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Home My WebLink AboutPermit Building 1993-11-08SPNII\rGFIELD RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726-3759 qs/s37 h, JOB NUMBER 225 Fifth Street Springf ield, Oregon 97 477 LOCATION OF PROPOSED WORK ASSESSORS MAP:TAX LOT:bo LOT:BLOCK:SUBDIVISION PHONE: OrtZf ZIP:STATE ?><2<z 7-Hzza.\ CITY: ADDRESS: OWNER NEW - REMODEL ADDITION DEMOLISH OTHEFI DESCRIBE WORK: EXPIRESADDRESS 5 -2 MECHANICAL: PHONE )e*ra) o4. CONTRACTOR'S NAME PLUMBING: GENERAL:. CONST. CONTRACTOR # RANGE * OF BDRMS: _ OFFICE USE - ZONING CODE: FLOOD PLAIN WATER HEATER: HEAT SOUBCE * OF UNITS: LAND USE: SECONDARY HEAT SQUARE FOOTAGE: OUAD AREA: * OF BLDGS: OCCY GROUP: * OF STORIES: CCNSTR, TYPE: -- To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspections requested before 7:00 a.m. will be made the same working day, lnspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS [--l Temporary Electricll Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Site lnspection - To be made after cxcavation, but Prior to setting forms. T< nough Electrical - Prior to {-7 Final Electrical - When attAover. Helectrical work is complete. Underslab Ptumbing/ Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. Final Mechanical - When all mechanical work is complete. Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing lnsP. X Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.lV4raming - Prior to cover.J\ ffiw"rttCeiling lnsulalion - Prior to - covef. Other Foundation - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench.ff"*^ll - Prior to taoing Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and installation of unit. Blocking and Sel-Up - When all blocking is complete. Floor lnsulation - Prior to deckirrg.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Conneclions - 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. Storm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Water Line - Prlor to fllling trench. Rough Plumbing - Prior to Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed.covet ,/<,tu:")2-8< AlfA ,^ ' tl E tl E tl E E E tl tl X f-l fence - When cornpleted. tl MOBILE HOME INSPECTIONS n rtl Lot faces Lot sq. ftg. Lot coverage TopographY Total height Lot Type - lnterior - Corner - Panhandle - Cul-de'sac P.L.HS ACC Setbacks GAR ISYHE PROPOSED WORK IN THE }lISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? -_ lf yes, this application must be signed and approved bY the 11 istorical Coordinator prior to permit issuance. APPFIOVED: N D E BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This pcrmit 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 Developrnent Cocle, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Clteck Fee: . ,--- Recei pt Nutnber:- DatePlans Rcviewed BY Date Paicl Received BY FnG aa.,aMe ,qF&- 2-+@ VALUE (A) X $/SQ. FT. I ,o Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport /zoi'_ -ef: Systems Developrnent Charge is due'on all undeveloped properties within the City limits which are being improved.SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE 1oo &G / zdo.l-2-) t .-(c) No FT. FT. Fi. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent MECHANICAL PERMIT /5ffi zf]r(D) N0 Od fo Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan By signature, I state and agree, that I have caref ully examined the completecl application and do hereby certify that all information hereon is true and correct, and I f urther certify that any alrd all work performed shall be done in accordance with the Orclinances of the City of Springf ield, and the Laws of the State of Oregon pertaining to the work described herein, ancJ that NO OCCUPANCY will be made of any structure without perrnission of the Building Safety Division' I further certify tlrat only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is re4dable from the street, that the permit card is located at tfG-(ont of the property, and the approved set of plans will remain on the site at all times during construction' \ Sig natu re Date MTSCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut .-_- ft Demolition State Surcharge Total Miscellaneous Permlts (E) '/ - 7" -;'l 2_-./o 7 gDATE PAID AMOUNT RECEIVED RECEIVED BY --- VALI DATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) }G?J_g _ __,? -r_ I CITY OF , JOB DESCRIPTION G:L-2 Permi ts rable and expireif sork is not start'ed rr.r'tbin 180 daysof issuance or if vork is sgspeaded for 180 days. 2. COITIRACTOR INSTAII,ATION ONLI Electrical Contractor 0REG0l,l ELE$RlC SERVICI AddressiS)r, (, ) -),r?- Frn. , Ci ty Phone €/€ - /6 [i Supervisor,cense Ntimber /jgJ t.\. ExpiratiooDate /U - /- ?S- Constr Contr. Number ,--]._rcl (:_ Expiration Date q 1 ture of Supervising Eleetrician Ovners Name Ci ty Phone OIINER INSTALI.ATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: DATE: RECETPI *: ,1 1000 sq.ft" or less Each ,additional 500 sq. ft or portion thereof Eaeh }lanuf 'd ffome or s 8s-00 s 1s.00 ilodular Dvelling Service or Feeder s 40-00 Services or Feederslnstallation, Alterations or Relocati on: 200 amps or less 201 aurps to 400 a,nps -401 amps to 600 amps ]601 amps to 1000 anps_ 0ver 1000 amps/volts Reconnect Only Tenporary Services or Feeders Installation, Alteration or Relocation Hiscellaneous (Service/feeder -Each ins.tallation Ptrmp or irrigation $ Sign/0utline Lighting_ SLinited Energy/Res S Limited Energy/Comm S 225 ETETE STREET SPRINGFIELD OREGON 9, INSPECTION REOtIBSf,: OFEICE: 726-3759 1. IOCArION OF B C s s0. $ 60. $100. 00 40 $r.30 00 00 00 00 00 00 $g $ I r- *- | -200 amps or less S 40.00 0ver 401 to 600 amps _ S 80.00 Over 600 amps or 1000 volts see *Bn above D. Branch Circuits Nev, Alteration or Extension Per Panel one circuit t S ss.oo €S_5u Eaeh Additional Circuit or vith Service or Feeder Perni r lL) $ 2.009-f E 5 SIDTOTAL OF ABOVE 5f State Surcharge TOTAL not included) 40.00 40.00 20.00 \a@ ,a <rS RECETVED BY -b es Items aaaressltl{S Lr,u--r^ ( /1, / ( sPrrrNGFrr:LL) 225 FIFTE STRBEf, SPRINGFIEIJ, OREGON 97477 INSPECTI0N RBQI EST. 726- OFPICE: 726-3759 1 as not rgqu ire opeoilic land uce ELECT?.ICAL PERHIT APPLICATION 200 amps or less 0 n 201 amps to 400 amps -L /.- 401 amps to 600 amps _601 amps to 1000 amps_ Over 1000 amps/volts _ Reconnect 0nly fne zoning, and approval. Authorued m 3\ --" -\' \ Permits are\ non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. COIflRACTOR INSTALI.ATION ONLY Electrical Contracto City Job Number SCEEDULE BBLOV Nev Residential-Single or HuIti-FamiIy per dvelling unit. Service fncluded:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular Dvelling Service or Feeder $ 8s.00 s 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: &ee*N_'$ot2 A Sum r JOB DESCRIIPTIONt t rn lr Vrt"r-:t -\L- B Addr Ci ty Supe $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 40.00 s5.00 80.00 e rBl| ess rvisor Li cense Number A7 2C-S Expiration Date q c. Temporary Services or'Feeders Installatlon, Alteration or RelocationConstr Contr. Number Expiration Date b+Au Electrician 200 amps or less I S 201 amps to 400 amps * S over 4b1 to 500 amps - $ 0ver 600 amps or 1000 volts se a5oIil Signature of Supe rv Ovners Name Address \c Ci ty one OVNER The installation is being made on property I own which is not intended for sale, Iease or rent. 0rners Signature: DATE: D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 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/Outline Lighting_ S Limi ted Energy/Res $ Limited Energy/Comm $ ST,BTOTAL OP ABOVB 5Z State Surcharge TOTAL 40.00 40.00 20.00 36.00 OFEGO'U RECEIVED BY: 5 U) @ FiRE DA},IA.GE REPORT OR ELECTRiCAL HAZARD ,)bffi 3t50-/ DATE:tD-s-? 3 TO: FR0t'1: SUBJECT: Bu'i'ldi ng Department Springfield Fire Department Structural Damage to Building Address or 'location of bu'ilding Name of ov,ner Type of buiiding Estimated value of building Estinrated loss to building Date of fire (Dwelling, S e, l{arehou , etc. ) $ 30,ooo to -s-13 Location or damage i n bu i'l di ng (""+, tDa( Is d"r k , efrcttat a rw) in*cntor. TRcof,-ra1l , Exterior, interior, etc.) Structural weakness as a resu'lt of the f ire (Burned raf ters , Beams , .lo i s ts , etc . ) Addr'ti onal oert'i nent i nfcrna t,'on e PO o El ectri ca i iJazard (,l./iring, 0utl ets , etc. ) q3 S'iq ned ;t" /,.' $ i ao, DDh