HomeMy WebLinkAboutPermit Plumbing 1995-06-19SP ELr)RESIDENTIAL
PERMIT APPLICATION
lnspections:726.3769
Of fice: 726.3759
LOCATION OF PROPOSED WOBK:
JOB NUMBER
225 Fifth Street
Sprlngf leld, Oregon 97477
)(qssessons MAP TAX LOT:
BLOCK.:SUBDIVISION
To request an inspection, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:oo a.m. wlll bemade the sante working day, lnspections requested after 7;00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Ternporary Electric
z
I-_l UnOerslab Plumbing/ Electrical/
-
Mechanical - Prior to cover.
Site lnspection - To lre mado
af ter excavatlon, but prior to
SettinO foilrrs.
Footlng - Af ter trenches are
excavated.
Masonry - Steel locatlon, boncJ
beams, grouting.
Foundallon - After forms are
erected but prlor to concrete
placement.
Underground Plunrbing - prior
to filllng trench,
Underlloor Plumbing/ Mechanlcal
- Prior to insulatlon or decklng.
Post and Bearry. - Prior to f loorlnsulatlon or decklng.
Floor lnsulation - Prior to
dec ki n g.
Bough Plurnbing - Prlor to
cover.
Rough Mechanlcal - prlor to
cover.
Rough Electrical - Prlor to
covor,
Electrlcal Servlco - Must be
approved to obtaln permanent
olectrlcal power.
Flroplace - Prlor to faclng
materlals and framlng lnsp.
Framlng - Prlor to cover.
lnserl - After flreplace approval
and lnstallatlon of unlt.
Sidewalk & Drlvewav - After
excavatlOn ls completo, forms
and sub.base materlal ln place.
Str€el Troes - When all requlred
trees are planted.
Final Plumbing - When allplumblng work ls complete,
Final Electrical - When allelectrical work ls complete.
Flnal Mecharrical - When all
mechanical work ls complete,
FInal Buildlng - When ailrequlred lnspectlons have beenapproved and bullding ls
completed,
O thor
MOBILE HOME !NSPE TIONS
Blocking and Set.Up - When allblocklng ls complete.
Plumblng Conneclions - Whenhome lras been connected towater and sewer.
Wall/Colling lnsulatlon - prlor to
cover.
Drywall - Prior to taplng
Wood Stovo - After lnstallatlon.
X;:l:arY
Sewer - Prior to rrrrins
Curbcul & Approach - After
forms are erected but prior tgplacoment ol concrete.
Storm Sewer - Prior to fllllng
trench.
Water Line - Prlor to filling
trench.I Fence - When completed.
Electrical Connection - Whenblocking, set.up, and plumblng
lnspoctions have been approved
and the homo ls connected tothe servlce panel.
Flnal - After all required
inspectlons are approved andporches, sklrtlng, decks, andventlng have been Installed.
PHON E
A),aSTATE ZlPi
OWNER
ADDRESS
CITY:
ADDITION DEMOLISH OTHEB
ADDR EXPI RES PHON E
ELECTBICAL
CONTBACTOR'S NAME
DESCRIBE WORI(
MECHANICAL
G EN ERAL:
LUMBING:
NST.
NTRACTOR ,
NEW --- FIEMODEL
- OFFICE USE -
OCCY GBOUP:
ZONING CODE:
FLOOD PLAIN
tr OF STORIES: _.-___-_
WATEB I.IEATER BANGE:
QUAD AREA:
,f OF BLDGS
SECONDAFIY HEAT:
SOUARE FOOTAGE:
, OF BDRMS:
--
LAND USE:
CONSTB. TYPE:
HEAT SOURCEI
/ OF UNITS:.
a
E
l
fl
tl
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Iotat hetght
Lot Tvpe
-**_- r te rio r
._* Corner
_- Panhancile
-- Cul-de.sac
IS THE PRO
HISTOFIICAL
POSED WORK IN THE
DISTRICT. OR ON
Date
THE HISTORICAL REGISTER?
-
lf yes, this application must be slgned
lnd aPProved by the HtstoiicatCoordinator prior to peflnit issuance.
APPROVED:
BUILDI
AND B .ry.gl1LuE, PLAN cHECKUILDING PERMIT
Thls permlt is grantecj on the cxpress conclition that the saidconstruction shail, in ail respecis, ;;"1;;; io"tn" o,oinrn.eadopted by thc City, ol Springf ierJ, inctuOing theDevelopment CocJc. regulating in" "1r",iu.tion "no ,." ofbulldings, and may bc suspended or revol(ed at any timeupon vioration of any provisions of saicr irJrnrn"u..
Plan Check Fee: .--'-._
Dale Patd:
Recel pt Nurnbcr:-_.-..
Fleceive<J By;
PI ans Rcviewcd -t,
s
p
ystems Developmcnt Charge is c,ue on all undevelopedroperties withln tho Clty linrits whiclr are being improved.
ADDITIONAL COMMENTS
I f urther agree to ensurc that all required lns pections arerequested at the proper ilm e, that each acJcJress ls readablefrom the street, that the pe rmit card ls located at the frontof the property, and the ap proved set of plans will remalnon the site times du rlng construction
Slg natu re e.",- e.
By slgnature, I state and agree, that I have carcf ully examlnedthe compreted applicauon and c10 hcrsby ccrilfy that aillnformatlon hereon is true anc, correct, and I lurther cerilf ythat any and all work performed shall be done in accordancewlth the Ordinanccs of thc Ctty or Sprtngfieii, and tne Lawsof the State of Oregon pertalnlng to thc wort< descrlbedheroln, and that NO OCCUparuCy wttt trn m",ln of anystructure wlthout pcrrnission of Ure Bultdlr.'rf Lrfuty Divislon.I lurther certi,y that only contractors anc,"emptoyees whoare ln compllance wirh ORS 70i.OSS wiil be used on thlsprolect.
PL.HSE GAR ACC
N
S
E
BUILDING PERMIT
VALUE
(A)
.-
so. FT. x $/so. FT.ITEM
Main
Garage
Carport
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
VELOPMENT CHARGE (SDC)
(B)
SYSTEMS DE
ITEM
Flxtures
Resldenrlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
Zf,a'
FEE
N0
FT.
z
ea
Plumblng permlt
State Surcharge / ,
Total Charge
r+ ,7s
(c)
?_ eo
-/
-27azz--3-*-,..__
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
(D)
N0
Mechanlcal permlt
lssu ance
Stale Surcharge
Total Permlt
Fu rn aco
Exhaust Hood
Vent Fan
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk tr
CurUcut ' ft
Demolltlon
state surcharge
Total Mlscellaneous permits (E)
ToTAL AMoUNT DUE (exclu.ding etectrica \ _43(A, B, C, D, and E Comblned)
?
AMOUNT BECEIVED
. RECEIVED BY ----
DATE PAID
VALIDATION:
RECEIPT NUMBER
Date
FT.
/(d
C'TY OF oaEGorv
SPF|II IELD
225 FIFTE STREET
SPRINGFTELD, oREGoN 97 477
INSPEGTION REQUESTz 726-37
OPPICE: 726-3759
1 OF
The following project as snbrnrttarJ has thezon:ng. and does not require s1.i*,iic li.n,J uapprovel.
A
\{t
i::w
fl,
LEGAL/7 o Db2 7)
JOB DESCRIPTIONtkz2e€)4<t
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. COT,ITRACTOR INSTALI.,ATION ONLY B.
Electrical. contrac.or (og^ ,fliil Qfu'lr"'-t'
Address v,c:r6ry 2kq
Ci ty J, phone aL|{-o)or
Supervi sor License Number 3a6-t
Expiration Date,(,
L c
Constr Contr. Number 2-o"* LlaL
Expiration Date c
Signa re of Supervising Electrician
a,
D
Owners Name
3. COHPIJTE FEE SCEEDIILE BELOV
New- Residential-Single or
Multi-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
Sertice or Feeder
s 8s.00
$ 1s.00
s 40.00
Services or Feeders
InstalIation, Alterations
or Relocation:
200 amps or less L
201 amps to 400 amps
-
40L amps to 600 amPs
-
601 amps to 1000 amps-
Over 1000 amps/voIts
-
Reconnect 0n1Y
Temporary Services or Feeders
Installaiion, Alteration or Relocation
200 amps"or less $ 4O'OO
over 4b1 to 600 amps
-
S 80.00
Over 600 amps or fbOO voTEs see rrgn uffif
Nev, Alteration or Extension Per Panel
E
One Circuit $ 35.00
f..f, eaaitional
Circuit or vith Service
or Feeder Permit
-
$ 2'00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/0ut1ine Lighting-
Limi ted EnergY/Res
-
Limited EnergY/Comm
SUBTOTAL OF ABOVE
5% State Surcharge
32 Administrative Fee
TOTAL
Co
DESCRI1 i5'PTION2./
APPLICATION
TZ
Sum
lL
Is s0.00
s 60.00
s100.00
s130. 00
s300.00
$ 40.00
Address t1(tY
Ci ty ( phone _J db-'.t{ o
OVNER ALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent'
Ovners Signature:
s 40.00
$ 40.00
$ 20.00
$ 36.00
5c
DATE:
RBCEIVED
5
i ,,ro_#-
ELECTPJCAL PBRHIT
City Job n^a", ? 5/ 3/Z-
Address:
Issued by:Date:
Statemeht: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon l-aw, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statementbefore abuilding permit canbe issued. This statement is required
for residential building, electrical, mech.anical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3,{ or 38
K 1. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
38. I will be my own general contractor
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above informationis correct and thatl have read and do understand the Information
Owners Construction Responsibilities on the reverse side of this form.
(Signature of applicant)
(White copy to issuing agency perrnitfile,
pink copy to applicant)
Notice to
(Date)
Permit*, ?5o?GQ
3A. Mv seneral contractor is
w