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Home My WebLink AboutPermit Building 1991-04-15RESID ENT!AL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOS q)oe]2 h, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 TAX LOT: ,dJ RK: ASSESSORS MAP:f-la7)4411 LOT:BLOCK:SUBDIVISION r.-tGB PHON E: OQSTATE:ZIP: tl^r Q-> vl 1)CITY: ADDRESS: OWNER: NEW - FIEMODEL ADDITION ,Y DEMOLISH OTHEB DESCRIBE WORK: AME ADDRESS EXPIFIES 4?q il|4 1 q293,/4 CONTRACTOR'S PHONE PLUMBING: G EN EFIAL: MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # fRlStr) k3 VlJ \ t \\\\ WATER HEATER _ OFF]CE USE _ S OF BDRMS: RANGE: * OF UNITS: LAND USE: ZONING CODE: FLOOD PLAIN: SECONDARY HEAT SQUARE FOOTAGE: OCCY GFIOUP: * OF STORIES: QUAD AREA: * OF BLDGST 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 INSPECT!ONS Tem ectric gh Mechanical - Prior to nal Plumbing - When all cover.plumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. gh Electrical - Prior to nal Eleclrical - When allcover.elec al work is complete. Underslab P!umbing/ Electrical / Mechanical - Prior to cover.Eleclrical Service - Must be approved to obtain permanent electrical power. Final Mechanical - When all mechanical work is com plete. nal Building - When all Fireplace - Prior to facing materials and framing lnsp. required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.ming - Prior to cover. undation - After forms are Other erected but prior to concrete placement.l/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.rywall - Prior to taping MOBILE HOME INSPE TIONS Underlloor Plumbing / Mechanical - Prior to insulation or decking.Wood Stove - After installation. - -/' I APosl and Beam - Prior to floor 'J insulation or decking.lnsert - After fireplace approval and installation of unit. Blocking and Set.Up - When all blocking is complete. lnsulation - Prior to Plumbing Connections - When home has been connected to water and sewer. decking.Curbcut &Approach - After forms are erected but prior to placement of concrete.Sanitary Sewer - Prior to f illing trench.Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Storm Sewer - Prior to filling Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place.tre h. Line - Prior to filling Fence - When completed. tre Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. Street Trees - When all required trees are planted. Rough Plumbing - Prior to cover. a<<, I N )l d 1q1- -7??StQ o^.-. .1, . Onm- C)t ilv.e,/ 4ry) E r - -/'| _..{Fooling - After trenches are 'J excavated. E E E E E r E 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 --..d THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the H istorical Coordinator prior to permit issuance. APPROVED A{tcl YoO a? I VALUE 33(A) X $/SQ. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport BUILDING VALUE, PLAN CHECK AND BU!LDING 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. 'LL Iq r lor bL I ans Date t9 I iewed Date Paid Receipt Number: Plan Check Fee: Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home PLUMBING PERMIT FEE6 N0 FT. FT. (c) Plumbing Permit State Surcharge Total Charge * * M.EADDITIONAL COM NTS Woad Stove/ lnsert/ Fi replace Unit Dryer Vent I @ / 5 (D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Furnace 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 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 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 is located at the front the approved set of plans will remain Signat 4- rs-Date SI at al mes duri of the property, ction.ont MISCELLANEOUS PERMlTS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined)-_/I 4sVALIDATION: RECEIPT NUM DATE PAID AMOUNT RECEI RECEIVED BY FT. \ .{-C\PlNal@ SPTIIN(;FIELO l: ;ll.; LSO ELECTRICAL PERHIT APPLICATION225 ITI}-I'H S'I'REET ,1'. SPRINGFTELD, ORBG0N 97477''',' INSPECII0N A.EQIIBSTI 726-3769 x oFFICE: 726475q ^ J\' C,?--=\ JobNunbe.{ID?BL\q L.OP LEGAL Permits are non-transferable and expireif vork is not started vithin 190 daysof lssuance or if vork is suspended fori80 days. 2. CONTRACTOR INSTAII.,ATION ONLT Electrical Contractor Adrlroec Ci ty Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Ovners Name Address Ci ty Phone The installation is being made onproperty I ovn vhich is not intendedfor sale, lease or rent. Onners Signature: DATE: P,ECEI SCBEDLIIJ BELOS Nev Residential-Single or Multi-Family per dvelling unit. Service Included: Items Cost L500 sq.ft. or less Each additlonal 500 sq. ft or portion thereof Ea nh Mrnrr f r d l{nmo ^r- - Hodular Dvelling Service or Feeder $ 8s.00 $ 1s.00 $ 3s.00 Services or Feeders (10 Branch Circuits included). Installation, Alterations or Relocation: A Sum B 100 amps or less 101 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps- over 1000 amps/volts -Reconnect 0n1y $ $ $ $1 00 00 00 00 35 60 90 30 C. Temporary Services or FeedersInstallation, Alteration or Relocation One Circuit Tvo to ten Circuits Eaeh AddtrI ten orportion thereof $300.00 $ 3s.00 $ 3s.00 $ so.oo F- $ 1s.00 200 amps or less $ 35.00 Over 401 to 600 amps _ $ 80.00 Over 600 amps or 1.000 volts see rtBtr above D. Branch Circuits Nev, Alteration or Extension Per Panel V/ Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 36.00 Sign/0ut1ine Lighting- $ 36.00 Signal Circuit or limited energy panel $ 36.00 ST'BTOTAL OP ABOVB 5Z State Surcharge TOTAL D'NI?(-I?TTTFN 5 @ Permit No: t* Address: lssued Date: R OFFICE USE ON STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. 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. Fil! in the applicable blanks, and initial box 1 and either box 2A or 28: q/NJ 1 I own, reside in, or will reside in the completed structure. My general contractor is Gontractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. 2. OR lwill be my own €efrare{ contractor. nature Perm pp cant CONSTRUCTION CONTRACTORS BOARD 0244J 1190 ula.[fj\ru$- B lf I hire subcontractors, I will hire only subcontractors reoistered with theConstruction Contractors Board. lf I chanoe my mind and Eo hire a oeneralcontractor, lwill contract with a contrattor-who is reoistered with theConstruction Contractors Board and I will immediately-notify the officeissuing this building permit of the name of the contraitor. ' ! hereby certify that the above information is correct and that ! have read and understandthe lnformation N_otice to Property Owners about Construction Responsibilities on the reverse side of this form. Date COPY TO ISSUING AGENCY PERMIT FILE COPY TO APPLICANT @r *