HomeMy WebLinkAboutPermit Building 1993-10-19I
SPRINGFIELE'
RES ID ENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726'3759 Zfr,
JoB NUMBE a ?VzVg>-
225 Fifth Street
Springfteld, Oregon 97477
/1ao rU, /9 7L sfLOCATION OF PROPOSED WORK:
ASSESSORS MAP:z TAX LOT:
LOT:BLOCK:SUBDIVISION
To request an lnspeclon, you must call 726-3769. Thls ls a 24 hour recorrtlng. A.!l inspectlons requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumblng 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 locatlon, bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prlor
to fitllng trench.
Underlloor Plumblng/Mechanical
- Prior to insulation or decking.
Sanitary Sewer - Prior to filllng
trench.
Slorm Sewer - Prior to filllng
trench.
Waler Llne - Prlor to fllling
trench.
Rough Electrical - Prior to
cover.
Electrical Service - Must be
approved to obtain Permanent
electrical power.
Fireplace - Prior to facing
rnaterlals and framlng lnsP.
Framing - Prlor to cover.
Wall/Ceiling lnsulation - Prior to
cover,
Orywa!i - Prior to taPing.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work ls complete.
E
a
w
w
IX
w
l-l Wood Stove - After lnstallatlon
lnsert - After flreplace aPProval
and lnstallatlon of unlt.
Curbcut & APProach - After
forms are erected but Prior to
placement of concrete.
Sidewalk & DrivewaY - After
excavation is comPlete, forms
and sub-base materlal In Place.
l-l Fenco - When comPleted
Slreet Trees - Wlren all requlred
trees are planted'
Final Building - When all
requlred inspections have been
approved and building ls
completed.
Other.---
MOBILE HOME INSPE TIONS
Blocking and Set-UP - When all
blocklng ls compiete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and Plumblng
inspections have been aPProved
and the home is connected to
the servlce panel.
lVl Post and Beam - Prlor to floor4 lnsulatlon or decklng.
l-71 Floor lnsulatlon - Prlor to4 decking.
Flnal - After all required
inspections are aPProved and
porches, sklrting, decks, and
venting have been installed.
dui',PHONE:Waltti
av1 ZIP:
oo
OWNER:
ADDRESS;
CITY:
Iac
DESCRIBh, WORK:
ADDITION DEMOLISH OTHERNEW
-
FIEMODEL
MECHANICAL: -
-
PHONEADDRESS
llc
,*ELECTRICAL:
CONTRACTOR'S NAME
CONST.
CONTRACTOR #
GENERAL:
PLUb#\G
sE-
rtll
_ OFFICE
* OF BDFIMS:
WATER HEATER:
r OF UNITS:
LAND USE:
ZONING CODE:
FLOOD PLAIN
r OF STORIES:
OCCY GROUP:
SECONDARY HEAT
SQUARE FOOTAGE:
CO!..ISTR, TYPE:
HEAT SOURCE:
RANGE:
OUAD AREA:
r OF BLDGS:
Rough Plumbing - Prior to
cover.
4Sao
tl
ir
tl
fl
EXPIRES
E
E fl
Lot laces
Lot sq. ftg.
Lot coverage
TopographY
Total helght
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Set
P.L.HSE GAR ACC
N
S
E
I- HE PFIOPOSED WOBK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this appllcation must be slgned
and approved bY the Historlcal
Coordinator prior to permit lssuance.
APPROVED:
!
:
ewed
BUTLDING VALUE, PLAN CHECK
AND BUILDTNG PERMIT
This permit is granted on the express condition that the said
construction shall. in all respects, conlorm to the Ordinance
adopted by the City of Springfield' lncluding tho
Development Code, regulatlng the constructlon and use of
bulldings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
te
?-z >47
79.?3
Recel pt t'tumoer: /D'/Z
Date Paid:
Plan Checl< Fee:
Rec By:
BUILDING PERMIT
ITEM SO.'FT. X $/SO. FT.VALUE
/e.73(A)
Carportrfu
Main
Garage
Total Value
Bulldlng Permlt Fee
State Surcharge
Total Fee
u/-5>
2-23
Systems Development Charge is due on all undeveloped
properties withln the City limits which are being improved.SYSTEMS DEVELOPMENT CHARGE
S-?'W(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
No
FT,
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
(D)
No
Mechanical Permlt
lssuance
state surcharge
Total Permlt
Furnace
Exhaust Hood
Vent Fan
i
By slgnature, I state and agree, that I have carelully examlned
the completed application and do hereby certlfy that all
lnformation hereon ls true and correct, and I further certlfy
that any and all work performed shall be done ln accordance
wlth the Ordinances of the City of Springfleld, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
siruci;ii; iviih<>ut pcrn:issicn cf !he Buildlng Safety Dlvlslon.
I further certi{y that only contractors and employees who
are ln compliance with ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all required lnspectlons are
requesled at the proper tlme, that each address ls readable
Date
lrom the street, that the perm card ls located at the front
Slgnat
set of plans wlll remalnof the property, and the aP
durion the slte at lll
MISCELLANEOUS PERMITS
Moblle Horne
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Mlscellaneous Permlts (E)
AMOUNT RECEIVED
BECEIVED BYTOTAL AMOUNT DUE (excluding electrical)
(A, B, C, O and E Comblned)
1/8.23
\
VALIDATION:
REcErPr NUMBER /c6 ZZ
DArE pArD -/7 + 3
OREGO'UCITY OF
225 EI,WE SmEBr " '
1 OP
ii5J;r:r,ff,:,:##ffi"ls . BLECTRICAL PERHIT APPLICATION
SPFlINGFIELO
Ci ty Job NunberSPRINGEIBLD' ORBG0N 97477 / n,4l. rNspBcrrou iuousst: 726-3169, h+lh*
, OPEICB z 726-3759 '""1 - - -t') nle+ p-Ja;.(tI
C6HPLETB
,JOB\-)riqffiitIZ,;
permits are non-transferable and expire
lf uork is not started vithin 180 days
of lssuance or lf vork ls suspended for
180 days.
2 COIIMACTOR INSTALIJ\TTON ONLY
Elec cal Contractor
Address
Ci ty
Supervisor Li ,ber
Explration Date
Constr Cont Number
Explrat Date
of Supervlslng Blect
Ovners Name
Address
Cl ty Phone
OSNER ALI,ATION
PEB SCIIEDTILE BELOV
.ident laI-Single or
Multi-Family per dwelling unit.
Service Inclttded:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf 'd llome or
Modular Dvelling
Servlce or Feeder
s 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
Sum
B
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect Only
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
201 amfs to 400 amps
-
$ 55.00
over 4b1 to 6oo am-ps
-
$ 8o.oo
Over 600 amps or 1000 voTts see rrDrr a56;6-
Branch Circults
Nev, Alteration or Extension Per Panel
one Ci rcui g / $ 3s . 00 fifi=Each Additional
Circuit or wlth Service
or Feeder Permi t 2 g 2.00 7. *
Hiscellaneous (Service/feeder not included)The installation ls belrig made on
property I own vhich is not intended
for sale, Iease or rent.
s s0.00
s 60.00
s100.00
$130.00
$300.00
$ 40.00
an
c
Dl
E
-Each installation
Pump or irrigation $ 40
sign/outline Lighting- S 40
t iii ted Energy/Res
-
$ 20
00
00
00
00Ornerst
DATB:
5 STIBTOTAL OT ABOVE
5f State Surcharge
TOTAL
CBIVBD
(L)