HomeMy WebLinkAboutPermit Building 1991-10-18RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
SPRINGFIELD
?.ot zqJOB NUMBER
225 Fifth Street
Spri ngf ield, Oregon 97 477
LOCATION OF PROPOSED WORK:
ASSESSORS MAP l*t*ba tr TAX LOT I t1.0
LOT:BLOCK SUBDIVISION
OWNER R+r-rr+ rDerr-S PHONE:
ADDRESS:
CITY:ar€-tlfsF TE-\-)D STATE:ZIP:1A 1
DESCRIBE WORK:t@zNEW
-
REMODEL ADDITION DEMOLISH OTHER Ift-l*s,a DPL-
CONTRACTOR'S NAME ADDRESS
CONST.
CONTRACTOR #EXPIRES PHONE
G EN ERAL:
PLUMBING
hJ,L, Poref. Crnlfr
MECHANICAL:
_ OFFICE USE _
QUAD AREA:
# OF BLDGS
LAND USE:FLOOD PLAIN
* OF UNITS:ZONING CODE:
OCCY GROUP:
Y OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
* OF BDRMS:
WATER HEATER:RANGE:
SECONDARY HEAT:
SOUARE FOOTAGE:
To request an inspection, you must call 726-3769. This is a24hour recording. All inspectlons 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
Temporary Electric Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
Site lnspection - 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.
Electrical Service - Must be
approved to obtain permanent
electrical power.
#Final Mechanical - When all
mechanical work is complete.
Footing - After trenches are
excavated.Fireplace - Prior to facing
materials and framing lnsp.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.Framing - Prior to cover.
OtherFoundation - After forms are
erected but prior to concrete
placement.Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to filling trench.l---l Drywall - Prior to taping
MOBILE HOME INSPE TIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After installation.
Post and Beam - Prior to floor
insulation or decking.
Blocking and Set.Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Conneclions - 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.
Storm 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.
(;z-* Uonrr'+ 7-b Ta|
@e_
tl
tl
E
E
E
E
r
E
E
E
E
E
E
lnsert - After fireplace approval
and installation of unit.
tl
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
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
VALUE
(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 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.
Plans Reviewed By
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
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N0
FT.
FT.
FT.
PLUMB!NG PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
4,so
fy\ rO r @9 {5,oo
2,6,25(D)
N0
1.25
Vent 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 f urther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, 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 f ront
of the property, and the approved set of plans will remain
a
on the site at all times duri ng construct
Signatu re
MISCELLANEOUS PERMITS
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)
Zro,LS
VALIDATION
-|
RECEIPT NUMBER ')-l LrL4
AMOUNT RECEIV D
RECEIVED BY
Date
Date
-
DATE PAID I C'' . t?. ( I
c,rw oF OREGO'Y
t'1 offi'on OP INSTAIJETIONn " iHttK,
225 PTF{,E, SI?EEf,
SPRTNGPTBLD, ORBGON 97477
INSPBGTTON REOIBSf,: 726-3769
OPPICB: 726-3759
SPFIIT.GFIELE,
ELEcIRIcAL psilfTT APPIJcATToN
City Job Nunber
3. COHPI,ETB FEE SCEEDT'IA BBLOV
A. Nev Resldential-Slngle orHultl-Pamlly per dvelllng unit.
Service Included:
Items Cost
1500 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Hanufrd Home or
-Modular DveIIing
Service or Feeder
s 8s.00
$ 1s.00
$ 3s.00
B
c
D.
I.IEGAL\1C)PTION
\\\Sum
L.
Permits are non-transferable and explreif vork is not started vlthin 180 dlysof issuance or if vork is, suspended ior
180 days.
2. CONTRACTOR INSTALI,ATTON ONII Services or Feeders (10 Branch Circultsincluded). Installation, Alteratlons
or.Relocation:
100 amps or less
101 amps to 400 anps
-401 amps to 600 anps
601 aurps to 1000 amps-
over 1000 amps/volts
-Reconnect Only
Electrical Contracto bl hs5
Address
Phone (otf - t" t 7t
Supervisor License Number zTqz=
Expiration Date q n
Constr Contr. Number
Expl ra t
s trlclan
Ovners ,
Address
ci Phone
The installation is belng made onproperty I ovn vhlch is not lntendedfor sale, lease or rent.
Ovners Signature:
DATE:
RECEIPT t:
Temporary Servlces or FeedersInstallatlon, Alteration or Relocation
201 amps to 400 amps
-
$ 4o.o00ver 401 to 600 amps
-
S gO.oO
Over 600 amps or'1000-EEs see nBr aEoE
Branch Circults
Nev, Alteration or Extenslon per panel
50..OO
Hiscellaneous (Service/feeder not included)
-Each lnstallatlon
Pump or irrigatlon S 36.00Slgn/outline Lighttns- S 3G.oo
SUBTOTAL Or ABOVE Sb,c)J
5Z State Surcharge
TOTAL
$ 3s.00
s 60.00
$ 90.00
sl30.00
$300.00
$ 3s.00
One Circuit
Tvo to ten Circuits
Each Addtrl ten orportlon thereof
s 3s.00
s s0.00
s 1s.00
E
RECEIVED
5
q
ci tY-E:e.O^.o:.--
(
.. REslDEl''lAL"
APPLICATI)ILr/ERMIT
225 llorth |th Street
Springfield, Oregon 97477
Butlding Diutsion
7 26-37 53
tb Loeaf.icn:4 Llozrx Z9'rv+
l-\tcl a.r-er\=,t\A-C,
dlv',:t:: GZ4 tjovz:ru 'Z-b
hltr: *A
SPFIINGFIELD
Tc.i tot ll lI1 *
'7"L'
,4lq1
Fr,'irl'sc)'J I'l?rl I lr*1 O
.-Rar-t \6
br<- -t2-- ?Do
Descril>e l"oY'k:
Value
60
Pate of APPlicaticn
()n t rit(: L(l
t'n r. t'rt l.
'lrtrnb:i.n3,
lccirirrt Lclt L
i Lur: t ri::rt
(%p,ar,<-o1Z L.
S *
, Cesignated iob
twne and plone
job aCitess, tYPe
Requests ?ecelxea
"72-b z
of inspec|icn
befcre 7:0C ctnunber,
nunbet'.
Fbo,x,
irrtr a'1,,tafl.i)t1 l'l lectrit irttr
It is lhe resPonsibilitY o
fnon the st?eet, and that
* Pui l.din1t D.lut:i.ott il?ilttote
P:?O(:!D|-!P9 F1n 10,
uotl
,f the permit holder to see that aL!. inspections aye nade at the prope" time, that ecch cdilress is realabie
the pemrtt
d pl'an shc
Located at the front of the -ptopertyon tlp Buildi.nl :'tL: at aLL tines'eard is
lL venain
rl
.'i ll. t'e madc the came
t,ctlucs
CALL 726-3769 (rccordet') state yout' City
be ready for inspection,Conttactars on Oxmers
rlq1, r,etprcsts mcde aftet' 7:00 on uiLL be made the ncst :nrking daY
Ycur City Desigra.ted Job Nwnben fc:
erc'auation, but
fcrns,
ltttt;E: 't'o be n<
LCII O
'!'o be nrzde afbet
pr-icr tc se! uP of
r N s t) r,A,t' r oN / vA po R rlA R R I E R tllgEEQllpN :_.
To be nnCe after aLL insuLatlcn a"a
rcou-Jted oattot bavrie?s are in plaee
bui before anu l.ath, gltpstm boarC or
tnLL cbuering- is cpplied, and before
oty insulation is concealed.
DnYIlAf,t, INSPECTI1N: Tc be tmde
;tt;;;TlZrwiTft s .in plaee,
but prior bo cnlJ taflng.
--1 t):tDERSLaA PtUtEIilc, ETCTRIM
| ;'*x:tt;nlcAn '!o be nude bcfot'e cnY
-' t,torl' is coucred.
-'1 !'carlilG s Fou:tDATrcN: ?o be nace
- | ,;J"-,* trrr*l*; "". orcauated and-
fc>nns are erected, bttt Pt'ior to
'Jt.rttring ecnereta.
r'l
,/ ),,i;1 to:i|c:!1LUl"l3 I Ilc s|l'/E:?
ilASONRY: Steel location, bond
fiiffilg4ot,ting or oet'ticals in
accondaitie Ltith u,B.c. section
ct1<
I'IOODSTAVE:
ccmpT;;il.
After installation ie
c PyLottf i',[ -ttrinehes.
|ilfltJ'-Llan pr,unflc i ntcllu : -:',, L,e matlc ttriar Lo Lr$taLLatlon ol
l'!oor tnstiction or decking'
x
ixl
,1ND nf:Al.l:To be natlc Ption to
I floor insulation ot'
. i,,,.i ilni.
" ),,. : ] 1 !' ! M lR f :t c . l.: r,E eT n ! c A !.l--aE!Jl --
.1.'.,1,',1i... ;1ry 2r6yl: [s Io l,t' aoL*cr(td
,.,,; il thr.se inspectiot:s haoe beer
r,:, :. i.' , rn,/ dppt'olea,
t't: i'l:!!1!!-: Pt'i.or to plceir4 fccing
,:, ,*,-l avl belore franing insy'za-
t!'t!J ): lfireb be requestetl aften-.i,,,1 , ,,,r' t"ough plurbing, e'l-ectri-t .; t:,,,r)nnical. ALl, toofing
lt'tt!,.1 .\ t:hinYr^r", etc. rntst be
'rr,.', r,r,i. llo ttcrk i.s to lrc eon-
:!, t iottil this insPeetion lss
',. ", t'!.' tnr! appt'olcd.
CURB & APP\ICAC!! APIION: After fonns
a";-"r""il but prior to Pouring
concrete.
SIDEl,tAt,K '9 DRII!t"'l't.1I: For aLL con-
.r;te pa,ri"g;Gni; stneet night-
of-unu'. to be naCe after aLL exca-
uLtlr-n- eanplete & for'n wt'k & sub'
base'naterial in Place.
i
t_
IENCE: h4ten conP'l'ete -- Pt'oui'de
jilii on notsable seetians through
P. U. E.
A!.t.pt'o;i,t<:tconcltti.onsrr;ir<"'hrr$thei'nstal-Lat;-onofatreettl?n-\.:"@lcttonofthe
tttqtti.ncd Lanrlseap.tng,'i,t)|,.',-^r"t be sati.s7if,2-L,"fol""- thn BUILDIN1 fiiAL can be requested'
FTNAL BUrr,DrNc: Ttrc tinal Btdlding rnspection nr,at be requested after the Pinal Plwnbing
Elr:ctr,ical, onC tte"totli)ii f inpn"t"':onn itquo been nade anl appt'oved'
NDCt,t.:A,UOU'r:ilt!..,rnt.,Actt,:;:;rnr,E,AD't\s'.l':fiiilrronEtriDEATlloccsrT0cr?y
ll
Date
s
':laQ
OR
Sdrilat'y eeset eapped at ptopertg line
Septic tank p:nped attd fi'lled wtth gra:se|
Final - l{hen abcrte itens a.re canpleted
and uhen Cenolition i-s complete o? atru3-
tut,e nooed and prenises cleaneC up'
Ilcmes
Bloeking cnd Set-uP
Plunbing connections '- salre? and uaten
Electrical Ccnnection - Bloeking, set-u' -
and olwnbinq eonneetions mtst be dPP?ctec
befire reqieating eleclrical inspecliot
Accescor! BuilCing
skirting, decks,pcrehes,
Leted.
Final - After
etc. ate conP
Pnlte 1 ol 3
-
Phonc:
ubdi.t i-sion:
',,lrli t ien
- i-trrll'r':!14---)
,,o,,rrn ,,n.,..
_l
u
I
Uf-
/r'.'ii
L- CO L"
SOLAR I4-CESS REQ'-JOB NO BeCYoor:,s
Gt
Lot ['aces -
Building V<llue & Permit
Ihispermiticgranted.ontheeipressconditionthatthes':ir1"'r'rtr:;lr'rr'rlr'('''i
slall, itr all t'espects,"';t;i;;1t'the. Ordinatice adopLeJ l.tiy Lli': t't t;t ;i
ifrt"ilftiti, inc|irdtng' the Toni'ng crdinanc.e' ta''iulcti.ttj .Llrc a',"t':'" '' ):
;e ;;" of Luild.ings, ancl fiey b.e- susp.enrle'{ or reuokec at ct!\ tr.'r" 'ii ' t: 1) '
tation o1 ,r,ry pt'cuisions of said Ordinarrces'
Buildi,ng Permi,t
State
n Clutc
Date Pa'-d:
tteceipl: ll
Signed
IlouseP. L.
-- Fees --
Value
Aacess
'Lace
ote
TTTG xITEM
# of Storles
LOT TYPE
Interio?
Cotner
PanhandLe
Cul-de-sac
% of Lot Cooeraga
Total Height
TopograPhY
l'lain
(rtrade
Carpont
Accesao?u
C-rocoLEer+sc
TOTAI, VAT,UI
3o,b
D.U.U. t.o &
2,ga
6q,a3
NO,CHARCE Plumbing Permit
No pet'cott t;lnLL aottsLtaab, ins!;aL!'r. aLLcr. ot chatt lc itttl tlL'il -ct' t'; j'; I ;' "
plwnbing or t)raitnge systln in ahoie or itr prtt't'-ut:Le:;:t stidt i''ct'sott i" :''t"
i)'jot p"o""o"*o, o7"o ullla pt"'ttor's LicensZ' ercept that a p""soil /rilr ir'
plmbing uork to lrr"pri'ty*"iiZi-ii o*na' Leised or opcrated b'1 tl;'t: ai;pii-
canl;.
Eirtutes I tA*
ResidentiaL (1 bath)
Seuer
oD
Plwnbing Pemit tD
State , ['a
t3 x5 *
ITEI|I Electricq I Perm it
IlhereStal:eLaunequit,estlzattheelectricaluorkbedonebyanSlecLric.tl.
contracto", the electrlZot pirll..o"- of this,lterndt siutl noL l:c :taliJ wttti
the LabeL iuts been signed by the Electrtcal CotlL''datot"Nan/Esterd Circuits
Set oice
Stcte
Total
NC,CIIARCE Mechqnicol Permit
Es,halst HooC
Vent F@l
I'lcodstote
PermLt fssuance
Mechanical Penmt
*
-. ENCROACHMEN? .-
Secat'i Plant Eranirtet'Date
Petmit
I ITAVE CAREFULLL LXAMINED sfi2 sentpleted application fo-r pennit' crul do
herebu certifu that aLl-informati'on het'eoi is tt'ue anC correcL' anC I
';"'rri:"r-;'";;1.7i iiit-i"y ;i aLL uo.rk pellomed stull be done in aacor-
dance uith the ordinanc"n"- of iho city 'of -springfield,
.and Lh.c La;s of thc
ili7ZZ|- or",son p"ot"iiTio-'to ttp wi*4a;cribbd ho,etn, cnd ttat No ,ccu-
pANCr uitl be nnce of";;;;" ,i;";i\i- ",itiiit permission of the su.itaty !.!-
i'tsi.on. I further certi"fy that only contraetors atd enplcyecs tsho a're Ln
Lipll.rn"n ittt, ons 701,'055 ui,LL be- used on this proiectCtsbeut
Sideualk
L Labe
Mobile Horne p
{TOTAL AMOUNT DUE:,15 .ob Signed
7d
?otal Chargea