.11r,) working ctay, inspections rcqueste(l after 7:00 a.m- will be made the following work day.
REOUIRED TNSPECTIONS
t- | lerttp,rr,rr y Electt ir:LI
| | Site' ltt:.l,ccti(llr - - ltr ht) trt.rrle
t ',rfl,ir,;. ,v,tl1r,rt, lrrrl ptiot t,,
'j!:tlllr(l ,lllis.
L_l
x.
r_J
,K
fl
Rorrgh Meclr;rtrical - Pri()r to
<:ov,:r. lP/El Va)T
ffJ:fl:l
Ele,ctric:tl - Ptitir to
Final Plurnbin{, - Wltrrrt ;rll
lrltrtrtbing wclt k is cotnl rli rttl.
Fin:rl Electrical - Wlr,'rt all
clectrical worli is cotlllrl(-lc.
Final Mechanical _ \ry'l;r,11 all
rrter;hanical work is or)ntl.,lctrr
Final Buildilrg - Wltt:tt ;rll
required inspcctions lt:rvr: bt,'t:tr
irpproved and lruilding ts
completed.
Other
-
A
I<
r_l
L]
,X
K
F
Under slrrb Plurrrl.:,i rrg/ Electrical I
Meclralrical - [rtior to ct,t'er.
FootinO - Allcr tr()nches are
exc:lva t ( )(1.
Masonry - Stt:cl locatioll, l)ond
bear[rs,,lroutit'tg.
Foundalion - After forms are
erecte(l t)ut prior to concrele
placen r(it lt.
Undclgr ouncl Plttrrrbing - [)rior
to filltttl; trencll.
Undertloor Plumbing/ Mechanical
- frri<-r to insulation or (lecking.
Post an(l Beant - Prior to floor
insu lilt ii.,11 or (,t.)ol(r ll0.
Floor lrrsulation - Prior to
declit tt< I
Sanitary Sewer -' l'rior to f illing
t rcnc l).
Stornr Sewer - l)tior lo lillirtg
trench.
Water Line - Pricir to fillltlg
trcnc lr.
Rough f)lumbirrg - Prior tci
covcl.
r_l Fireplace - Prior to f;rcitrg
rnaterials and framing lrtsP.
f, tt''"t"g -- Prii>r lo covcr'
Wall/Ceilirrg lnsulation - Prior to
Eleclrical Service - Mtrst be
a[)[)roved lo olrlait-t perll];lnent
elet:trical [)ower.
covcr.
tJ
[-_l Drywall - [)rior to taPir.tg
[-l Wood Stove - After installation
t_l lnserl - A{ter lirePlace aPProval
an(l inst:illation of unit.
rl Curbcut & Ap;rroach - After
forilts are crected but l.rrior to
l)lacement of concrete.
I I Sidewalk & Drivcway - Af terl--J cxcavation ts (:()rrrl)lete, forms
an(l sub-base tltirtcrial itr place.
[
--l tu""" - w]re n cornPletecl.
i_l Street Trees - Wlten all required
trecs are [)l,irrtted.
MOBILE HOME INSPECTIONS
Blocking and Set-Up - Whetr ,rll
blocking is ctitltplete.
Plunrbing Cottttections - Wlt,,tt
llome has bet.:tt connot:tt:cJ to
water and sewcr.
Electrical Contreclion - Whctr
blocki rrg, set-U [), artcl ;-rltr tttbitt1.;
irrspections lt;tve bet:tr atlr[)rov(j(i
irnd the hotrte is corlticolod l()
llre scrvice p;rtrel.
Final - After iill rctlLrirecl
inspections ate approvcd ancl
porches, skirting, deck:;, and
venting have been install(rd.t_l
\
(
IDD
tl
tl
fl
P.L.HSE
N
S
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total height
Lot Type.
-
lnterior
-
Corner
-
Panhandle
..- Cul-de'sac
Setbac ; THE PROPOSED WORI( IN THE
--l'-.ilsrontcAL DtsrHtcr, oFl oN
THE HISTORICAL REGISTEB?,---
lf yes, ttris application must be signed
and approved bY the [Jistorical
Coordinator prior to permit issuance.
APPFiOVED:
GAR ACC
q:
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condilior-r th.lt the said
construction shall, in all rcspccts, conform to tlre Orclinance
arlopterJ by ttre City o{ Springficld, ir.rcluding the
Developtrtent Cocje, rclltrlatin-<1 the construcliorl antl use of
buildirrtts, an<l rnay b<.' :rtlsl;ended or revol<crl at ;l11y tirllc
upon violation oI any provisions of said otclitrarrces.
-Lfi-s2
PI *'#'ewe
uttt lte t
Plan Chcck Fec
Date Paid:
Receipt N
Received
VALUE
fi,aD fu
(A)
X $/SO. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
J24,fo
_ 5,2_?
D?-te
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carrport
Systems Development Clrarge is due on all undeveloped
properlies within the City limits which are bcing improved.
SYSTEMS DEVELOPMENT C
(B)
HARGE (SDC)* oze
ADDITIONAL COMMENTS
y'eazf
Ar€Al{ru< F"rV/t€e
ftzsz4.
-e4rt(@
ITEM
Fix t u res
Rcsidential Batl.t(s)
S.lriitary Scwr:r
Watr:r
Stortn Sewer
Mobile Home
PLUMBING PERMIT
FEE
N
FT.
FT.
FT.
(c)
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsertl Fireplace Unit
Dryer Vent 4tD-
Mechanical Permit
7,(D)25,
N0Verrt Fan
/< oe
_/o d0_
,7tlssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exl-raust Hood By signature, I state and agree, that I have caref ully examined
the cotnpleted application and do hereby certify that all
information hereon is true and correct, and I f urtl-rer certify
that any and all work perlormed shall bc done in accordance
with the Ordinances ol the City of Springf ielcl, arrtl the Laws
of the State of Oregon pertaining to the wotk described
lrerein, ancl tlrat NO OCCUPANCY will t,re trt;trtr) of atry
structulo witltout pertnissiorl of the Building S;rtcty Division.
I further certify that only contractors and emllloyees who
are ln compliance witl-t ORS 7O1.O55 will be rr:r(-'(J on lhis
proiect.
lfurther agree to ensure that all required in:;pet:tions are
requested at the proper time, that each address is rea<Jable
aL
K a?
from the street, that tlte p ermit card is locatccl at ttre f ront
ti
Date
gnature
pproved set of plans will rerrtainof the property, and t
on the sit during construction.
MISCELLANEOUS PERMITS
Mobile Homc
State lssuance
Slato Surcharge
Sldewalk *=-- lt
Curbcut =-- ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
5?r tq
NECEIVED BY
AMOUNT RECEIVED
VALIDATION
BECEIPT NUMBER
DATE PAID
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, anct E Coml>lned)
EA?I_
SI"ItNGFtELr)
db
225 FIFTB STREEf,
SPRINGFIELD, OREGON 97477
Ci ty
Supervi sor cense Number
Expiration Date
Constr Contr. Number
,h.".71-LHp
q \qa
INSPECf,I0N REQI BST z 726-376
0FPICE: 726-3759
1
Permits are non-tr
if vork is not sta d
erable and expire
vithin 180 daysof issuance or if vork is suspended for
180 days.
2. COI.ITRACTOR INSTALI^O.TION ONLY
Electrical Contractor
Address
ELECTRICAL PBRHIT APPLICATION
Number
rEB SCBEDULE BELOIJ
ev Residential-Single or
dvelling unit.
Service Included:
I tems
1000 sq.ft. or less
Eaeh additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
-Modular DveIling
Service or Feeder
Services or Feeders
Installation, Alterations or
Relocat ion:
spei
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/voIts
Reconnect 0nly
SUBTOTAL OT ABOVB
5Z State Surcharge
TOTAL
'!i:Prui*,cl
dcee nct
Cos t
$ 8s.oo
$ 15.00
$ 40.00
s0.00
60.00
100.00
130.00
300.00
40.00
Sum
B
$
$
$
$
$
$
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Expiration Date
Signature of Supervis Blectrician
200 amps or less $ 40.00
0ver 401 to 500 amps _ $ 80.00
Over 600 amps or 1000 volts see I'B'r above
Owners Name
Address
Ci ty Phone 1 0h" {}1
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit -....|_ $ 3s.oo e
Each Additional
Circuit or vith Service
or Feeder Permit S 2.00OTINER INSTALI^ATION
The installation is being made on
property I or*rn vhich is not intended
for sale, lease or rent.
Owners Signature:
DATE:
E Miscellaneous (Service/feeder
-Each installation
Pump or irrigation $
Sign/0utline Lighting_ $
Limited Energy/Res _ $
Limited Energy/Comm $
not included)
40.00
40.00
20.00
0cl5
RECEIVBD B
J0ti tio - clLolqG
CITY OF J' T(INGFIELD SYSTEMS DEVELOPI'IT'TT CIlARGI.
WORKSHEET
(coHl'IERCiAL & RESIDENTIAL)
NAI.IE 0R COI'IPANY, l(oW D \n lr Af, lNt g
LOCATION:lb?,+(?-?- 3T. ll ou q%b l2boo
LOZ - &sp rft or.tDEVELOPI'IENT TYPE:
BUILDING SIZE:
i. STORM DRAINAGE
THPERVIoUS SQ. FT.
(See Reverse For Ru
?. SANITARY SEI.IER-CITY
.L7. .9
?--7
TSI
x so.186 PER SQ- FT.
X 538.55 PER PFU
- Ft.
2rZ
s
S.
'lb
noff Coefficients I f Actual Imperv- Area Is Unknown)
NO. OF PFU'S
(See Reverse To Determine Total PFU'S)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x x s388-61
x _ x $388-6r s
x x s388-61 s
4. A N RATiVE
BASE CHARGE (SUBToTAL ABoVE) X .os s 2e)
TOTAL-C iTY SDC S bZ
5. SANITARY SEI.'ER-H1.IHC
NO. OF PFU'S X SI3.25 PER PFU .+ S]C MW'IC AOHIN. FEE
(Use PFU Total From Item 2 Above)
r'lr^,r'lc CREDIT iF APPLiCABLE (SEE REVERST)
S
s-
s+
Ki p Burdick
SDC Coordinator
(See Attachment C To Detennine Trip Rates
SUBTOTAL
)'(ADD ITEMs 1,2, & 3)$ 6o23
TOTAL-HWMC SDC
TOTAL SDC
("
s 6"-1V