HomeMy WebLinkAboutPermit Building 1995-09-06RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726.3759
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LOCATION OF PROPO D K:
ASSESSOFIS MAP:
LOT:
SP rlINGFIELD
q\
JOB NUMBER
225 Fif th Street
Springf lelcJ, Oregon g7417
TAX LOT:
SUBDIVtStON: ---BLOCKi
OWNER;
ADDR
CITY:
PHONE:
ZIP:STATE:
ADDITION OTHEBDEMOLISHNEW._- REMODEL
DESCBIBE WOR
NAME ADDRESS EXPIRES PHONE
MECHANICALI
ELECTFIICAL
PLUMBING:
G EN EBAL:
CON CONST.
CONTRACTOR ,
- OFFICE USE -
'Y OF UNITS:
FLOOD PLAIN
QUAO AREA:
I OF BLDGS:
, OF BORMS:
OCCY GFIOUP:
I OF STOFIIES:
CONSTB. TYPE:
HEAT SOURCE:
WATEH HEATER:___FIANGF.:
, Thls ls a 24 hour rccordlng. All I
ted after 7:00 a.m. wlll bo made
REQUIRED TNSPECTTONS
Rough Mechanlcal - prlor tocover.
h Electrlcal - prlor tocover.
To request an inspcction, you must call 726.3769,made thc sanre worklng <1ay, lnspections rcques
Tornporary Electrlc
Slto lnspectlon - To be mado
af ter excavailon, but prlor tosettlno foill1s,
U-ndersl:rb plumblng/ Electrical /Mechanlcal - prloi lo cover.
Foollng - Af ter lrenches areexcavated,
Masonry - Steel locatlon, bonclbeams, groutlng,
Underground plumblng - prior
to fllllnq trench.
Underlloor plumblng/ Mechanlcal
- prlor to lnsulation or decklng.
Post and Boany. - prlor to f loorlnsulatlon or docklng.
Floor lnsulalion - prlor todecklng,
Sanllary Sewer - prlor ro flllingtrench.
Storm Sewer - prlor to lilllngtrench.
Water Llne - prior to fillingtrench.
Rough Plurrrblng - prlor tocover.
nspectlons requested before 7:00 a.m. wlll belhe followlng worl< day.
l-_l rinar ptumbing - When ail
-
plumblng worl< ls complete,
Flnal Eloctrlcal - When ailelectrlcal work ls complole,
I-_l Flrral Mochanlcat - When alt
-.
mechanlcal work ls complete.
Flnal Buildlng - When ailrequlrod lnspectlons have beenapproved and bulldlng lscompteted,
Electrlcal Servlce - Must beapproved to obtaln pcrmanent
electrlcal power.
Flroplace - prlor to faclngmaterlals and framlng lnspl
Framlng - prlor to cover,
Foundallon - After lorms areerecled but prlor to concretoplacomon t.ffWdttCelllng lnsulatlon - prlor to* cover. J
fl OrVwa| - prlor to taptng
[-l Wood Stovo - Alrer lnstailatton.
MOBILE HOME INSPECTIONS
[l ln":1, - After ftreptace approval
-
and lnstallailon of unlt.
[-l B]ocktng and Sot.Up _ When ail.J btocklng ls compleie,
Curbcut & Approach - Af terlorms are erected bUt prlor toplacomont of concrctc,
Plumblng Connoctlons _ Whenhomo has been connected lowater and sewer.
Sidowalk & Drlveway - A(terexcavatlon ls completo, formsand sub.base materlal ln place.
Eleclrlcal Connection _ When
P]?:filg, ser.up, ano prumorng'tnspo.ctions have been approvedand tlre home ls connected tothe servlce panel,l-l fence - When compteted
fl Street Troes - When ail roquired
-
troes are plantod.
SECONDARY HEAT:
SOUARE FOOTAGE;
[--l otho'
-
T-l nlnat - After all required
-
tnspeclions are approved and
Oor9.hos, sklrtlng, docks, andvenilng havo been lnstailod.
Lot facos
Lot sq. ftg,
Lot coverage
Topography
Total holght
Lot Type
-
lnterlor
-
Corner
-
Panhandle
-
Cul-de'sac
J THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OB ON
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
and approved by lhe Historical
Coordinator prior to permit issuance,
APPBOVED:
PL.HSE GAR ACC
N
S
E
Total Value
Bullding Permit Fee
State Surcharge {
Total Fee
VALUE
4u
(A)
6
X $/SQ. FT.
BUILDING PERMIT
ITEM SO. FT.
Maln
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express concJiliorr that the said
constructlon shall, ln all respects, conform to tire Ordinance
adopted by thc City of Springfielcl , includlng the
Development Code, regulating the co0struction and use of
bulldlngs, and may be suspended or revokcd at any time
upon violation of any provisions of saicJ ordinances.
Hecelpt Nurnbcr:.--..
Plans Rcvlewe<l By Da te
Plan Check Fee
Date Pald
Received By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmcnt Charge Is due on all undeveloped
propertles withln tho City limlts whiclr are being lmproved.
ITEM
Flxtu res
Besldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flroplace Unlt
Dryer Vent
(D)
Vent Fan No
Mechanlcal Pe rmlt
lssuanco
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnaco
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby cerilfy that all
lnformatlon hereon ls true anci correct, and I f urther cerIfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs of the City of Sprlngf ietd, and the Laws
of the Stato of Oregon pertalnlng to thc worl< described
hereln, and that NO OCCUPANCY will be macJe of any
structure wlthout perrnission of the Bulldirr0 Safety Dlvislon,
I further certlly that only contractors and employees who
are ln compllance with OBS 701,055 wlll be used on lhls
proJect.
l{urther agree to ensurc that all requlred lnspections are
requested at the proper time, that oach address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
e at all times during construction
teloa
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
(t
Curbcut ' l,
Demolltlon
State Surcharge
Total Mlscellanoous Permlts (E)DATE PAID
VALIDATION:
RECEIPT NUMBER
AMOUNT REC
RECEIVED BY
TOTAL AMOUNT DUE (excludlng clectrical)
(A, B, C, D, and E Comblned)
SPFlI^lGFIELc,
RESIDENTIAL
PERMIT APPLICATION
lnspections:726'3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
JoB NUMBE " 7r't ? I
225 Fifth Street
Springfield, Otegon 97 477
D3/-D TAX LOT:ASSESSOBS MAP:
LOT BLOCK SUBDIVISION
ZIP:STATE
PHoNE:
a'-c/-+r//A
CITY:
ADDRESS:
OWNER:
NEW -- BEMODEL ADDITION DEMOLISH OTHEB
DESCRIBE WORK:
ELECTBICAL:
EXPIBES PHONEADDRESSCONTRACTOR'S NAME
MECHANICA
CONST.
CONTBACTOR '
GENERAL:
PLUMBING
FIANGE:
# OF BDRMS
- OFFICE USE -
ZONING CODE:
FLOOD PLAIN
WATER HEATER:
E OF UNITS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OUAD AREA:
E OF BLDGS:
LAND USE:
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspectlon, you must call 726-3769. Thls ls a 24 hour recording. All lnspections requested before 7:00 a.m' wlll be
made the sanre worklng day, lnspections requested after 7:00 a.m. wlll be made the following work day.
REOUIRED INSPECTIONS
Temporary Electric ffi Rough Mechanlcal - Prior to fl fi"ut.Plumbing.- When all4 cover. EF plumblng work is complete.
Site lnspection - To be made
after excavation, but Prior to
setting lorms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanlcal - Prior to cover.
Electrical Service - Must be
approved to obtaln Permanent
electrlcal power.
Final Mechanlcal - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to facing
materlals and framing lnsP.
Flnal Building - When all
required lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prior to cover.
Other
Foundallon - After forms are
erected but prior to concrete
placement.
Wall/Celling lnsulatlon - Prlor to
cover.
Underground Plumbing - Prior
to f llling trench.I-l Drywall - Prior to taplng.
MOBILE HOME INSPE TIONS
Underlloor Plumbing/ Mechanical
- Prior to insulatlon or decking.Wood Stovo - After lnstallatlon.
Post and Beam - Prior to floor
insulation or decklng.lnserl - After flreplace aPProval
and installatlon of unlt.
Blocking and Set-Up - When all
blocklng ls complete.
Floor lnsulalion - Prior to
decking.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 f illlng
trench.Electrical Connection - When
blocking, set-up, and plumblng
lnspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation ls complete, forms
and sub-base material in Place.
Water Line - Prlor to filling
trench.
Fence - When comPleted.
Street Tress - When all requlred
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
ventlng have been installed.w Rough Plumbing - Prlor to
cover.
E
E r E
W
E
E
tl
r
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Tyf
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
IS THE PROPOSED WORK IN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
P.L.HSE GAR ACC
N
s
E
VALUE
(A)
BUILDING PERMIT
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
qutLDtNG VALUE, PLAN CHECKAND BUILDING PERMIT
This permit is granteci on the express condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfietd, inctuding theDe.velopment code, regulating ihe cbnstruction and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances.
Receipt Number:_.._
DatePlans Revi ewed 8y
Plan Check Fee
Date Paid
Received By:
s DEVELOPMENT CHARGE (SDC)
(B)
SYSTEM Systems Developmcnt Charge is due on all undevelopedproperties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
N0
FT.
FT.
,/h///.c
(c),22
Plumblng Permit
State Surcharge
Tolal Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
/*e/v/-e
(D)?42a
No/
Mechanical permit
lssuance
State Surcharge
Total Permit
,/2rr,B
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have carefully examlnedthe completed application and do hereby certify that alllnformation hereon is true anc, correct, and I f urther cerillythat any and ail work performed shail be done in accordancewlth the Ordinances of the City of Springfield, and the Lawsof the State of Oregon perlaining to the work describedherein, and that NO OCCUPANCy will be made of anystructure without perrnission of the Building Safety Division.I further certify that only contractors and employees whoare ln compliance with ORS 701.055 will be used on thisproiect.
I further agree to ensure that all required inspections arerequested at the proper trme, that each address ls readabre
from the street, that the permit card rs rocated at the frontof the property, and the approved set of prans wirr remainon the site at all ti during construction.
Sig natu re
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk -- ft
Curbcut _..-_ ft
Demolitlon
State Surcharge
Total Mlscellaneous permits (E)
TOTAL AMOUNT DUE (exctuding eteclricat)
(A, B, C, D, and E Combined)
vhlroarroru;
FIECEIPT NUMBER
DATE PAID I
AMOUNT RECEIVED
RECEIVED BY ---.-
FT.
^?z-,{
SPTTIFiCiF tELO
The lollowing proj
zoning, and does
approval.
ect as submittad has th:.'-'f
not require sPeciiic ls/lcl ij ,*
l-'NlD
225 FIFTE STREET
SPRTNGFTELD, OREGON 974
INSPECTION REQTIE ST: 726-
OFFICE: 726-3759
1
JOB pE
Permi ts are non-trans ferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INST
Electrical Contracto
Address
ELECTRICAL PERHIT
Ci ty Job Nunber
3. COHPIJTE FEE SCMDULE BELOV
A Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:Items Cost
^ -l 1000 so. f t. or less
Df <er.h ,ddition"l 5oow"q. ft or portion
thereof
Each Manuf'd Home- or
Modular DveIIing
Service or Feeder
s 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or ress I
20L amps to 400 amPs
-
40L amps to 600 amPs
-
601 amps to 1000 amps-
Over 1000 amps/volts
Reconnect 0niy
B
C
D. Branch Circuits
Nev, Alteration or Extension Per Panel
Sum
Ci ty
Supe
Phone
s s0.00
s 60.00
s100.00
s130.00
$300.00
$ 40.00
to00
&
rvisor L se"Number
Expiration Date to *7i
Constr Cont r. Number io b3 l1
Expiration Date 9^ 1a
s _cUr rvising Electrician
Ovners
Address
Ci ty
OVNER
The installation is being made on
property I ovn vhich is not intended
for sa1e, Iease or rent.
Ovners Signature:
Temporary Services or Feeders
Instal}ation, Alteration or Relocation
200 amps''or less S 40.00
201 amos to 400 amps T $ 55.00
Over z,bf to 600 amps
-
$ 80.00
Over 600 amps or 1bO0 voITs see uB" aETE-
e
One Circuit
Each Additional
Ci rcui t or vi th Servi cer,1
or Feeder Permit
-+
$ 3s.00
s 2.00ON
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0ut1ine Light ing_
Limited Energy/Res
Limi ted Energy/Comm
5. SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
$
$
$
s
40.00
40.00
20.00
36.00
DATE:
0l
JRECEIVED
,ro--NM*--
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