HomeMy WebLinkAboutPermit Building 1993-09-01CONTRACTOR NAM ADD
CONST.
ONTRACTOR #EXPIRES
r)
PHON
4GENERAL:
PLUMBING
MECHANICAL:
ELECTRICAL
).)a
SPR FIELEI
WOR
BLOCK:
h,
SUBDIVISION
TAX LOT
LOCATION OF PROPOS
ASSESSORS MAP:
RESID ENTIAL
PERMIT APPLICATION
lnspections:726-3769
Office: 726-3759
LOT: _---
225 Fifth Street
Spri ngf i eld, Oregon 97 477
PHONE:
ZIP:STATE:
OW
ADDRE
CITY:
ADDITION EMOLISH OTHER
DESCRIBE WO
NEW
-
REMO
_ OFFICE USE _
OUAD AREA:
# OF BLDGS
FLOOD PLAIN:
ZONING CODE:
, OF BDRMS
Final Electrical - When alt
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.
Post and Beam - Prior to floor
insulation or decking.
Floor lnsulation - Prior to
decki ng.
Sanilary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Electrical - Prior to
cover.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Fireplace - Prior to facing
materials and framing lnsp.
ing - Prior to cover.
Wall/Ceiling lnsulation - Prior to
cover.
| - Prior to taping
Wood Slove - After installation
lnsert - After fireplace approval
and installation of unit.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
[--l Fence - When completed.
Street Trees - When all required
trecs are planted.
LAND USE:
E OF UNITS:
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
WATER HEATER:RANGE
SECONDARY HEAT
SQUAFIE FOOTAGE:
To request an inspection, you must call 726-3769. This is a 24 nour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested afler 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
[-l Temporary Electrictt Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
"_D( I )y'Final Building - When all
fl required inspections have been/ approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When all
blocking is complete.
Plumbing Conneclions - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Rough Plumbing - Prior to
cover.
QZ
JOB NUMBER
Curbcut & Approach - After
fornrs are erected but prior to
placement of concrete.
E
E
E
E
tl
tl
E
E
fl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de'sac
Setbacks
P.L,HSE GAR ACC
N
S
E
lS THLv-,1OPOSED WORK lN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTEFI?
-
lf yes, this application must be signed
arrd approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit 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 Cocje, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions o( said ordinances.
Reviewed By DateP
Plan Check Fee
Date Paid
Receipt N umber:
Received By
VALUE
b3
(A)
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FT.
Main
Garage
Carport
Systems Developmcnt Charge is due on all undeveloped
properties within the City limits which are being improved.SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
No
FT.
FT.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Mechanical Permit
(D)
N0
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Orclinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division'
I further certify that only contractors and employees who
are in compliance with ORS 701.O55 will be used on this
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
of the property, anci the approved set of plans will remain
tionon the si I tirn
Signature
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut -- ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
RE CEIPT NUMBER
VALIDATION
DATE PAID
AMOUNT RECEIVE
RECEIVEDTOTAL AMOUNT DUE (excluding electrical
(A, B, C, D, and E Combined)
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
J aI
''3"EAB'15ffiS]?{r">
'/.25 lfllnll 5'I'RI':l':'[
sl,ruNGrII|LI), 0ltli(:ot'l 97 47'l
INSPIIC:I'ION RDQUIIS'I: 72-6'3'169
0FItICE: 7?.6-3759
JOB DESCRI ON
Pernrits arc non-transferable a
IiIcc trical Con t rae tor t^ A)
Ad<l r:ess
2Iy
eP P,LECI'RICAL PINTHIT APPLICATION
J *- CitY Job Nunrbcr
]. COHPLU'TII TEE SCNEDULI DBLOV
Nev Residentlal-Single or
HuIti-FamiIy per duelling unit.
Scrvlce Included:
Items Cost
t
\ \q'r\"
A
D.
E
\
c Sum
lf vork is no( started vlthin 180of issrrance or if vork Is suspen<t
180 days.
2. COI.nTIACTOR INSTALLATION ONLY
ci ry I: tAA^ Ltr r'no'e . ? I4-S-I? C
Sr,rpcrvi..;or License Ndnrbcr lq-s
Expiratiorr Date l*g.<
Con:; t r Corr t r. Numbe r
Expi ra t ion Da te
si ure of Supervisi ng [lectrician
Ovners lne
Arld rcss \o-
1000 sq.ft. or less
Each additional 500
sq. ft or portlon
t lrc reo f
Each Hanuf ,d ltome or
-Hodular DueIIing
Service or Feeder
Servlces or Feedersfnstallatlon, Alterations or
Relocation:
200 amps or less $ 5O.OO201 anrps to 4oo amps
-
S 60.00401 amps ro 600 amps
-
g1oO.O0
601 amps ro 1000 amps- $13O.OOover 1000 amps/volrs
-
$3oo.o0Reconnecr 0nly -i- $ /10.00 S
Temporary Services or FeedersInstallatlon, Alteration or Relocatlon
200 amps or less S 4O.OO2ol amps to 4oo amps
-
$ ss.ooover /rol. to 6oo amps
-
S so.o00ver 600 amps or 1000-6'fEs sce rrgl ufiffie-
Branch Clrcul ts
Nev, Alteratlon or Extenslon per panel
exp I re
days
ed for
$ 85.00
$ 1s.00
s 40.00
$ 3s.00
$ 2. oo
B
C
i City ['ltonc
0vNrin ALLATION
I'he installation is bcing ma<le onproperty f own vhiclr is not intendeclfor sale, Iease or rent.
Ovners Slgna trtre:
Plrmp or irrigation
Sign/OutIine Lighting-
Limi terl Energy/iles e-
Limi ted Energy/Comrn
l'liscellaneous (.Servlce/feecler not lnclu<led)-Eaclr installation
s 40.00
$ 40.00
$ 20.00
$ 36.00
SUI}TOTAL OP ADOTIE5f State Surclrarge
TOTAI,
4DATE:
RIiCNI I'T il:
Rli(:riIvr:r) IY;--
5
,4
li; ; ;
Q.10 t10
,eol
Lq 4
One Ci rcul t
Each Additional
Circui t or vi th Serviceor Feeder permi t
--
FD-16
\10SPR I};GF I E'-} EI RE DEPAii.T}1E.\-T
FIRE DAI4AGE REPORT
OR
ELECTRICAL HAZARD
DATE: 2- 13 -q7
TO:
FR0l.'l:
SUBJECT:
Building Department
Springfield Fire Department
Structural Damage to Building
Address or location of building 33d9 LD I
Name of ot./ner
Type of building la44;& Dnu t r
ie, etc. )
Estirlated val ue of bui I di no s @o 6<C
Est'imated I oss to bui ld'inq ooo o3
Date of fire 2- 17- q7
Location of damaqe i n bui'ldi nq
(Rcof, Wal I , Exterior, interjor, etc. )
Structural weakness as a result of the fire
(Burned rafters , Beams, "1oi sts, etc. )
Addi ti onal pert'inent i nforma tion
Electrical Hazard ..J orffirh. ,t^=- Aa-!Fo-,-r-a
(l,lirinq, 0utlets, etc. )
CC:u,)Z.1-1
SiqnedR". fu
*-t.r{rreLB
l**l**r
SPrrIN FIELD
oluoa
BLOCK
qr,
tr'J *t', nll ud Br.39eLOCATION OF PROPOSED WORK:
--TAX LOT:
SUBDIVISIONLOT:
JOB NUMBERRESIDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Of{ice: 726-3759
PHONE:
Qav)-ztPSTATECITY:
ADDRESS
OWNER:
MOLISH OTHER
DESCRIBE WORK
NEW
-
REMODEL ADDITION
EXPIRES PHONEADDBESS
vl4 3c3 4
d
(n^^^,rr,'ulU-A
CONTRACTOR'S NAME
MECHANICAL
ELECTRICAL:
CONST.
CONTRACTOR '{
G EN ERAL:
PLUMBING
RANGE:
# OF BDRMS
_ OFFICE USE _
LAND USE:
ZONING CODE:
FLOOD PLAIN
WATER HEATER
I OF UNITS:
SECONDARY HEAT
SQUARE FOOTAGE:
QUAD AREA:
, OF BLDGS
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
Temporary Eleclric Rough Mechanical - Pricr to
cover.
l-1*lnal PlumbinotZ plumbing *orti - When all
is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Eleclrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing / Electrical /
Mechanical - Prior to cover.Eleclrical 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.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, .grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Other
Wall/Ceiling lnsulalion - Prior to
cover.
Underground Plumbing - Prior
to f illing trench.fl orywall - Prior to taping.
MOBILE HOME INSPE TIONSUnderlloor Plumbing/Mechanical
- Prior to insulation or decking.
Post and Beam - Prior to floor
insulation or decking.lnsert - After flreplace approval
and installation of unit.
Blocking and Set.Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - 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 f illing
trench.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Eleclrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Water Line - Prior to filling
trench.
Fence - When completed
Streel Trees - When all required
trees are planted.
Final - After all required
inspections are approved andporches, skirting, decks, and
venting have been installed.
f. /Rough Plumbing - Prior to19 cover.
ASSESSOFIS MAP:
225 Fifth Street
Spri ngf ield, Oregon 97 477
"7 Ln . +0q1
tI
E
f_l Framing - Prior to cover.
r Wood Slove - After installation.
E
tl
tl
E
tl
r
E
r
E
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type \i-
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
:ie t bac ks
HSE GAR ACCPL.
N
a
E
--;
TI-{E PROPOSED WORK IN THE
r]ISTOFIICAL DISTFIICT, OR ON
THE HISTORICAL FIEGISTER?
-
lf yes, this application must be signed
ancl approved by the Historical
Coordinator prior to permit issuance.
APPROVED
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granteci on the express condition that the said
constructron shall, in all respects, conform to the Ordinance
acJopted 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'
Fteceipt Number:-_==-
DatePlans Reviewed By
F'lan Check Fee
Date Paid
Received By:
VALUE
(A)
BUILDING PERM!T
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT. X $/SQ. FT,ITEM
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
tuoo
3r.Sri
rl1"
N0
FT.
FT.
(c)
t.(>
30 0()Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certif y
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division'
I further certify that orrly contractors and employees who
are in compliance with ORS 701'055 will be used on this
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
f rom the street, that the permit card is located at the f ront
of the property, and the approved set of plans will rentain
Sign
Date \"q .q\
on the site at all times during ruction.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut -- ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
Slot lqz
4
0a
a-)lq
3r Lo
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
3tsa
FT.