HomeMy WebLinkAboutPermit Building 1992-02-26SPRINGFIELD
JOB NUMBER
225 Fifth Street
Spri ngfield, Oregon 97 477
TAX LOT:
SUBDIVISION L/rA LrN\n[ qq](r
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WOR
ASSESSORS MAP:-l
LOT:5 BLOCK:
oR 9zYz tSTATE:
PHONE:7 v1-76;?
ZIP:CITY:
ADDRESS
OWNER:
NEW X REMODEL ADDITION DEMOLISH OTHEB
DESCRIBE WORK:
EXPIRES PHONEADDRESSCONTRACTOR'S NAME
ELECTRICAL:
MECHANICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
\\\
\
\CONSTR. TYPE:vN7
_ OFFICE USE _
WATER HEATER
HEAT SOURCE:
RANGE:
* OF UNITS:
LAND USE:
# OF BDRMSA,erf4_
€-
SECONDARY HEAT:
SQUAFIE FOOTAGE:
OCCY GROUP:
# OF STORIES
QUAD AREA:
* OF BLDGS:
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.
REQUIRED INSPECTIONS
E'"',oorarY Electric RT Final Plumbing - When allE plumbing work is complete.
tr
K
x
l{Post and Beam - Prior to floor14 insulation or decking.
Et-Floor lnsulation - Prior to,{3decking.
pl--Sanitary Sewer - Prior to filling-H trench.
frf6torm Sewer - Prior to fillingIJ'trench.
H**Line - Prior to fillins
IFT-Rough Plumbing - Prior to.G cover.
$lfCurbcut & Approach - After|Sforms are erected but prior to
placement of concrete.
lVt-Sidewalk & Driveway - After[3e*""rrtion is compiete, forms
and sub-base material in place.
l-_-l fence - When completed.
a.
Fireplace - Prior to facing
materials and framing lnsp.
Wood Stove - After installation.
lnsert - After fireplace approval
and installation of unit.
Street Trees - When all required
trees are planted.
Other
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When all
blocking is complete.
Plumbing Conneclions - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
or decking.
p-Rough Mechanical - Prior toQ cover.
[Ef6ough Electrical - Prior toGcover.
'f--,.6lectrical Service - Must bel4ppror"d to obtain permanent
electrical power.
ftf--Final Electrical - When all
r.......J electrical work is complete.
kTinal Mechanical - When allLl mechanical work is complete.
lX--finat Building - When allsrequired inspections have been
approved and building is
completed.
.Fl-Framing - Prior to cover.
Xf--wall/Ceiting lnsulation - Prior to._COVef.
ffiDrVwatl - Prior to taping.
ffi underttoort@lL--\l - Prior to insulation
6t"";
q/aH,
t
?-]=EE
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
6,6007t lnterio r
Corner
Panhandle
Cul-de-sac
Lot
Y
ks THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the H istorical
Coordinator prior to permit issuance.
APPROVED:
il'
P.L.HSE GAR ACC
N 6 I
S t//
t3'to'
E )A,
/063 3f1o 4 Z,,l,o l, i o
VALU E
lz.Ot
!617rI to
16',f.Fo
l7.fg
ua.I8(A)
X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Su rcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
320 /4./o
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.
6-2>+ I
'v4%
Date
e&7Receipt Numbe
By:
Plan Check Fee:
Date Paid
Recei
542rya.tr./*5lezs
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)700, 70
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
/6o,ce
/60,ec
€ .oo
{ 66,co
7
(c)
N0
FT.
FT.
FT
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIO\AL COMMENTS
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
4f .{c
'3,0o
/(.lc:
/d,00
I .13
4?,8i
3, oO
(D)
4,c o
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rn ace
Exhaust Hood
Nol
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 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
Signatu
Date
on the site at all ti during construct
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Total Miscellaneous Permits (E)7q t,
/6'.qt
L2 .7C
Demolition
State Surcharge
Sidewalk
Curbcut
47 ,,/i *
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
tLaaAae
DATE PAID
AMOUNT RECEIV
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
C'TY OF OREGO'V
SPTIIN(;FIELO
225 FIFTB STREET
SPPJNGFIEID, 0REGoN 97 477
INSPECTION PGQUEST. 726-3
0FFICE: 726-3759
1. LOCATION OP
T,EGAL DESSRIPTIOH
Permits are non-transferable and expireif vork is not started vithin L80 daysof lssuance or if vork is suspended fori80 days
Z. COI{TRACIOR INSTALI..ATION ONLY
Electrical Contractor ' fll{'r" z 1i
Address
PERHIT APPLICATION
City Job Number
rEE SCIIEDUIA BELOII
ent ial-Single or
Hulti-Family per dvelling unit.
Service Included:
Items Cost
L500 sq.ft. or less / $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
-Modular DvelIing
Service or Feeder $ 35.00
fl
100 amps or less
101 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect Only
h
Sum
-€
B. Services or Feeders (L0 Branch Cireuits
included). Installation, Alterations
or Relocation:
ctry frzz- tfui*phone ?24?aa':T
Supervisor License Number 2=f ? S
Expiration Date
Constr Contr. Number ?V/A
Expiration Date
Slgnature of Supervising Blectrician
Temporary Services or FeedersInstallation, Alteration or Relocation
00
00
00
00
00
00
35
$3oo
35
$
$
$
$1
$ 3s.00
$ s0.00
$ 1s.00
60.
90.
30.
$
C
200 amps or less E- $ 35.00 #
0ver 401 to 600 amps $ 80.00
Over 600 amps or 1000-voTts see rrgrr
"ffi-
0tlners
Address
Cl ty Phone
OSNER INSTALLATIOT{
The installation is being made onproperty I ovn vhich is not inte4dedfor sale, Iease or rent.
0vners Slgnature:
DATE:
D. Branch Circuits
Nev, Alteration or Extension Per Pane1
One Circuit
Tvo to ten Circuits
Each AddtrI ten orportion thereof
Miscellaneous (Serviee/feeder not included)
-Each installation
Pump or irrigation g 36.00sign/outline Lighting- $ 36.00
Signal Circuit or
limited energy panel $ 36.00
STIBTOTAL OF ABOVE
5X State Sureharge
TOTAL
RECEIYED BY:
5
/7-22--, 2// // /Q6
JOB DBSCRIPTIONz ;z 7 //-;: ;rr
2
Met rooolitan
Wastewater
Manaeenrent
-YLonr m tsston
c0l,,ililsst0l,J t,/iE !,, E,t RS
Hrb 3,enntit-Eug:ne Cc'rncili,rrscr
Siere D.'ly-Eugene La/ aepres€r:e:iie
S:31i Ergsi::lr-S;',glieid Lei ieprese,i:a:i,e
Chris Larssn-Springfielo Cc'incil!a rstt:r
Chris IJalsa,n-Lanr Counly Lay Bet'eserialive
Jeiry Rust-Lan€ Counly Cct':-,ri:s:rnet
l\iark \"'estling- Eugene Lay Hei'i'es t t'lel ive
i,iTH A:\D A STFEETS sFRlliGFlELD CtTY HALL SFFi::.GF;ELD, CF,EGC!'l 97,177 TELEFiiOl.lE (503) 717-4551
I.lUI'iC COl{IiECTION CHARGE
Building Address:
Reference Number:Tax Lot Number:
Ouner:
Address:Phone Number:
Ci ty:State:Zipz
b1
4"s&6 oc
<$€.sr
s 2c7,17
idential Fee ($222.00)
Commereial Fee (nev non-residential development/
- remodel)
Total fixture unit charge (see reverse of this form) $
SUBTOTAL $
Credit Due (see reverse of this form)
TOTAL I,i''JMC CHARGE
&Date Received:
Receipt Number:
Received By:
Building Job Number:
q\
Fi:<ture Unit Calculatio:r TabL Eber of nev f ixtures nultiplied by r:nitcalculate only the trET additionaL fii;tures.
e: liuequivalen ts. F OTE: For remodels,
Fi>:ture Type
Bathtub
Drinking fountain
or grease/oi]/solrds/etc. . . .or sand,/auto I'ash/etc. .
othes;asher
(3 cr rnore) . . .rk trap (1 per ]'t.il.)Receptor for refri.g/-*'ater staticn/etc.....
Receptor for Cotrl-,er sir:k/dishr.sh::/etc. . . . .Shover, sing)_e stalL
Shouer, tang (per nead)
Sink, bar, conmercial..
Sink, conmercial/industrial/etc. . .Urnial, stal1/va11..
Lrash basin/lavatory, singJ_eVater cLoset, pubLic installation..
LTater closet, private. . .
Miscellaneous:
Total fixture uni ts
i of Unit
Fixtures Equivalents
Fixttrre
Llnits
Floor drain. . .
fnterc€ptors f
fntereeptors f
Laundry tub/cI
Clothes vasher
1{ob i 1e hone pa
2
1
L
3
6
2
6
6
1
3
2
1
2
3
2
L
6
4
Total Uni ts:
x 513.25 each = Total Charge: g
Credi t CaIcul-ati.on TabI Based on total value of property at time of permitappLd L on.
Year .Lnne>:ed-.o the Citv Credit per $1,OOO
ASSF ssed val
tVoO
t97 9
19E0
19 81
1982
1983
1984
1985
1985
1987
1988
'l ooo
1990
$2.66
S2.54
$2. s3
$2.41
S2.le
$2.04
$1.5e
S1.3s
$1.1s
So. e2
So. se
s0.23
J. 66 (f = s t7. srCreci i t
I^ + ^I 'd L E
;ts
A*ssesse \7aL u e TotaI Credi t