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Home My WebLink AboutPermit Building 1994-03-07SPRINGFIELE, RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPO ASSESSORS MAP: Zfr, JOB NUMBER 225 Fifth Street Springfield, Orcgon 97 477 TAX LOT: qr\ LOT: - BLOCK:SUBDIVISION PHONE ZIP: q 6€_STATE: ION - DEMOLISH OTHER OWNER ADDBESS CITY: DESCRIBE WORK: NEW- REMODEL AME ADDR EXPI RES PHONEScTRACTOCONTRACTO CONST. MECHANICAL: ELECTRICAL: G EN ERAL: PLUMBING OUAD A BANGE: S OF BDRMS: oFFrcE u$E -ilu WATER HEATER: .* OF UNITS: HEAT SOURCE: CONSTR. TYPE:VN ZONING CODE: FLOOD PLAIN # OF BLDGS SECONDARY HEAT: SQUARE FOOTAGE: LAND USE: OCCY GROUP: # OF STORIES ,l To request an inspection, you must call 726-3769. Thls ls a24 hour recording. All inspections requested before 7:00 a.m. will be made the same working day, lnspections requested after 7:00 a.m. will be made the following work day. REOUIRED INSPECTIONS l--l Temporary Electric L___l 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. E*;;tt Electrical - Prior to ,X Final Electrical - When all electrical work is complete. 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. K Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing lnsp. ,E Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting. )Crun.ing - Prior to cover. ffiwatttCeiling tnsulation - prior to-Gco,er. (tF-Jtty tS tf++TA) N Drywall - Prior to taping' X'Foundation - After forms are erected but prior to concrete placement. Other Underground Plumbing - Prior to filling trench. MOBILE HOME INSPECTIONS Underf loor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After installation 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. 'Vf Floor lnsulation - Prior toiA(oecrino (F snqa 6 t+d+lfin)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.Electrical 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. Water Line - Prior to filling trench.[-l Fence - When completed. Street 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. r E E E E [j E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE GAR ACC N S E B, IS 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 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 ( (\(( s Reviewed / /#"r Receipt Numbe By: l- Plan Check Fee: Date Paid Recei upon violation of any isions of said ordinances BUILDING PERMIT ITEM SQ. FT. Main Garage X $/SO. FT.VALUE ^{3 13,o3 3 (A) ort Total Value Building Permit Fee State Surcharge Total Fee Systems Development Charge ls due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHAR (B)Wiee ADDITIONAL COMMENTS ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge 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 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 Springfield, 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 proiect. 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 permlt 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. qDate Xnn.,,," MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut -- ft Demolition State Surcharge Total Miscellaneous Permits (E) a?7 / 22.7/DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined)/%?1 ffirD- 5bF" 7->^?7 CITY OF 0mgsoal OPEICE: 726-3759 1. DESCRIPTIONo) ol-2,O -1aoo DESCRTPTION 2.COI{I?ACTOR INSTALI,ATION ONLY EIect cal Contractor Address Cl ty Phone Supervisor Li Number ExP iration Date Constr Contr. Number Expiration Date Slgnature of SuPervlsing EIec Owners Name Address ?qt S Zt Ci ty Phone-l L- t8 ol SPRTNGF!ELO EI,BCTRTCAL PERHIT APPLICATION City Job Nunber q 40 I qc) 3. COHPI,ETB FEB SCEEDUIA BELOV Nev Residential-Single or MuIti-FamilY Per dvelling unit' Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Hanuf'd Home or Hodular DveIIing Servlce or Feeder $ 1s.00 $ 40.00 B. Services or Feeders Installation, Alterat ions or Relocation: $300. $ 40. 200 amps or less I 201 amps to 400 amPs - 401 amps to 600 amps - 601 amps to 1000 amPs- 0ver 1000 amPs/volts - Reeonnect 0nIY Temporary Services or Feeders Insiallation, Alteration or Relocation lr,e A IAGALt? e nBn Sum affi a permits are non-transferable and expire ii vort is not started vithin 180 days oi i""u.nce or lf vork ls suspended for 180 days. $ $ $ $130 50. 60. 100. 40.00 55.00 80.00 - ^oo\O00 00 00 00 00 00 200 amps or less $ 201 amps to 400 amPs - q over 4b1 to 600 amps -l $ Over 600 amps or 1000-6-f[s se Branch CircuitsiD E OSNER INSTALI.ATION The installation is being made on property I own vhich is not intended for sa1e, lease or rent. Nev, Alteration or Extension Per Panel One Circuit $ 35'00 Each Additional Circuit or vith Service or Feeder Permit t. $ 2.00 5-eO Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0uttine Light ing-- Limited EnergY/Res Limited Energy/Comm -SUBTOTAL OT ABOVE 5Z State Surcharge TOTAL Ovners Siguature: $ 40.00 $ 40.00 $ 20.00 $ 36.00 5 DATE:3 RECBIVBD OP $ 85:00 c. lssued ov: CB Date: 72]E4 Permit No:Qqogq Address Qqr s. 3 /1)-l WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONS!BILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration underORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. A 1 2 3 My general conlractor is , Contractor registration num I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3.B 'zhC-I will be my own-greneral contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 3)n l, q gnature of Permit App Date CONSTRUCTION CONTRACTORS BOARD 0244J 8t91 proiect as su.bmitlthe tollowing , 225 PITTE STRBET SPRTNGFIEID, OREGoN 97477 INSPBCTTON REOUEST: 726-3769 OFPICE: 726-3759 4'{ 1.OF IJGAL DBSCRTPTION Permits are non-transferable and expire if vork is not started vithin 180 days of lssuance or if vork ls suspended for 180 days. 2. CO}ITRAqTOR INSTALI,ATION ONLY Electrical Contractor Address Citv Phone Supervisor License Number Expiration Date -- Constr Contr. Number Expiration Date Signature of Supervlsing Blectrician ovners nane- Wl. ft@to/4Zlb 'uI fl/' .-BLECIRICAL PERI{IT APPLICATION City Job Nurnber 3. COHPI,BTE PEE SCEBDTIT,E BELOV A. Nev Residential-Single or MuIti-Family per dvelling unit. Service Included:Items Cost D. eri haa 'llr- '.,llowing :r;,j,i.,.;,::., :.: "SPRIIrIGFIELD lr'l 5. STIBTOTAL OF ABOVB 5Z State Surcharge TOTAL h JOB DBSCRIPTIONs -d- -47,7;--i n* n '{ r<. Cl ty yr? thone 722-/ff / OSNER INSTALT.ATION The installatloir is beirig made on property I ovn vhich is not intended for sale, Iease or rent. 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Home or Modular Dwelling Servlce or Feeder $ Bs.oo $ 1s.00 $ 40.00 B. Serviees or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amPs - 401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect 0nIY Temporary Services or'Feeders Installation, Alteration or Relocation 200 amps or Iess $ 40.00 201 amfs to 400 amps - $ 55.00 over 4b1 to 6oo am'ps - $ 8o.oo over 600 amps or 1b00ETIs see uB" a56il6- Branch Circuits Nev, Alteration or Extension Per Panel One Circuit Each Additional Circuit or vith Service or Feeder Permi I ll E. Miscellaneous (Servlce/feeder not included) s 3s.00 $ 2.00 Sum ZL $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 i. Address Signature: DATE: -Bach installation Pump or irrigation Sign/OutIine Lighting_ Limited Energy/Res $ 40.00 $ 40.00 $ 20.00 $ 36.00 2-2? RBCEIVBD -7V 1# nct /9- ^ or,^ / 3! C7962 ,rized Si! c. i No. 14a t qa CITY OF SPRINGFIELD SYSTEMS DEVELOPI-{ENT CHARGE }IORKSHEET (cot'lt'IERcIAL & RES IDENTIAL) NAME OR COMPANY:I t-LtA^,t I Strp rft{ ,*L(?A?Dt/u LOCATION:gq1 1 b'1 \s O'L O l'r. ib - r\"16oO*t" DEVELOPMENT TYPE:(DN BUILDING SIZE:t o , L5 x V'z iNcLuPe, ENttg LoT SiZ I STORM DRAINAGE IMPERVIOUS SQ. FT.x $0.203 PER SQ. FT. X $42.08 PER PFU .Ft 7'Ls 2. SANITARY SEl,lER-CITY NO. OF PFU'S (See Reverse) 3 TRANS PORTAT I ON NO OF UNITS X TRIP RATE X COST PER TRIP 4. SANITARY SEI.lER-MI^IMC ADMiNISTRATIVE FEES BASE CHARGE (SUBToTAL AB0VE) X .05 LJ,- Ki p Burdick SDC Coordinator NO. OF PFU'S (Use PFU Total From Item 2 Above) Ml,lMC CREDIT IF APPLICABLE (SEE REVERSE) $ $ $15.125 PER PFU + $10 Mt.lMC ADM FEE s TOTAL-MWMC SDC SUBT0TAL (ADD ITEMS 1,2,3 & 4) X x X x $424.3i x $424.31 x $424.31 5 1t '4', 23 TOTAL SDC sLq