HomeMy WebLinkAboutPermit Building 1997-06-18SPRIhlGFIELD
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JoB NUMBE ^ ?7" ?y'S
225 Fifth Street
Sprlngfleld, Oregon 97477
RESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Oflice: 726-3759 qfr,
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT
-
BLOCK:
TAX LOT:
SUBDIVISION
PHONE:
.JYSTATE:='r, ?2y'2 4CITY:
ADDRESS:
OWNER:
NEW _ REM9DEL t/-aoDrrroN
d)
DEMOLISH OTHER
DESCRIBE WORK:
MECHANICAL:
-
ADDRESS EXPIRES i PHONECONTRACTOR'S NAME
ELECTRICAL:
GENERAL:
CONST.
CONTFIACTOB ''
RANGE:
r OF BDRMS:
- OFF]CE USE -
LAND USE:
WATER HEATER:
ZONING CODE:
FLOOD PLAIN:
Y OF UNITS:
QUAO AREA:
r OF BLDGS:
SECONDARY HEAT:
SOUARF. FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng, All lnspectlons requested before 7:00 a.m, wlll be
made the same worklng day, lnspections requested after 7:OO a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prlor to
cover.
[-l Final PlumbinglJ plumbing worl<- When all
ls complete.
Slte lnspectlon - To be made
after excavatlon, but prior to
settlng forms.
Rough Electrical - Prior to Flnal Electrical - When all
electrical work is complete.cover.
Underslab Plumblng / Electrical /
Mechanlcal - Prlor to cover.
Eleclrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Final Mechanical - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framlng lnsp.
Kl al Buildlng - When all
uired lnspectlons have been
Masonry - Steel locatlon, bond
beams, groutlng.
approved and buildlng is
completed.
E ,E(rt"-lng - Prlor to cover'
Foundatlon - After forms are
erected but prlor to concrete
placement.Wall/Celllng lnsulatlon - Prlor to
cover.
tl Underground Plumblng - Prlor
to fllllng trench.ff"*all - Prlor to ta,lns'
MOBILE HOME INSPECTIONS
Underfloor Plumblng / Mechanlcal
- Prior to lnsulatlon or decklng.Wood Stove - Aiter lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnserl - After flreplace approval
and lnstallatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulation - Prior to
decklng.Curbcut & Approach - After
forms are erected but prior to
placemcnt of concrete.
PlumNng Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prlor to fllling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prlor to fllllng
.trench.
Sidewalk & Driveway - After
excavation ls complete, forms
and sub-base materlal ln place.
Water Llne - Prlor to filling
trench.
Street Trees - When all requlred
trees are planted.
Final - After all required
lnspections are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
Bough Plumbing - Prlor to
cover.
PLUMBING:
E
tl tl
E
E
E
E
fl
E
E
E
[--l ottrer
r
tl
E
tl
Fence - lVhen coi'rrpleted.
E
E
.,.
J THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTEH?
-
lf yes, thls applicailon rnust be slgnedand approved by the Historlcal
Coordinator prior to permit issuance,
APPROVED:
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
-
lnterlor
-
Corner
-
Panhandle i
-
Cul-de-sac
P.L.HSE GAR ACC
N
S
E
cLot Type
VALUE
g.zt /e 1e
f,a
Garage
2C.f,\
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
'it t
x $/so. FT.
,15t,5 2
(A)
BUILDTNG PERMIT
ITEM SO, FT.
Main
Carport
C/4C/Afi7 o,t' zae
/b/+
lq co
Thls permit is granted on the express condition that the saidconstruction shall, in all respects, conform to the Ordlnanceadopted by the City . of Springfield, includlng thep.e,y9lon-ent code, regutatins ine donitiuciion ano use ofoutrotngs, anc, may be suspended or revoked at any tlmeupon violation of any provisions of said ordlnances.
DatePIans Revi ewed By
Receipt Numbe
E,
PE
UB L D N G NLA c EH c K
NA BD U LD N t:MR T
Date Paid
Beceived By:
Plan Check Fee:
EVELOPMENT CHARGE (SDC)
(B)
SYSTEMS D Systems Development Charge ls due on all unc,evelopedproperties wlthln ilre City llmlts which are being improved.
ITEM
Fixtures
Resldenilal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
PLUMBTNG PERMIT
FEE
Nc
FT.
-
(c)
Plumblng permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/Fireplace Unit
MECHANICAL PERMIT
N0
Dryer Vent
(D)
Furnace
Exhaust Hood
Vent Fan
Mechanlcal permit
lssuance
State Surcharge
Total Permlt
By slgnature, I state and agree, that I have carefully examlnedthe completed appllcailon and do hereby certify that alllnformation hereon is true and correct, and I f urther cerilfythat any and all work performed shall be done in accordancewith the Ordinances of the City of Sprlngfield, and the Lawsof the state of oregon pertainrng to the work descrrbedherein, and that NO OCCUPANCy will be made of anystructure without permission of the Buildir.lg Safety Divislon.I further certify that only contractors andlmptoyees whoare ln compliance with ORS 701.055 wlll be usec, on thlsproject.
2'lDate
lgnature 4,4/J K
L-(9 ^
U rther ree toag en U thare a lt redregu tinspec ons areuesroqtedahetiproperhatfr9,each address S readablfromhetrerhatheBt,,mpor card s o cated at the fro ntthofeprodanv,pert the sepproved of wlplans remalnnoethatsitealmriesdurlaoNSngtrucon.il
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
--
ft
Curbcut _-- ft
Demolitlon
State Surcharge
Total Miscellaneous permils
42F?/' '--.
(E)
ToTAL AMOUNT DUE (exctu.ding electricaD .+2."22(A,B,qQandECombtned),?AMOUNT RECEIVED
RECEIVED BY
DATE PAID
VALIDATION:
RECEIPT NUMBER
- ,3f
- 1i! 'z-
-
FT.
FT.
-
*fi ,11':Jil3% Bt? x-1' ffi l,.;il''';:'ffi .',.,
tuo'oo")on,.* \rt(
SPFlw.iFlELEt
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Admini.strative Fee
TOTAL
ELECIRICAL PERHIT APPLICATION
Job Number
3. COHPLETE FEE SCBXDTILE BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
i-000 sq. f t. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 8s.00
s 1s.00
s 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
20L amps to 400 amps
-40L amps to 600 amps _60L amps to 1000 amps_
Over 1000 amps/voIts
Reconnect On1y
ss0
s60
s100
$130.00
s300.00
$ 40.00
C
h,
225 FIFTE STREET
SPRINGFIELD, OREGON 974
INSPECTION REQUESTz 72
0FPICE: 726-3759
,-)
nutnotti"O Slgnaturs
1. LOCATION OF STALI-ATION
I,EGAL DESCRTPTION
JOB
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
LBO days.
2. COMRACTOR INSTALI,ATION ONLY
Electrical Contractor
Address_
A
Sum
'-=qitY
00
00
00Phone
Supe r License Number
Expiration
Constr Con Numb e
Expi ra Date
ture of Supervising Electric
Ovners Name
Temporary Services or Feeders
Installation, Alteration or Relocation
D. Branch Circuits
Nev, Alteration or Extension Per Panel
oneCircuir I $35.00
Each Addi tional
Circuit or vith Service
or Feeder Permit S 2.00
200 amps''or less $ 40.00
201 amps to 4OO amps
-
S 55.00
over 4b1 to 6oo amps
-
S Bo.oo
Over 600 amps or 1000 volTs see rrgtt uf,o*
fr n-rZ ^f;
Address 212
Ci ty . Phone 726@A1
OVNER INST
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:
E MiscelLaneous (Service/feeder
-Each instal-l-ation
Pump or irrigation $
Sign/Outline Lighting- S
Limited Energy/Res $
Limited Energy/Comm S
?9-o
not included)
40.00
40.00
20.00
5
RECEIYED
2?
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