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Home My WebLink AboutPermit Building 1996-04-15SPrrINGFIELD RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PFIOPOSED WORK TAX LOT: 769. Thls ls a24 hour recordluested afler 7:00 a.m. wlll bem ng ade the following work All lnspections requested before 7:00 a.m. will REQUIRED INSPECTIO NS day. m Rough Mechanlcal _Prlor to Flnal plu mbing - When ailcover. plumbi ng worl( is complete. !^llnt Etecrrtcat _ prror tocover.Final Elect rlcal - When ailelec trical work i s complete.mbing/ Eleclrical/ Prlor to cover.Eleclrical Servlce _Must be ASSESSORS MAP:>-/?= -V=\22 To request an lnspectio n, you must call 726-3made the same work lng day, lnspections req l-l femporary Etectrtc Slte lnspecllon _To be madeafter excavation. bsetting forms.ut prior to Underslab plu Mechanlcal Footlng - After trench es areexcavated approved to obtain permanentelectrlcalpower. w l::i^x;;i Tf,fl ,;"y*;?"ill E i{{ii"'J " *,?ffi l,Ji,t,,x,, o u ",approved and building i.- -""" completed. be [1T], - Steet tocailon, bondDeams, grouilnO. F-orrndatlon - After forms are:l::!.d but prtor to concretep,acement. ,'J'ffiI3;.,,13d Piumbrne - Prior 3 ff ,'l',"iJ,?,Jf,i,,,:i, llT::[,,;;] ,?""",1 i,?i"i.,-xi ; IJ:.' t o, oo r E ll.:l tnsutation _ prlor to - decking. ;3ll;" Sewer - Prior to rtrrins iffi.a"*"r - Prior to fnring ,Y;l:i..,"" _ prror to fiilins Rough Plumblng - prtor tocover. ll:p,,":" - prtor to factnsmaterlals and framing lnspi [Z rt"mtng - Prror to cover. t] g*i:eltlns tnsutatton - Prror to W Drywall - Prror to taprng. Wood Stovo _ After lnstallatlon. :?." il ;,fl|,L,,j? t;i: a p p rova I !11U_cut & Approach _ After ;?:;;;T:, ";ec teo"o,, t o,i o i"tt ljl:yl|k &.Driveway _ After :l :"Jl [ :,1 l: ;Ij,i""i i ^i:1,:; Fence - lvhen completed. MOBILE HOME INSPE TIONS 8,'ffi,',if ,i"j.i.,"J;yl- when a,, ;:S'j}:Hii1"d;Yr"' ftffi*:{'J*i*- [lit+*[i*bp,l'.d;# Other \ PHONE STATE:ZIP: CITY: ADDRESS: OWNER: REMODEL ,r DESCFIIBE WORK: NEW -.-DEMOLISH OTHER ADDRESS EXPIRES PHONE ELECTRICAL: PLUMBING: MECHANI CONTRACTOFI'S NAME GENERAL: CONST. CONTRACTOR # - OFFICE USE - LAND USE: r OF BDBMS: r OF UNITS: WATER HEATER RANGE: OUAD AREA: I OF BLDGS: SECONDARY HEAT: SOUARE FOOTAGE: OCCY GROUP: # OF STORIES: FLOOD PLAIN: ZONING CODE: CONSTR. TYPE: HEAT SOURCE: [-_l Street Trees - When ail requlred.+ trees are planted. JoB NUMBER-%32- 225 Fifth Street Sprlngtleld, Oregon 97477 t LOT BLOCK:SUBDIVISION: -- tl tl fl P.L.HSE GAR ACC N S E Lot faces Lot sg. ftg. Lot coverage TopographY Total height Lot TyF,- - lnterior - Corner - Panhandle - Cul-de-sac IS THE PROPOSED WORK iN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this applicatlon must be signed and approved bY the Historical Coordinator prior to permit issuance. APPROVED: BUTLDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said consiruction shall, in all respects, conform to the Ordinance adopted by the City ol Springfield' including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon vi,olation of any provisions of said ordinances' Plan Check Fee: DatePlans Reviewed By Receipt Numbe Date Paid Fleceived BY: BUILDING PERMIT VALUE i?:-? (A)?t SO. FT. X $/SO. FT.ITEM Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fec Systems Development Charge is due on all undeveloped propertie" withln tlre City limits which are being improved'SYSTEMS DEVELOPMENT CHARGE (S (B) Dc) ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) SanitarY Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT FEE N0 FT FT, FT. (c) Plumblng Permit State Surcharge Total Charge Wood Stove/ lnsert/ Flreplace Unit DrYer Vent MECHANICAL PERMIT No *-)'13 L/_ 5?f .- 4? ,y4a. (D) a. 4zZ .-'A 9.o a ,7 Furnacc Exhaust Hood Vent Fan Mechanical Permlt lssuance State Surcharge Total Permit By slgnature, I state and agree' that I have caretully examlned the completed appllcatlon anO do hereby certify that all lnlormatlon hereon is true ancl correct' and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordinanccs of the City o( Sprlngf ietd' and the Laws of the State of Oregon pertainlng to the work described hereln, and that NO OCCUPANCY will be made of any structure without permission of the Buildirrg Satety Divislon' I lurther certily that only contractors and .employees who are in compliance with ORS 701'055 wlll be used on thls proiect. Signa Date re proved that all required insPections are t {urther agree to ensure that each address is readable roquested at the ProPer time' it card ls located at the front (rom the street, that the Perm set of Plans will remainand theof the ProPerty'tiouring coon the site at all tiMISCELLANEOUS PERMI Mobile Home State lssuance State Surcharge Sidewalk - Il Curbcut - ft Demolition State Surcharge Total Miscellaneous Perlnits (E) TS TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 1 // VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY z ; a2-ry*@t Z IaI Ia sP6tHiftELo ?rt, 225 EIFTE STREET SPRINGFIEI.D' OREGON 97477 INSPEC;TION REOIIEST z 126- OFFICE: 726-3759 ug6 ELECTRICAL PERUIT APPLI b Nunber 3. COHPLETE FEE SCMDULE BELOU Nev Residential-Single or MuIti-Family per dvelling unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 8s.00 $ 1s.00 $ 40.00 B Services or Feeders Installation, Alterations or Relocation: 3-_c\ 3i,f8otr""'a 1. LOCATION OF INSTALLATION a ZA hrA -r,€ 2- S 7- ON JOB ON U 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. CONTRACTOR INSTATLATTON ONLY Electrical Contractor Address A Sum 1: 200 amp 201 amp 401 amp 601- amp soststst r less o 400 amps -o 600 amps _o 1000 amps s s0.00 s 60.00 s100. 00 s130. 00 s300.00 $ 40.00 e - .tu tv Phone pervisor License Number Expiration Date Constr Contr. Number iration Date Signature of Supervising Electrician rs Name s, ess Z' 9 OVNER TNSTALLATION he installation is being made on roperty I ovn vhich is not intended or sale, lease or rent. s Temporary Services or Feeders Installation, Alteration or Relocation Over 1000 amps/voIts Reconnect Only C 200 amps''or less 201 amps to 400 amPs _ Over 401 to 600 amps 0ver 600 amps or 1000-toTt one Circuit --,!4Each Additional Circuit or vith Servicer, or Feeder Permi t lO $4$s $Bs see 0.00 s.00 0.00rrgtt u[[!!- s 3s.00 s 2.00 D. Branch Circuits Nev, Alteration or Extension Per Panel E. Miscellaneous (Service/feeder not included) -Each lnstallation Pump or irrigation _Sign/0ut1ine Lighting_ Limi ted Energy/Res 5. SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL $ 40.00 s 40.00 s 20.00 $ 36.00 DATE: RECEIVED B ture: 0 \u_1il RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PRO ASSESSORS MAP: LOT; SPRII\{GFIELD ZC BLOCK: JOB NUMBER 225 Fifth Street Sprlngfleld, Oregon 97 471 l D TAX LOT: SUBDIVISION L- 6S PHONE: ZIP:STATE:7 //<,6/r-? e_-d,/CITY: ADDRESS OWNER: ADDITION DEMOLISH OTHEH DESCR'BE WOR NEW-.- REMODEL ADDRESS EXPIRES PHONE s L d F-{LOut/lt /nE CONTRACTOR'S NAME ELECTRICAL: MECHANICAL: CONST. CONTRACTOR # GENERAL: PLUMBING - OFFICE USE - LAND USE: I OF UNITS: WATEFI HEATER RANGE: ZONING CODE: # OF BDRMS QUAD AREA: I OF BLDGS: OCCY GROUP: r OF STORIES: CONSTR. TYPE: HEAT SOURCE: SECONDARY HEAT: SQUARE FOOTAGE: To request an lnspecilo n, you must call 726-3769.Thls ls a 24 hour recordlmade the sarne workl ng day, lnspections req ng.All lnspections requesteduested after 7:00 a.m. wlll be made the following work before l:OO a.m wlll be REQUIRED INSPECTI day. [--l remporary Electric ONS Rough Mechanlcat _Prlor to f-ffiinat '----J plum cover.Plum bing - When allSIle lns pecllon - To be made blng worl(is complete. af ter excavatio n, but prior to f!4orgh Etecrricat _ prior to.< cover-setting forms [].Ftnat - electi Eleclrical -When alttl $:5:,lt9,i:913i15'::y::,,, x rical work is complete. Electrlcal Servlce _Must'be Flnal Mechanical _approved to obtain Permanent mechanical work ls When all Footlng - After t renches are electrlcal power.complete. excavated. M-a-sonry - Steel locailon, bondbeams, grouilng. l-o111!grfon - After forms areerected but prlor to concreteptacement. li"ffilx;.,ii:drfumbrng - Prior 3 H'l'iiJ,?,:ffi,,,:?, llTm,,ff l Il:l!.t" - prtor to factnsmaterlals and framlng lnspi Framlng - prlor to cover. Wall/Celling tnsulallon _ prlor tocover. Drywall - prlor to taplng. Flnal_Buildlng _ When ail l:ly,l"d.lnspecttons have beenapproved and buildinq iscompleted. Olher Wood Slovo _ Afler lnstallailon. ll*l : After ftreplace approvalanc, lnstallailon of unlt. ,C^ylb9r, & Alrproach _ Afterrorms are erected btrt prior topracemcnt of concrete. MOBILE HOME INSPE TIONS l-"-"t 1To Beam - Prror to froortnsulation or decking. Floor lnsulalion _ prlor toclecking. B,*[,'X$,i"l.i"J;![- when a,, Ily1birn connections _ When :.o^T9 hr: been conneaed towater and sewer.Sanitary Sewer - prior to fillingtrench. Slorm Sewer _ prlor to flllingtrench. Y:::r-Llne - prlor to fiilinstrench. Sidewalk & Driveway _ Afterexcavation is compi'ete, formsand sub-base material in ptace. Fence - Vvhen completed. ,'i' ^*xr,u*:#if:.:l_o Jh".home is connected totne service panel. Lu'i#tl Plumbins - Prror to l-_l Street Trees - When ail required - trees are planted.[iT#Hlt**{i,"l;,ffi 01//pp ,5A,I5, FLOOD PLAIN: flrl rn t]tl E E Lot faces Lot sq. ftg. Lot coverage TopograPhY Total height Lot Type - - lnterior - Corner - Panhandle - Cul-de-sac Se PL.HSE GAR ACC N S E i-.aS THE PROPOSED WORK iN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and apProved bY the Historlcal Coordinator prior to permit issuance' APPBOVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said consiruction shall, in all respects, conform to the Ordinance "Jopt"O by the City of Springfield, including the Development Code, rejulating the construction and use of Ouif Oin'g", and may be suspended or revoked at any time upon violation of any provisions of said ordinances' DatePlans Revi ewed BY Plan Check Fee:. Date Paid: Recei Pt Number: Fleceivecj BY: VALUE (A) BUILDING PERMIT Total Value Building Permit Fee State Surcharge Total Fee SQ. FT. X $/SO. FT.ITEM Main Garagb Carport Systems t)evelopment Charge is due on all undeveloped properties within tlre City limits which are being improved'SYSTEMS DEVELOPMENT CHAR (B) GE (SDC) ADDITIONAL COMMENTS ITEM Fixtures Besidential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home PLUMBING PERMIT N0 0 FT. FT. FT. (c) q u) Plumblng Permit Stato Surcharge Total Charge Wood Stove/ lnsert/ Flreplace Unit Dryer Vent MECHANICAL PERMIT No (D) Furnace Exhaust Hood Vent Fan Mechanical Permit lssuance State Surcharge Total Permit By slgnature, I state and agree' that I have caref ully examlned the completed application and do hereby certify that all lnformation hereon is true ancl correct' and I lurther certi{y that any and all work performed shall be done in accordance wlththeordinancesoftheCityofspringfield'andtheLaws of the State ot Oregon pertalnlng to the work described herein, and that NO OCCUPANCY will be made of any structure wlthout permission of the Buildirrg Safety Division' I further certify that only contractors and employees who are in compliance with ORS 701'055 will be used on this proiect. ensure that all required inspections are er time, that each address is readable o I {urther agree to requested at the ProP mit card ls located at the front from the street, that the Per set of Plans will remainof the PropertY, and the aPProved tion.es during coe site at MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sldewalk - ft Curbcut .- ft Demolition (E) To tal Miscellaneous Pertnits AMOUNT RECE VALIDATION BECEIPT NUMBE DATE PAID RECEIVED BYTOTAL AM (A, B, c, D' OUNT DUE (excluding electrical) and E Combined) State Surcharge \Jh.ct