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Home My WebLink AboutPermit Building 1993-09-02SPRI]{GFIELE,RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSE K: ASSESSORS MAP: LOT: 9st 3*1 h, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477c$ TAX LOT BLOCK:SUBDIVISION ,*1't OWNER: ADDRESS: CITY: I STATE: PHONE: ZIP: MOLISH OTHER DESCRIBE WORK: NEW - REMODEL ADDITION NAM ADD EXPIRES o E t I \t/ MECHANICAL: ELECTRICAL: CONST. TRACTOR #CON PLUMBING: GENERAL: g OF BDRMS: _ OFFICE USE - WATER HEATER r OF UNITS: QUAD AREA: # OF BLDGS FLOOD PLAIN: ZONING CODE SECONDARY HEAT: SQUARE FOOTAGE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: To reguest an lnspectlon, you must call 726-3769. Thls ls a24 hour recording. All lnspections requested before 7:00 a.m. will be made the same worklng day, inspectlons requested after 7:00 a.m. wlll be made the following work day. REQUIRED INSPECTIONS l--l Jemporary Electric Rough Mechanical - Prior to cover. Final Plumbing : When all plumbing work is coinplete. Site lnspeclion - To be made after excavation, but prior to setting forms. Rough Electrical - 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. Building - When all Fireplace - Prior to facing materlals and framlng lnsp. required lnspections have been approved and building is completed.Masonry - Steel locatlon, bond beams, grouting,Framing - Prior to cover. OtherFoundation - After forms are erected but prior to concrete placement./Ceiling lnsulation - Prior to cover, Underground Plumbing - Prior to filling trench.wall - Prior to taping. MOBILE HOME INSPECTIONS Underlloor Plumblng / Mechanicat - Prior to insulation or decking.Wood Stove - After installation. Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and installatlon of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to decking.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 filling trench.Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Slorm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Water Line - Prior to filling trench. Fence - When completed. Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. Rough Plumbing - Prior to cover. .4 RANGE: LAND USE: E tl E fl E E E E E E r E E E E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac l>-r HE PROPOSED WORK lN THE HISTOBICAL 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 S E VALUE (A) X $/SQ. FT. Total Value Bulldlng Permit Fee State Surcharge Total Fee BUILDING PERMIT 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 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. Receipt Number:- Plans Reviewed By Date Date Paid: Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Residential Bath(s) Sanltary Sewer Water Storm Sewer ,Moblle Hom6 FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State'Surcharge Total Charge ADDITIONAL COMMENTS 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 examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify 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 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 lrom the street, that the permit card ls located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Date Signature MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sldewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) ( DATE PAID VALIDATION: RECEIPT NUMBER AMOUNT REC RECEIVED BY Plan Check Fee: - q- 2--q9I CITY OF SPF 'FIELD,OREGO'V 225 FIFTE STNBBf, SPRTNGFTBU), oREGoN 97 477 INSPBGIION RBQIIB$Ir 726-3 0PPICE: 726-3759 1 OP Qst 1n Hultl-Fantly per dvelllng unlt. Servlce Includedr Items Cost 769 Ctty Job Number 3.COUPI.BTE TEE SCEEDUT.E BETOIT al-Slngle or _&_ Sum DWL Permlts are non-transferable and expllf vork ls not started vlthln 180 days of lssuance or lf vork ls suspended for 180 days. ' 2. COI}TRA TOR INSTALI.ATION ONLY Electrlcal contracto, L.R. BRABHAI,I, INC. Address 68 ll. "Q" ST. , ct SPFLD Phone 747-6638 Supervlsor Ltcense Ntimber I 473S Expl ratlon Date 1011195 Constr Contr. Number 08699 1000 sq.ft. or less gach addltlonal 500 sq. ft or portlon thereof Each Hanuf'd Home or -. Hodular Dvelltng Servlce or Feeder b $ 85.00 $ 15.00 $ 40.00 $100. $130. $300. $ 40. B. Servlces or Feeders Installatlon, Alteratlons or Relocat lon: 200 amps or less 201 amps to 400 amPs _ 401 amps to 600 amps _ 601 amps to 1000 amps_ 0ver 1000 amps/vo1ts __ Reconnect Oniy $ 50. $ 60. 00 00 00 00 00 00 Temporary Servlces or Feeders Installatlon, Alteratlon or Relocatlon ' 200 amps or less $ 40.00 Over 401 to 600 amps S 80.00 0ver 500 amps or 1000 volts see uBtr above Slgnat of Supervl slng Electrlclan Owners ll-Aa k Address 261 b t5 Ct ty phone 1 +b,Qoo4 OIINER INSTALI,.ATION The lnstallatlon ls belng made on property I ovn vhlch ls not lntended for sa1e, lease or rent. Omers Slgnature: DATE: c. Explratlon Date 10118/93 D. Branch Circults Nev, Alteratlon or Extenslon Per Panel One Cl.rcui t Each Addltlonal $ 3s.00 35,fi Circuit or vith Service or Feeder Permlt - S 2.00 -B. Hlscellaneous (Servlce/feeder not lncluded) -Each lnstallatlon Pump or irrlgation Sign/0utllne Lighting- Lfunited Energy/Res _Llmlted Energy/Comm 5. STIBTOTAL OT ABOVB 5f State Surcharge TOTAT s 40.00 $ 40.00 $ 20.00 $ 36.00 2b,0 RECEIVED APPLICATION K .-J \o <--/td*lW CTTY OF SPRINGF"IELD Fire & Life Safety w\g] FIRE DAI.4A.GE REPC)RT OR ELECTRICAL HAZARD DATE: TO: FR0tl1: SUBJECT: Bu'ild'ing Department Springfield Fire Department Structural Damage to Building zzY+fu, 4+hAddress or location of bujlding I'lame of o\^rner Type of building Estimated value of building Est'imated loss to building Date of fire (Dwel 1i ng, Store, I^larehouse, etc. ) $ S.fir) s lqD laq Locat'ion of damage in bujld'ing r (Roof, Wall, Exterior, Interjor, etc.) Structural weakness as a result of the fire 'Str"clyn(, 9Ov^rwl rurt fu l rned raf s, Beams, .1oists, etc.) Add'i t'ional pert'inent jnformation El ectri cal Hazard l;n C- (l,i'irinq , 0utl ets , e ned _>Lqq 44.,,orrru Occ sig o -\ qlsths $ l^)^ ll <atli,.'tn)