HomeMy WebLinkAboutPermit Building 1991-10-03SP'lINGFIELE'
BLOCK:
I
qn
ILOCATION OF PROPOSED WORK:
TAX LOI
SUBDIVISION
ASSESSORS MAP:
LOT:
JOB NUMBER
RESID ENTIAL
PERMIT APPLICATION
lnspections:726-3769
Office: 726-3755
225 Fifth Street
Springfield, Oregon 97 477
ONE:
ZIP:
P
STATE:
OWNER:
CITY:
ADD
ADDITION DEMOLISH OTHER
DESCRIBE WOFIK:
NEw l/ REMoDEL
ADDRESS PI RESNAME
ELECTRICAL:
MECHANICAL:
CONTRACTO
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
LC
LRANGE:WATER HEATER
_ OFFICE USE _
FLOOD PLAIN
ZONING CODE:
* OF BDRMS:
LAND USE:
* OF UNITS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. This is a24 hour 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
ffiat-o"rarY Electric K Rough Mechanical - Prior to
cover,
l$finat Plumbing - When allr-Aplumbing work is complete.
ffi finat Electrical - When allu electrical work is complete.
Vffin.l Mechanical - When allA,l 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.
Post and Beam - Prior to floor
insulation or decki ng.
Floor lnsulation - Prior to
decki ng.
Rough Plumbing - Prior to
cover.
;'dnorgtr Electricat - Prior toQ cover.
E"Electrical Service - Must be
approved to obtain permanent
electrical power.
Fireplace - Prior to facing
materials and framing lnsp.
lnsert - After fireplace approval
and installation of unit.
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Fence - When completed
Street Trees - When all required
trees are planted.
x"
fffoundation - After forms areq erected but prior to concrete
placement.
[fgnd.rground Plumbing - Prior
Y---j to fil ling trench.
z^:
f{I nderlloor*ElgElbin€r, Mechanicalr x - Prior to i-nsulation or deckingl
K
K.
Xf,rraming - Prior to cover.
IYf wrttlceiling lnsulation - Prior toQ cover.
Kl DrVwall - Prior to taoing'
,K *"oO Stove - After installation.
Final Building - When all
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.
#sanitary Sewer - Prior to fillingGtrench.
p{",or- Sewer - Prior to filling(lJ trench.
E];;;;Line - Prior to rirrins
K tr
q\h#,
\\\ \QUAD AREA:
g OF BLDGS:
tl
E
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
--!1nrcrior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
&zq.'( zlra(
IL
THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED
P.L.HSE GAR ACC
N /g'
S Z Z (
I (
Z
E 76.'
X $/SO. FT.
1
(A)xz z ,;3
i3,c 3
Total Value
Building Permit Fee
State Surcharge
Total Fee
/,6 0,90
BUILDING PERM!T
ITEM SQ. FT.
Main
Garage
Carport
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 Spri ngfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
Plans Reviewed By Date
upon violation of rovtsrons
PIan Check Fee:
Date Paid
Receipt Number:
Received By:
ord i nances.
SYSTEMS DEVELOPMENT C
(B)
HARGE (SDilu %
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
71,A O
qa <o
4 .16
/
(c)f 5 ,76
N0
FT.
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
4. ;a
7 .oo
/5.o a
A9,5a
,/o,oo
/. 78
,7z,AB(D)
i,oo
Vent Fan
Mechanical Permit
lssuance
State Su rcharge
Total Permit
MECHANICAL PERM!T
Furnace
Exhaust Hood
No/
By signature, I state and agree, that I have carefully 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 Ordinances of the City of Springfietd, 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 701.055 will be used on this
project.
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, and the approved set of plans will remain
on the site all ti
0
Sig natu re
Date
onstruction
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
M tuta c
Total Miscellaneous Permits (E)
2.a5 (
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
64azl d
/2 -3^9 .
e
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
7/
a ,a a
,4
IJGAL DESCRIPTION
Electrlcal Contractor
Address
cl Phone
Supervisor Llcense Number
Expiratlon Date
Constr Contr. Number
Explration Date
s of ising Electrician
1500 sq.ft. or less /
Each additlonal 500
sq. ft or portlon
thereof
Each Manuf,d Home or
-Hodular Dvelling
Service or Feeder
$ 85.00
s 1s.00
$ 3s.00
B. Servlces or Feeders (10 Branch Circuits
included). Installation, Alteratlons
or Relocation:
225 PIFTE SMBBE
SPRTNGFTEIJ), ORBG0N 97 477
INSPBCII0H REOIIESTz 726-3769
OPFICE: '726-3759
1 0r
EUqTRICAL PERHIT APPLTCATION
Ci ty Job Nunber
COHPI^RTE PEB SCIIEDUI^E BBLOS
Nev Residential-Slngle or
Hulti-Famlly per dvelllng unlt.
Servlce Included:
ftems Cost
-.
100 amps or less
101 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 arps-
0ver 1000 amps/volts
Reconnect 0n1y
SI''IINGFIELE,
One Circuit
.Tvo to ten Circults
Each Addt,1 ten orportion thereof
SI,BTOTAL OP ABOVB
5Z State Surcharge
TOTAL
3
A
JOB
Sum
fuo
Permits are ion-transferable and expirelf vork ls not started vlthln 180 daysof lssuance or lf vork ls suspended for
180 days.
2. CO}II?ACilOR INSTALIJTION ONLY
C. Temporary Services or Feeders
fnstallatlon, Alteration or Relocatlon
$ 3s.00
$ 60.00
$ e0.00
$130.00
s300.00
$ 3s.00
s 3s.00
$ s0.00
s 1s.00
7r.no
s see ng, "ffi
D. Branch Circuits
Nevr.Alteratlon or Extenslon Per Panel
200 amps or less (
201 amps to 400 amps
-Over 401 to 600 amps _Over 500 amps or 1000 volt
$ 3s.00
s 40.00
$ 80.00
Address q Lr/
Phone \l+L&g0)-
OUNER INSTALI.ATION
The lnstallatlon ls belng.nade onproperty I ovn vhlch is not lntendedfor sale, Iease or rent.
Ovners Slgnature:
DATE:-?/
7 'ct*?
E. Hiscellaneous (Service/feeder not lncluded)
-Each installation
Pump or irrigation $ 36.00
Sign/0ut1ine Lighting- S 36.00
Slgnal Clrcuit or
Iimited energ'y panel $ 36.00
/Ap .oo5
p Irc_qT\rrrD yrw . /V/Fi**<_,,ffi-
I ai 4A:44 ef zat
ct
fu1etro Dolitan
Wastewater
ManaqenrentrYLOMMTSSION
t,,_1'.1'.' SS,:"'.':'.,:i : S
c.r a4--r.i_r, -!-: a-. .-......-
..o I ir ..,,_1, -.-.t.-
=t-...!-..,.
!.,...--,-l!-,1!4,
(--.. l.-r...-_e...-..c -t-- =b-...!--.- ..
i.,,,: L;:S::._ Spr,r ;,,r,3 C: :..c,,:..: : -,
i- !'.'r:!:1-i.:'r Cl.;'.'.,'-:, i;; $t-:::.:
:.1, Q ,rr-' .--. la' -. . r.--,< .-:t
.- , ,vr. rL t vr- ,,
!.12,.. \,,tSlr;n^_r-; tre !_ai i:;.e: t r:::,. e
Fi:;H A:\D A SIFIEETS SFFIIiGF::LD CiTY l-'lpLL SFPii(GF:ELD, OFEGCi : ?:477 jiLEi::Ciri r5i3) 7i7.:551
l'i'Hl'iC C0liliECTI0l{ CHARGE
\nSuilding Address:
Reference Number:
Ovner:
Address:
Ci ty:State:
_ Res idential Fee ($222.00)
Credit Due (see reverse of this form)
Tax Lot I'lumber:
Phone Number:
Zipz
CD
s
Commercial Fee (nev non-residential development/
- remodel)
Total fixture unit charge (see reverse of this form)s
sSUBTOTAL
TOTF.L MT?HC CHARGE
<s (U OI
s
Date Received:Received By:
Building Job I'lumber:Receipt Number:
Fi:<tr.rre Unit Calculatia:: TabLe:"..-1.,.- -: .--.. !:..u.,,-rEr.:! DeJ iti: tLt res r,-,ultiplied byequivalents. li OTE: For re;r.odels. calcul:te c,nly rhe l,ET aiditiona]
Fi>:ture Type ; of Unit
Fi i: tures Equivalen t s
3athtub
Drinking fountain
Floor drain
fnterceptors for grease/oi1/soliis/etc.
Interceptors for sand/auto I'ash,/e:c....
Laundry tub/clothes -*a_sher
unit
fi:'ltirres
Fi:<ture
Urrits
Clothes uasher (3 or rnore)
]{obiIe home park trap (1 per t.i.:.:. )....?.eceptor for refrig/uater static:r:tc.Receptor f or Coi-"r.er sink/<iish;5ii;;=iq.
Shor.'er, si.ngLe stalI
aL
1
2
3
6
2
6
5
1
)
2
1
2
3
2
1
6
4
Urnial, stal1/va1I..
i'ash basin/lavatory, singl_e. .'t:ater eloset, public instalfa
Shover, gang (per head)..
Sink, bar, connercial....
Sink, commercial/industri
I'ater c1o_set rYiscellaneous:
aIle t c
ticn.
pr iva te
Tota1 Uni ts:
TotaI fixture units >; 513.25 each = Tota1 Charge: g
Credi t Calcu1ati on Table:3a-ced or total i'alue of property at t ime of permi tapplication.
Year .Lnne>:eCto the Cir_v
1Q?o
1980
10c)1
1982
1002
19A4
1985
L9e6
1987
1998
l AOO
1990
Credit per $t,oooassessed vaLue
(, aR
S2.64
$2. s3
$2.1r-
S2.1e
$2. 04
$1.5e
cl 1tr
S1.1s
90.92
$0. ssqn )-t
olCreci i t
Flate i-cse-cse td
S
IULd Cre L