HomeMy WebLinkAboutPermit Building 1998-08-03RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office:726-3759
NGFIELO
?ro?62JOB NUMBEN
225 Fifth Street
Springfleld, Oregon g7 4ll
LOCATION OF PROPOSED WOFIK:iza 4
ASSESSORS MAP:17033 Qz q
TAX LOT 0 €7oo
LOT
-
BLOCK:SUBDIVISION
PHONE:
ZIP:
2
CITY:6 STATE:&._
ADDRESS:
OWNER:
NEW- REMoDEL ADDtrtoN DEMoLTsH orHER Elf_Wzgn*l
DESCRIBE WORK:
ADDRESS ACTOFI #
I >Z_EXPIRES a PHONECONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
PLUMBING:
GENERAL:
LAND USE: :oregofil8PB{r}itdUyeu+e-.---
_ OFFICE USE -
GSg
by
e
,,ryelgE'__
THIS PERMIT SHALL EXPIRE
NOT
# oF uNlrs: follow rules adoptedtuilffpp
Notification Center. Those ru les are setCONSTR. TYPE
-jn€AR€'s2Eoo 1 -oo1 o thftfu&FCI!ffi :gge€€{--_..-
0090. you mav obrainsnfrig$rff ffie*ulm
r,lJtiE WBHS'
e oreg8RWiffi
calling the center. (Note: theUNDER THIS
# OF STORI
WATER
OUAD AREA:
# OF BLDGS
OCCY GROU
ro requ es t .n AAIil"8Qf60,&UPEESD.T r
made the same worklng day, lnspection
726-3769. Thls is a 24 hour
rs requested after 7:00 a.m
recordlng. All lnspections requested before 7:00 a.m. will bewlll be made the followlng work day.
REQUIRED INSPECTIONS
l--l Temporary Electrtc Rough Mechanlcal - prlor to
cover.
Flnal Plumbing - When allplumbing worl( is complete.
Slte lnspectlon - To be made
after excavatlon, but prior to
setting forms.Gd,Electrical - Prior to Electrlcal - When allectrical work is complete.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Electrical Servlce - Must be
approved to obtain permanent
electrlcal power.
Final Mechanical - When all
mechanlcal work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
Buildlng - \nihen all
Masonry - Steel locatlon, bond
beams, groutlng.
and framing lnsp.
required lnspectlons have beenapproved and building is
completec,.
- Prlor to cover.tl Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
E Wall/Celling lnsulatlon - Prlor to
cover.
Underground Plumblng - Prior
to fllllng trench.Drywall - Prlor to taplng.
Underf loor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng.
MOBILE HOME INSPE TIONS
Wood Stove - After lnstallatlon
Posl and Beam - Prlor to floor
insulatlon or decklng.lnserl - After fireplace approvgl
and installation of unlt.
Blocking and Set.Up - When altblocklng ls cornplete.
Floor lnsulation - Prior to
decking.Curbcut & Approach - After
forms are erected but prior toplacemcnt of concrete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to fllling
trench.
Storm Sewer - Prior to fllling
trench.
Sidewall< & Drlveway - After
excavation ls complete, forms
and sub-base materlal ln place.
Eleclrical Conneclion - Whenblocking, set-up, and plumbing
inspections have been approved
and the home is connected tothe servlce panel.
Water Llne - Prlor to filling
trench.[_l Fence - lVhen coinpleted.
Slreel Trees - When all required
trees are planted.
Final - After all required
inspectlons are approved andporches, sklrting, decks, andventlng have been lnstalled.
F
Rough Plumblng - Prlor to
cover.
(P3-Zo7f
q,
tl
E
E
tl
E
E
E
tl
tl
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-_
Corner
.- Panhandle 1
-
Cul-de-sac
.S THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
ll yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
P.L.HSE GAR ACC
N
S
E
fry__
k
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
VALUE
4,ctl
f,f. 5f(A)
/t
fr,rv
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
X S/SQ. FT.
r)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pernrit 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.
Plans Reviewed By Date
Receipt Numbe
Plan Check Fee
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)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Note:
Building Inspector may require
additional plans,infonnation,
and/or fees for tlic corrrpletiorr of
this project.
e t\h
Wood Stove/ lnsert/ Fl replace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rn ace
Exhaust Hoorl By slgnature, 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 certlfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs of the City of Springfield, and the Laws
of the State of Orc.gon pertainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Buildlng Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper tlme, that each address ls readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will remaln
on the site at all during constructlon,
Signatu re
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Ferrnits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
712
VALIDATION:
RECEIPT NUMBER
DATE PAI[)
AMOUNT RECEIVEO
RECEIVED BY
(:
FT.
FT.
)
The fcer.-_
an does not
Date
has ths lollorv
NOTICE:
THIS PERMIT
AUTHOHIZED
c.
IS C
769
OFEICE: 726-3759
1. IOCATTON OF ALIATTONNI
,",.J$Hl'n 8&Y/rEryPtlsr scrupulE BELov
1 .A. Nev Residential-Single or
HuIti-Family r dvelling unit.
ed:Items Cost Sum
1000 sq.ft. or lessgach additional 500
sq. ft or portion
thereof
Each Hanuf'd Home. or
-Hodular 'Dvelling'
Sertice or Feeder
$ 8s.00
$ 15.00
$ 40.00
.8. Services or Feeders
Installation, Alterations
or Relocation:
:"rlirJrrLgJIJGAL DESCRTPTION
D ,1 r3')
ie t\r
Permits are non-transferable and expire
lf vork is not started vithin 180 days
of lssuance or if vork is suspended for
180 days
2. CONTRACTOR INSTALI.ATION ONLY
Electrical Con tractor@
Address
citY Eugene ,
Phone 461 -0291
Supe rvisor License Number j4BEs
Expirq:t ion Date 10 / o't / sB
Constr Contr. Number la497
Expiration Date or /r o/ g
Signa of Electrician
Address
Cl ty Phone bY - 2I)8K
1t-1{-)(.
OVNER INSTALII\TION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
0vnersiL$ignature:
DATE:
200 amps or less
201 amps to 400 amps _401 amps to.600 amps
-601 amis to 1000 amps-
over 1000 amps/vo1ts
-Reconnect Only
s s0.00
s 60.00
$100.00
s130.00
s300.00
$ 40.00
D
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"or less $ 40-00
over 4b1 to 600 amps
-
$ 80.00
ou"i OOO amps or rboO-Gfts see nBrr aSoE
Branch Circui ts ; .-
Nev, Alteration or Extension Per Panel
one circuit I $ 35.00 W)
Each AdditionalCircuit or vith Service
or Feeder Permit
-
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/Outline Lighting_
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
E
$ 40.00
s 40.00
s 20.00
s 36.00
5
RECEIVED
JOB
.+ {rc'tr I
11 03 3b ty o:4cX)
s f 15- Zs4u
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE:)'t/-q8
T0: Building Department
FROM: Springfield'Fire Department
SUBJECT: Structural Damage to Building
Address or location of building slo 1) fr.. sl- sPPlD
Name of or./ner 1., A) T€ k f f{s cLtn *r
Type of bu'i 1d i ng R..iLr,t c e
(Dwei 1 i ng , Store, l^larehouse, etc. )
FD-l6
Estimated val ue of bui1di ng
Estimated loss to building
1o OCrO
c)c_0
Date of fire )-j tnB
Location of damage in building Ro"$ /n fi)C 4-.=-, -
Roof, lnlall, Exterior, Interior, etc.)
Structural weakness as a result of the fire C..-l .Roo'f o rs/s /
(Burned rafters, Beams, Joists, etc. )
Additional pertinent'information Fi,^.a*L1r-e u+N i<-\
"t
Electrical Hazard C,e-t.
L Ll--c>-; rzr- S cr- c-<.-! _
Wi ri nq , Out'lets , etc. )
cc
F
A)
L C--
I
S igned fq-
L'itr<
SA-,c.-+a-
(