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Home My WebLink AboutPermit Building 1991-07-02LE, RESIDENT!AL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 OF PFIOPOSED WORK: ASSESSORS MAP: LOT: Qloatc 4 JOB NUMBER 225 Fifth Street Spri ngfield, Oregon 97 477 TAX LOT:/22J22 BLOCK:SUBDIVISION PHONE: q7q7 yZIP: BA) STATE: OWNER ADDRESS: CITY: NEW - REMODEL ADDITION DEMOLISH OTHER DESCRIBE WORK: EXPIRES PHONEADDRESSCONTRACTOR'S NAME MECHANICAL: ELECTRICAL: PLUMBING: GENERAL: CONST. CONTRACTOR # QUAD AR RANGE: * OF BDRMS: WATER HEATER: _ OFFICE USE _ CONSTR. TYPE: * OF BLDGS: HEAT SOURCE: FLOOD PLAIN: ZONING CODE SECONDARY HEAT: SQUARE FOOTAGE: LAND USE: # OF UNITS OCCY GROUP: * OF STORIES: To request an inspection, you must call 726-3769. This is a24hour 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. REOUIRED INSPECTIONS l---l Temporary Eleclric 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. xr Rough Electrical - Prior to ffifinat Electrical - When allGelectrical 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. X Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Kf Framing - Prior to cover. ffiwatltCeiting lnsulation - Prior toQ cover. Xf-orVwatl - Prior to taping. Other Foundation - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After installation. r Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and installation of unit. 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 Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to filling trench.El'ectrical 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. Waler Line - Prior to filling trench. Streel 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. / - &dU*s 'c\t -^ /rtt - d//€ ,,a*z,' 25 (|Ls Att t., H nu),ilt? n. ,rorozl<,r) E Fence - When completed. r E E tl E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type '/lnterior - Corner - Panhandle - Cul-de-sac Setbacks 4/ao 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 4 PL.HSE GAR ACC N 6g' S 3e '7 E tgt VALUE ??4L:{4(.f"q233o (A)4a tt 2/2_?3 ?zoz@ Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport X $/SQ. FT. 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. iewed ;)o '). P /f - [ -/ate Receipt Number: Receive Date Paid 6-/?r-q/ Plan Check Fee:?? 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 Mobile Home FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood By signature, I state and agree, that I have carefully 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 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 front of the property, and the approved set of plans will remain on the site at all times during construction. /sisn"trr" /' -r.r/3,t-', 0, 6- t?-? /Date MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolitlon State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 16.t? VALIDATION RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY C'TY OF onEGorv 1. .IJTCATION OP+s',)- r\ 225 BIFTE SlTBBf, SPRTNGPIBU), oREGON 97477 INSPBGTIOII RB0UBST: 726-3769 OPFICB: 726-3759 SPtuN(iFrELf,' BIASIRICAL PERITIT APPIJCATION crty Job n"u"" 'Q l)[6 f] 3 COHPI,RTE TBE SCIIEDIII^E BBLOV A Nev Residentlal-Slngle or Multi-Family per dvelllng unlt. Service Includedl Items Cost 1500 sq.ft. or less Each additlonal 500 Sg. ft or portlon thereof Each Manuf,d Home or -Modular Dvelllng Servlce or Feeder $ 8s.00 $ 15.00 $ 3s.oo B. Servlces or Feeders (10 Branch Circuits included). Installation, Alterations or Relocation: Sum JOB DBSCRIPTION Permlts are non-transferable and expireif vork ls not started vithin 180 daysof lssuance or lf vork ls suspended for 180 days. 2. COI|TRACTOR INSTALIATION ONLT Electrlcal Contractor Address ct ty-Phone Supervlsor Llcense Number Expiratlon Date Constr Contr. Number C. Temporary Services or Feeders Installation, Alteratlon or Relocation 100 amps or less 101 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only (w00 00 00 00 00 00 $ss $60 $eo $130 $300 $gs Exp 200 amps or less $ 201 amps to 400 amps - $ over 401 to 600 amps - $Slgnature of Supervlslng Blectrlclan 0vners Name <f Cl ty Phone OIINER The installatlon ls belng.made onproperty I ovn vhlch ls not lntendedfor sale, Iease or rent. 0vners Slgnature: DATB: iration Date 3s.00 40.00 80.00 $ 3s.00 $ s0.00 $ 1s.00 Address 432-n 3rd S[ Over 600 amps or 1000 volEs see uBu a56ilE Branch Clrcuits Nev, Alteratlon or Extenslon Per Pane1 One Circult Tvo to ten Clrcults Each Addtrl ten orportlon thereof Miscellaneous (Service/feeder not lncluded) -Each installatlon Pump or irrigation $ 36.00 Slgnal Circult or Iimited energy panel_ $ 36.00 SUBToT L 0r ABOVE ')9. do 5Z State Surcharge D. B L7{ Y RECEIVBD 5 TOTAL 76.74- ,d/,n^,,d 1l )it //,o \Permit No: Address: lssued Date: OR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residentia! 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. Fill in the applicable blanks, and initia! box 1 and either box 2A or 28: I own, reside in, or will reside in the completed structure. 2. A. l-l My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR I will be my own general contractor. lf I hire subcontractors. I will hire onlv subcontractors reoistered with the Construction Contractors Board. lf I chanoe my mind and do hire a oeneral contractor. lwill contract with a contrattor-who is reoistered w'ith the Constructibn Contractors Board and I will immediately-notify the office issuing this building permit of the name of the contradtor. I hereby certify that the above inlormation is correct and that I have read and understand the lnlormation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. I CONSTRUCTION CONTRACTORS BOARD 0244J',U90 6TDa 7 WH|TE COPY TO ISSUING AGENCY PERMIT FILE PINR COPY TO APPLICANT?< J\ I -L--I I r-t*i;-, @s Z I I 1. rl-r B. tt)