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Home My WebLink AboutPermit Building 1997-01-09RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726.3759 LOCATION OF PROPOSED ASSESSORS MAP: SPRThlGFIELD JOB NUMBER q 225 Fifth Street Spri ng fleld, Oregon gZ 4ll TAX LOT SUBDIVISION: lJ'i LOT BLoCK: - OWNER: ADDRESS: CITY: PHONE: ZIP: 7 STATE ADDITION DEMOLISH OTHER DESCRIBE WORK: NEW- REMODEL ADDFIESS 153Qn -q{EX ES PHON CONTRACTOR'S NAME MECHANICALI ELECTRICAL: CONST. CONTRACTOR # GENERAL: PLUMBING - OFFICE USE - WATER HEATER: FLOOD I)LAIN ZONING CODE: RANGE: QUAD AREA: * OF BLDGS: SECONDARY HEAT: SQUARE FOOTAGE: # OF BDRMS: _ LAND USE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: # OF UNITS: - To req made uest an lnspection, you must call 726-3769. Thls ls a24hour rccordlng. All lnspections requested before 7:00 a.m. wlll bethe same worklng day, lnspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS Temporary Electric Rough Mechanlcal - prlor to cover. Final Plumbing - When allplumblng worl< ls complete. Slte lnspectlon - To be made after excavation, but prior tosettlng forms. Rough Electrical - Prlor to Final Eleclrical - When ail electrical work is complete.cover. Underslab Plumblng/ Electrical / Mechanlcal - Prlor to cover.Electrical Servlce - Must be approved to obtaln permanent electrlcal power. Final Mechanical - When allmechanical worl< is complete. Footlng - After trenches are excavated.Flreplace - Prlor to faclng Final Building - When allrequired lnspections have been Masonry - Steel locatlon, bond beams, groutlng. and framlng lnsp.roved and building is completed Framlng - Prlor to cover. Foundatlon - After forms are erected but prlor to concrete placement. Other WalllCelling tnsulatlon - Prlor to cover. Underground Plumbing - Prior to filllng trench.[-l Drywall - Prlor to taptng. Underlloor Plumblng/ Mechanlcal - Prlor to lnsulatlon or decking. MOBILE HOME INSPESI'IONS Wood Slove - After lnstallation. Post and Beam - Prior to floor lnsulatlon or decking.lnsert - After flreplace approval and lnstallatlon oI unlt. Blocking and Set.Up - When alt blocklng is complete. Floor lnsulation - Prior to decking.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Connections - When home lras been connected to water and sewer. Sanltary Sewer - Prior to filling trench.Eleclrical Connection - When blocking, set-up, and plumbing lnspections have been approved and the home is connected to the service panel. Storm Sewer - Prior to tllling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Water Llne - Prlor to filling trench, Fence - When completed. Streel Trees - When all requlred trees are planted. Final - After all required lnspections are approved and porches, skirting, decks, and ventlng have been installed.Rough Plumbing - Prior to cover. E E E tl E tl tl E fl tl E EE tlE ri:: Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type Y - lnterior - Corner - Panhandle - Cul-de'sac S i lrj THE PROPOSED WORK iN THE. HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this applicatlon must be slgned and approved bY the Historlcal Coordinator prior to permit issuance. APPROVED: GAR ACCP.L.HSE N S E W- BUTLDING VALUE, pTRN CHECK AND BUILDING PERMIT This permit is granted on the cxpress 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 Beceipt Numbe Plan Check Fee: Date Paid Received By: BUILDING PERMIT VALUE State surcharse 13?'C' Total Fee rt /--1 ,3C\) tI 4)(A) SO. FT. X $/SQ. FT.ITEM Main Garage Total Value Building Permit Fee SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT FT. FT. PLUMBING PERMIT Plumbing Permit Stato Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) N0Vent 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 examlned the completed application and do hereby certlfy that all lnformation hereon is true and correct, and I f urther certi(y that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, and the Laws of the State of Oregon perlainlng 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 701.055 will be used on this proiect. I further 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 ls located at the front of the property, and the approved set of plans wlll remaln Slgnature on the site at ructlon.I times du c MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Pennits (E) TOTAL AMOUNT DUE (excluding etectricat) (A, B, C, D, and E Combined) 24?Ab qaEIVED VALIDATION: UMBER AMOUNT REC FIECEIVED BY RECEIPT N DATE PAID l- Systems Development Charge is due on all undeveloped properties within tlre City limits which are being improved. a3 ?g C'TYOF SPrlII\lGFIELO 225 FTTTII STRNET SPRTNGFIELD, oREGoN 97477 INSPECTTON REQUEST t'.726-3769. % OFFICE: 726-3759 1. LOCATION OF ALLATION o JOB DESCRIT"TION 3,cA, I taE- a YE Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if.vork is suspen?ed for 180 days. 2... CONTTIACTOR INSTALLATION ONI,Y B. Electrical Contractor&tce*te 6 ertttr $tC Address/;) llna )?DE- Ci ty E t r-nn)ti Phone ?qtt-45b/ Supervisor License Number /Oq33 Expiration Date, consrr contr. Number ?o2oo Expiration Da te Signature 6f Supervising Electrician ELECTRTCAL PBRHIT APPLICATION Ci ty Job Number 3. COHPLETII FEE SCIIEDI.II^E BELOV A. Nev Residential-Single or MuIti-FamiIy per dvelling unit. Service fncluded: I tems Cos t 1000 sq.ft. or less Each additional 500 sq. f t or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 8s.00 s ls.00 s 40.00 Services or Feeders Installation, Alterations or Relocation: Sum 200 amps or less I 201 amps to 400 amps _40L amps to 600 amps 601 amps to 1000 amps- Over 1000 amps/vo1ts Reconnect Only $ s0.00 s 60.00 $100. 00 $130.00 s300.00s 40.00 = 0vners Nane J)4n1g r)A C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less S 40.00 0ver 401 to 600 amps $ 80.00 Over 600 amps or 1000 voTts see t'8"- aEE D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit S 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Ou tline Ligh ting_ Limi ted Energy/Res Limi ted Bnergy/Comm SUBTOTAL OT ABOVE 5Z State Surcharge 32 Adnrinistrative Fee 1'0TAL Address J.3 ? I ur Bt .t Ci Phone 729 - /talZ OIJNER INSTALI.TTION The installation is being made on property I oL,n vhich is not intended for sale, ]ease or rent. 0vners Signature: DATE: I(F,CIiIP'T' s 40.00 s 40.00 s 20.00 s 36.00 5 RIiCT:IVED I} 5a--wr /,bu54aD- The follrrlving project as oubmitteC has the followin zcni.,g, ard tJses not raquire tpeciiic lind uso SPRINGFIELO 1000 sq.ft. or less Each adriitional 500 sq. ft or portion thereof Each Manuf'd Home. or -Modula.r Dwelling Service or Feeder Services or Feeders Installation, Alterations or Relocation: D. Branch Circuits ft_ 77 INSPEC;TION REQLIEST : 726L3t76$tit i' ; OFFICE: 726-3759 1 ELECTRICAL PERHIT APPLICATION Job Nunber q q 3. COHPLETE FEE SCMDULE BELOV Nev Residential-Single or Multi-Family per dvelling unit. Service fncluded: I tems Cos t .. .225 FIFTE STREET SPRINGFIELD, oREGoN 974 LOCATION OF INSTALTATIONl2Llb svh # LEGAI ON A B c 3 boo Permits are non-transferable and expireif vork is not started vitirin 1B0 days of issuance or if vork is suspended for 1B0 days 2. CONTRACTOR INSTALIdTTON ONLY Electrical Contractor Address city- Phone, Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of. Supervising Electrician Ovners Name 200 amps or less 20L amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps Over L000 amps/volts -Reconnect 0n1y 200 amps''or less 201 amps to 400 amps -Over 40L to 600 amps -0ver 6O0 amps or 1000 vofts Temporary Services or Feeders Installation, Alteration or Relocation Sum s 8s.00 s 15.00 $ 40.00 s 40.00 s ss.00 $ 80.00 see ttB" a6ove s s0.00 s 60.00 $100.00 s130.00 s300.00 s 40.00 Address Ci ty Phone Nev., Alteration or Extension Per Pane), ^/ Mfifi"W +" rrE ruKG (#f ,, _ q 7 Each Addi tional \-/ ?u,t'7<-- :l';::i":'rXlil.t"'"W $*)1.o!!LfrCOVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation _Sign/Out1ine Lighting_ Limited Energy/Res Limited Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL $ s $ s 40. 40. 20 00 00 00 00 5 DATE: RECEIVED B 36. :. .' ., rl ( N