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Home My WebLink AboutPermit Building 1995-07-03SPRINGFIELO RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Oflice: 726-3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP:.2? 2fr, JOB NUMBER ?,7 --: 225 Fifth Street Springfleld, Oregon 97477 TAX LOT:027e SUBDIVISION a PHONE: ZIP:STATE:7Z?Z-CITY: ADDRESS: OWNER: a<> ,r ADDITION DEMOLISH OTHER DESCRIBE WORK: NEW- REMODEL Pl UL,IRING' EXPIBESADDRESS PHONECONTBACTOR'S NAME MECHANICAL: ELECTRICAL GENERAL: CONST. CONTRACTOR '' _ OFFICE USE - r OF BDRMS: RANGE: ZONING CODE: FLOOD PLAIN WATER HEATER: LAND USE: # OF1)NITS SECONDARY HEAT SQUARF. FOOTAGE: OUAD AREA: , OF BLDGS OCCY GROUP: * OF STORIES: CONSTR. TYPEr HEAT.SOURCE: To request an inspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7;00 a.m, wlll be made the same worklng day, lnspections requested after 7:00 a.m. will be made the followlng work day. REOUIRED INSPECTIONS l---l Temporary Electrlc l-l Rough Mechanlcal - Prlor toU COVer. Flnal Plumbing - When all plumblng worl( is complete. Slte lnspectlon - To be made after excavatlon, but Prior to setting forms. Rough Electrical - Prior to Final Electrlcal - When all electrical work is complete.cover. Underslab Plumblng/ Electrical / Mechanlcal - Prior to cover. Electrlcal Servlce - Must be approved to obtaln permanent electrlcal power. Flnal Mechanical - When all mechanical work ls complete. Footlng - After trenches are excavated.E a 8 Flreplace - Prlor to laclng materlals and framing lnsp. m Flnal Bullding - When all required lnspections have been approved and building is completed.Masonry - Steel locatlon, bond beams, groutlng.Framlng - Prlor to cover. Other Foundallon - After forms are erected but prlor to concrete placement.Wall/Celling lnsulatlon - Prlor to cover. Underground Plumblng - Prior to fllllng trench.@ o"*u" - Prlor to taping MOBILE HOME INSPECTIONS Underlloor Plumblng/ Mechanlcal - Prior to lnsulatlon or decklng.Wood Slove - After lnstallation. Post and Beam - Prlor to floor insulatlon or decking.lnserl - After flrePlace approval and lnstallatlon of unlt. Blocking and Set.Up - When all blocking is complete. Floor lnsulalion - Prlor to decking.Curbcut & ApProach - After forms are erecled but Prior to placemcnt of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanltary Sewer - Prior to fllllng trench.Eleclrical Connection - When blocking, set-up, and plumbing lnspections have been approved and the home is connected to the servlce panel. Storm Sewer - Prior to filling trench. Sidewalk & Drlveway - After excavation is comPlete, forms and sub-base material in Place. Waler Line - Prlor to filling trench. Fence - When completed. Str€ot Trees - When all required trees are planted. Final - After all required lnspections are approved and porches, sklrting, decks, and ventlng have been lnstalled.Rough Plumbing - Prlor to cover. LOT: - BLOCK: tl E E tl E E tl t_l E tl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Typ- - lnterior -- Corner - Panhandle - Cul-de-sac P.L.HSE GAR ACC N S E tback IS THE PROPOSED WORK iN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? .- lf yes, this application must be slgnedand approved by the Historlcal Coordinator prior to permit issuance. APPBOVED VALUE sO /6-u(A) BUILDING PERMIT Total Value Building Permit Fee State Surcharge Total Fec SQ. FT. X $/SQ. FT.ITEM Main Garage Carport BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT This permit is granted on the express condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Spri ngfield, including theDevelopment Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any timeupon 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 ilre City linrits which are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home PLUMBING PERMIT FEE N0 FT. FT. FT. (c) Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS By slgnature, I state and agree, that I have caref ully examlnedlhe completed application and do hereby cerilfy that alllnformatlon hereon is true anct correct, and I f urther ceril{y that any and alr work performed shail be done in accordance with the Ordinances of the City of Springfield, and the Lawsof the State of Oregon perlaining to the work described herein, and that NO OCCUPANCy will be made of any structure without permission of the Buildirrg Safety Division.I further certify that only contractors and employees who are ln compliance with OFIS 7O1.O5S wlll be used on lhisproiect. I further agree to ensure that all required inspections are reguested at the proper time, that each address rs readabre from the street, that the permlt card ls located at the frontof the property, and the approved set of plans will remain 3 on the Slgnatu Date Wood Stove/ lnsert/ Fireplace Unit Dryer Vent MISCELLAN EOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk _--- ft Curbcut __- ft Demolition State Surchargg MECHANICAL PERMIT Total Miscellaneous pennits (D) (E) N0 Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan TOTAL AMOUNT DUE (exctuding ctectricat) (A, B, q D, and E Combined) 2A ?? 7-DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBEFI ,'/-- CITY OF The tollowlng prrlr;ct eG $i.,birlittrld hei: the f:l SPT :FIELD ELE TRICAL PERHIT APPLICATION City Job NunAer ?5/??? afr, zonin6. and #ocr; rrtrr r(lclLiir(, ;g;eci{ic lunil usg apfrroval. LEGAL DESCRIPTION e-Z-ZI JOB u Permits are non-trans ferable and pire if vork is not started vithin 1B0 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Addr""s ci ty- Phone Supervisor License Number Expiration Date constr contr. Number Exoiration Date Signature of Supervising Electrician Ovners N Address icfZ A( 3 Ci ty u Phone INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: DATE: COHPIJ1TE FEE SCE}DTILE BELOH Nev Residential-Single or MuIti-Family per dvelling unit. Service rncluded t ,a*,s cost Looo sq.rt. or ress NIL s Bs.oo rach additional 500 ifl;,lir"'Portion \tlk g 1s.oo Each Manuf 'd Home or Tff Modular Dvelling Service or Feeder $ 40.00 Services or Feeders InstalIation, Alterations or Relocation: R- 225FIFTESTREET il 2 a< SPRINGFTELD, OREG0N 97477 -t;i':',t-l(-( ) - t-;! INSPECTION REQUEST z 1 26-371.6f,::r:ziyr OFFICE: 726-3759 ,.6ff J?IUru**T;'+A 3 B c @ s s0.00 $ 60.00 $100.00 s130. 00 $300.00s 40.00 Sum 5a. 0 " a66iE- P200 amps 201 amps 401 amps 601 amps Over 1000 Reconnec t ss 0 amps 0 amps 00 amps mps /voI ts nly 1e 4A 60 10 or to to to a 0 Temporary Services or Feeders Installation, Alteration or Relocation 200 amps''or }ess 201 amps to 400 amps Over 40L to 600 amps Over 600 amps or 1000-vorts D. Branch Circuits E SUBTOTAL OF ABOVE 5Z State Surcharge 32 Admini.strative Fee TOTAL Nev, Alteration or Extension Per Panel onecircuit A s35.oo Each Addi tional ''-!:;;!:i":',:il?,'"T'Wg 2.oo /L- Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation _ $ sign/outline Lighting- S l,imi ted Energy/Res - $ Limited Energy/Comm $ s 40.0 $ ss.o $ 80.0 see ItB 40.00 40.00 20.00 36.00 .a .a oe(da.2'P- "a7l .Ze! 0 0 s RECEIVED 5 f r',7 Yfu Permit *: ?f / ?? AD,a Address: DateIssued by Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exemptfrom registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I andZ, and either box 3,{ or 3B: w 1. I own, reside in, or will reside in the completed structure 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. 38. I will be my own general contractor If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify thatthe above information is correct and thatl have read and dounderstand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. OR ^fr of permit applicant) (White copy to issuing agency perrnitfile, pink copy to applicant) (Signature (Date) tr M /Lrz RESIDENTIAL PERMIT APPLICATTON lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: SPRI}.GFIELr, JOB NUMBER 225 Fifth Street Sprlngfleld, Oregon gZ 477 TAX LOT >tu 2b ASSESSOFIS MAP:?/ LOT - BLOCK:SUBDIVISION PHONE:2 STATE:2* zte: 7?7"YCITY: OWNER: ADDITION DEMOLISH OTHEFI DESCRIBE WORK: NEW- REMODEL ADDRESS EXPIRES PHON E CONTBACTOR'S NAME MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # GENERAL: PLUMBING _ OFF]CE USE - FLOOD PLAINOUAD AREA: , OF BLDGS: SECONDAFIY HEAT: SQUARE FOOTAGE: # OF BDRMS: .-- LAND USE: OCCY GROUP: r OF STORIES: CONSTFI. TYPE: HEAT SOURCE: WATER HEATER:-RANGE: # OF UNITS: _ZONING CODE: To request an lnspectlon made the same worklng , you must call 726'3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll beday, lnspections requested after 7:00 a.m. wlll be made the foilowlng work day. REOUIRED INSPECTIONS l--l femporary Etecrrtc Rough Mechanlcal - prior to cover.f/] Flnat ptumblng - When ailfJ plumblng work ls complete. Slte lnspectlon - To be made after excavatlon, but prlor tosetting forms. Rough'Electrlcal - prlor to cover.Flnal Eleclrlcal - When ailelectrlcal work ls complete. n Underslab Plumblng/Electrical/u Mechanlcal - prlor to cover.Electrical Servlce - Must be approvect to obtaln permanent electrlcal power. Flnal Mechanlcal - When ailmechanical wo6< ls cornplete. Footlng - After trenches are excavated.Flnal Bulldlng - Whon ailrequlred lnspectlons have beenapproved and building is completed.[l Masonry - Steet locailon, bondu beams, grouting. Flreplace - Prlor lo faclng materlals and lramlng lnsp. Framlng - Prlor to cover. Foundatlon - After forms are erected but prlor to concrete placemont. Other .- Wall/Celllng lnsutatlon - prtor to cover. f] l'Jffii:l"i,ll"ln'."orns - Prior . [-l orywan - prror to taprns. E Underlloor Plumblng/Mechanlcal - Prior to lnsulatlon or decklng. MOBILE HOME INSPE TIONS Wood Stovo - After lnstallation Post and Beam - Prlor to floor lnsulatlon or decklng. I Floor lnsulalion - Prlor to decklng. lnserl - After flreplace approvat and lnstallatlon of unlt. [-_l Blocking and Set.Up - Wtren ail - blocklng ls complete. Curbcut & Approach - After forms are erected but prior toplacement of concrete.{i., Sidewalk & Drlveway - After excavatlon ls complete, forms and sub-base materlal ln place. Plumblng Connections - Wltenhome has been connected towater and sewer. n Sanitary Sewer - prtor to filting - trench. Storm Sewer - Prlor to fllllng trench. Electrical Connection - Whenblocking, set.up, and plumbing lnspections have becn approvcd ancl the home ls connected tothe servlce panel. Water Llne - Prlor to filling trench.[-l Fence - When comptered. Street Trees - When all requlred trees are planted.w Rough Plumbing - Prlor to cover. - Flnal - After all requiredlnspectlons are approved andporchos, sklrtlng, decks, andventlng have been lnstalled. ADDRESS: i tl Lot faces Lot sq. ttg. Lot coverage Topography Total helght Lot Type - lnterlor - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE GAR ACC N S E S THE PROPOSED WORK IN THE - HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - ll yes, this appllcatlon must be slgned and approved by the Historlcal Coordinator prior to permit issuance. APPROVED BUILDING PERMIT ITEM SO, FT.X $/SQ, FT. '.1! VALUE Main Garage Carpor t Total Value Building Permit Foe State Surcharge Total Fee (A) BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Sprlngfleld, including the Development Code, regulating the construction and use of buildings, anrJ may be suspended or revokcd at any tlme upon violation of any provisions of said ordinances, Plan Check Fee Date Paid Becei pt Number Received By Plans Rcviewed Ely Date SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Developmcnt Charge ls due on all undeveloped properties within tlre City linrits which are belng irrrproved. PLUMBING PERMIT ITEM . Flxtures Besldential Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home FEE 57-* llott FT, FT. a Plumblng Permit State Surcharge Total Charge fr (c)z.e ADDITIONAL COMMENTS MECHANICAL PERMIT Furnacc Exhaust Hood Vent Fan N0 Wood Stove/ lnsert/ Flreplace Unit Dryer Vent I (D) By slgnature, I state and agree, that I have caref ully examlned the completed application and do hereby certlfy that all lnformatlon hereon is true and correct, and I f urther certlfy that any and all work performed shall be done in accordance with the Ordinances of the Clty of Sprlngf ield, and the Laws of the State of Oregon pertalnlng to the work descrlbed herein, and that NO OCCUPANCY will be made of any structure withou.t permission of the Bulldirrg Safety Divislon. I further certify that only contractors and employees who are ln compliance wlth ORS 701.055 will be used on thls proiect. I further dgree to ensure that all requlred lnspections 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,?nd the approved set of plans will remaln on the site at all times during const lon. I Slg natu re Date MISCELLANEOUS PERMITS Mobile Home State lssuance, State Surcharge Sldewalk - ft ,. Curbcut - ft I Demolition State Surcharge Total Miscellaneous Permits (E) VALIDATION: RECEIPT NUMBEFI DATE PAID ,/? -?2.?, AMOUNT RECEIVED BECEIVED BY &Zrz TOTAL AMOUNT DUE (excludiag electrical) (A, B, C, D, and E Combined) t . FT. Mechanical Permlt lssuance State Surcharge Total Permit