HomeMy WebLinkAboutPermit Building 1992-11-10,fu
t-)of, 9 3,6 AO7
SPFI,{GFIELD
SUBDIVI$ION:
TAX LO]I
LOCATION OF PROPOSED WOBK:
ASSESSORS MAP:
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726'3759
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97 477
LO1; .--*- BLOCK:
1/53PHONE
zlPSTATE:
1Lt1,.1tL
Qlv )8
CITY:
ADDRESS: .-*
OWNER:
REMODEL ADDITION4- DEMOLISH OTHER
&-,,tDESCRIBE WORK: - -
NEW --.-_
PLUMBING: .A')IA
PHONEEXPIRESADDBESS
0*\\01 /
c [lr\\0.,r./
ELECTFIICAL:
MECHANICAL:
CONTRACTOR'S NAME
GENERAL:
CONST.
CONTRACTOR #
3so
I r\l- OFFICE USE .
WATER HEATER:
LAND USE:FLOOD PLAIN:
ZONING CODE:
r OF BDRMS:
oCCY GROUP: ..
* OF UNITS:
SECONDARY HEAT:
SQUABE FOOTAGE:
I
# OF STORIES I
QUAD AREA:
r OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspection, you must call 726'3769. Thls ls a 24 hour recordlng' All lnspect
macle tho same worklno clay, lnspectlons requested after 7:00 a'm' wlll be made the foll
REOUIRED INSPECTIONS
[--l Rough Mechanlcal - Prlor toLl cover.
T7fRouoh Electrical - Prior to
/A{.or"-r.JEf rlnat Etectrlcal - When allJZ-Ielectrlcal work is comPlete.
lons requested before 7:00 a.m
owlng worl< daY.
Flnal Plumbing - When all
plumblng work ls comPlete'
Final Mechanlcal - When all
mechanical work ls comPlete.
wlll be
i\/Foundalion - After forms are
JALerected but Prior to concrete
placement.
K
K
x'
TemporarY Electrlc
Site lnspecllon - To be made
after excavation, btrt Prlor to
settlng {orms.
Understab Plumbing/ Electrlcal /
Mechanlcal - Prior to cover.
Masonry - Steel locatlon, bond
beams, grouting.
Underground Plumbtng - Prior
to filling trench.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng'
Post and Beam - Prlor to floor
lnsulatlon or decking.
Floor lnsulatlon - Prior to
deckl ng.
Sanltary Sewer - Prlor to filllng
trench.
Storm Sewer - Prlor to fllllng
trench,
Waler Llne - Prior to fllllng
trench.
[--l Fireplace - Prlor to faclngu materlals and framlng lnsP'
,St'uttng - Prlor to cover'
pz{ watltceltlng lnsulatlon - Prior to
JZ*cover.
Eotruult - Prlor to taPing'
l-l Wood Stove - After lnstallatlon'
Eleclrical Servlce - Must be
approved to obtaln Permanent
electrlcal Power.
lnsert - After llrePlace aPProval
and lnstallatlon of unlt.
Curbcut & APProach - After
forms are erected but Prior to
placement ol concrete.
.9 Flnal Bulldlnq - When all
.ftqutred lnsPlctions have been
approved and bullding is
comPleted.
Other
MOBILE HOME INSPECTIONS
Blocking and Set'UP - When all
blocklng ls comPlete.
Plumblng Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
Sldewalk & Drlveway - After
excavatlon ls comPlete, forms
and sub.base materlal ln Place'
cover,
Fence
P,.and
a7 tL13l
n
__EW__
A {\T\
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tl
Footlng - After trenches are
excavated.
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P.L.HSE GAB ACC
S
W
E
.THE PROPOSED WORK IN THE
Lot Type
'.* lnterlor
i
-
Cbrner
-
Panhandle
-
Cul'de-sac
etLot faces drsroRlcAL DlsTBlcr, oR oN
THE HISTOBICAL FIEGISTER? ..-
lf yes, this appllcatlon must be signed
and apProved bY the Hlstorlcal
Coordinator prlor to permit issuance'
APPROVED:
By slgnature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
lnformatlon hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springf leld, and the Laws
of the State of Oregon pertainlng to the work descrlbed
hereln, and tlrat NO OCCUPANCY wlll be made of any
structure wlthout permission of the Buildlng Safety Divislon.
I further certify that only contractors and employees who
are ln compliance with ORS 70'1.055 will be used on this
project.
I further 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 ls located at the front
of the property, and the approved set of plans will remain
on the slte at all times during constructlon.
Aurnt rlut frnll
Lot sq. ftg.
--Lot coverage
TopograPhY
\r)" t
Total helght I J
natu re
Date
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 tlre 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
any provisions of said ordinances.eq t z2,
Fleceipt Number:- [aQ4 |
to I t<la2
ewed ByPlan
L
Date
Fleceived
upon vlolation of
Plan Check Fee:
Date Paid:
BUTLDING PERMIT
)
(A)
lctb 100"
n.;1oo'
P,g,to
VALUESQ. FT. X $/SO. FT. =
?SA lLt a
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
403
/47,r?
Systems Developrrrent Charge is due on all undeveloped
properties withln the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)NA
ADDITIONAL COMMENTS
ITEM
Fixtures
Residentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
No
FT,
FT.
FT.
PLUMBING PERMIT
Plumbing Permlt
State Surcharge
Tolal Charge
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
lt
Demolition
State Surcharge
Total Mlscellaneous Permlts (E)
TOTAL AMOUNT DUE (excludlng electrlcal)
(A, B, C, D, and E Comblned)
J41E
VALIDATION:
RECEIPT NUMBER.
DATE PAID
36
\o6
, ))0
BECEIVED BY
AMOUNT RECEIVED
-
J
Itl,nlr,-,
Aitr225 FTFTII STREEI
SPRTNGFTELD, ORBGON 97477
INSPEcf,IoN REQUESTt 726-3769
OFPTCE: 726-3759 99.
1 LOCATION OF Yn\P
IJGAL DESCRTPTTON3/
JOB DES(RIPTTON
ELECTRICAL PERHIT APPLICATION
City Job Number
SCTTEDULE
i aI-Si nglHuIti-Family per
Service Included:
f tems Cos t
$ 8s.001000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Manuf,d Home or
-Hodular Dvelling
Service or Feeder
$ 1s.00
$ 40.00
Services or FeedersInstallation, Alterations or
Relocation:
200 amps or less
20L amps to 400 amps
-401 amps to 600 amps
-60L amps to 1000 amps-
over 1000 amps/vorts
-Reconnect Only
Temporary Services or Feedersfnstallation, Alteration or Relocation
dvel
i BELOII
eor
Iing uni t.
Sum
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for180 days.
2. COI|TRACf,OR TNSTALI..ATION ONLY
Electrical Contractor
B
Address
ci tY- Phone
Supervisor License Ndmber
Expiration Date
Constr Contr. Number
Exp iration Date
Signature of Supervising Blectrician
owners w^^" .56OA10?:E S-Atfl
Address 2S2G N,z{Ds7,
$ty VFlt , Phone 7y'/r,'4/S{
OIINER INSTALI,ATION
The installatlon is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
Ir
RECEIPT
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one Ci rcui t t/ S 35. O0 3L@Each Additional
Ci rcui t or vi th Servi ce
or Feeder Permi t I $
Hiseellaneous ( Service/feeder
-Each installation
Pump or irrigation $
Sign/OutIine Lighti.g- S
Limi ted Energy/Res _ $
Limited Energy/Comm S
2.oo ZlP
200 amps or less $
20L amps to 400 amps
-
$
Over 401 to 600 amps _ $
Over 600 amps or 1000 volts se
STETOTAL OF ABOVB
5Z State Surcharge
TOTAL
c
s s0.00
$ 60.00
$100.00
$130.00
s300.00
$ 40.00
00
00
40.
55.
80.
e"
00
E
B" a6o-G-
not included)
40.00
40.00
20. 00
RECEIVED BY:
?
5 3#w_
r
E--
3
A.