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Home My WebLink AboutPermit Building 1996-06-106bxy'a., SP;lTN IELD RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 ry/JOB NUMBER 225 Fif th Street Spri ng f leld, Oregon 97 477 LOCATION OF PROPOSED WORK:3 ASSESSOBS MAP:o LOT BLOCK: k TAX LOT SUBDIVISION PHON E: ZIP:STATE: 5. CITY: ADDRESS: OWNER: NEW - REMODEL ADDITION DEMOLISH OTHER DESCRIBE WORK: zgdcj_&rzy,rr o"qzlt t, Zz 6,p?-€tz> PHONEADDRESS FAlus Ehlcrs I t 2l EXPIRESCONTRACTOR'S NAME GENERAL: MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # PLUMBING: _ OFFICE USE _ r OF BDRMS: RANGE:WATER HEATER: ZONING CODE:# OFTJNITS: LAND USE:QUAD AREA: * OF BLDGS: SECONDARY HEAT: SOUARF- FOOTAGE: OCCY GROUP: r OF STORIES: CONSTR. TYPE: HEAT.SOURCE: To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested belore 7:00 a.m. wlll be made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the following work day. REQUIRED INSPECTIONS Temporary Electrlc Rough Mechanlcal - Prlor to Final Plumbing - When atl plumblng work is complete. Slte lnspectlon - To be made af ter excavatlon, but prior to setting forms. Underslab Plumbing/ Electrical / Mechanlcal - Prlor to cover. Footlng - After trenches are excavated, Masonry - Steel locatlon, bond beams, groutlng. Foundatlon - After forms are erected but prlor to concrete placement. Underground Plurnblng - Prior to filllng trench. Underlloor Plumblng/ Mechanlcal - Prior to lnsulatlon or decklng. Post and Beam - Prlor to floor lnsulatlon or decking. Floor lnsulatlon - Prlor to decking. Sanltary Sewer - Prior to filling trench. Storm Sewer - Prlor to filling trench. Water Llne - Prlor to filllng trench. t--1l)fllough Electrical - Prior to f- c\er. \4f Electrical Servlce - Must besqpproved to obtaln permanent eJectrlcal power. 'fTlPinut Electrlcat - When altla dhctrical work is complete. ffi finat Mechanical - When ail la\necn"nical work ls complete. It-zI Framlng - Prlor to cover.,,,+_ )yf wrtllCeltlng tnsutatlon - prtor to',q'cover. p oo*"ll - Prlor to taPing' Flreplace - Prlor to faclng materlals and framing lnsp. Wood Stove - After lnstallatlon lnsert - After flreplace approval and lnstallatlon of unlt. Curbcut & Alrproach - After forms are erected but prior to placemcnt of concrete. Street Trees - When all requlred trees are planted. Final Buildlng - When all required lnspections have been approved and building ls completed. MOBILE HOME INSPE TIONS Blocking and Set.Up - When all blocklng rs complete. Plumbing Connections - When home has been connected to water and sewer. Electrical Connection - When blocking, set-up, and plumbing lnspections have been approved and the home is connected to the servlce panel. Final - After all required inspectlons are approved and porches, sklrting, decks, and ventlng have been installed.(r*t: Prumbrns - Prror to DA, /Z .Qz7a-o o<7v/,-e FLOOD PLAIN: E tl E E Other - tl I--l Siaewalk & Drlveway - After - excavation ls completc, forms and sub-base material in place. [_l Fence - When completed.ll tl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot , - lnterior - Corner - Panhandle - Cul-de-sac BUILDING PERMIT ITEM SO. FT.X $/SQ. FT.VALUE Main Garage Carport M Tolal Value Building Permit Fee State Surcharge {rS-3 Total Fee 5e>r 7r'st (A)/lc 3r IS THE PROPOSED WORK iN THE - HISTORICAL DISTRICT, OR ON THE H ISTORICAL REGISTER? - lf yes, this application must be signedand approved by the Historlcal Coordinator prior to permit issuance. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City ot Springfield, inctuding the Development Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee: Date Pald Receipt Number Received By: Plans Revi dBv Date SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within tlre City linrits which are being improved. PLUMBING PERMIT ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home xaae_ar N0 FEE ,mz) FT. FT. FT. Plumbing Permit State Surcharge, 7J- f , y'f Total Charge (C) aa /2') /A >o ADDITIONAL COMMENTS MECHANICAL PERMIT Fu rnace Exhaust Hood Vent Fan No/290 Wood Stove/ lnsert/ Flreplace Unit Dryer Vent Mechanical Permit lssuance State Surcharge Total Permit P4// I fN 10,o4 7/- r 4/- (D) /,2o '2J- yd By slgnature, I state and agree, that I have caref ully examlned the completed application and do hereby certlfy that all lnformation hereon is true and correct, and I f urther certify that any and all work performed shall be done in accordance wlth the Ordinances of the City of Sprlngfield, and the Laws of the State of Oregon pertainlng to the work described herein, and that NO OCCUPANCY wlll be made of any structure wlthout perrnission of the Bullding Safety Division. I further certify that only contractors and employees who are ln compliance with ORS 701.055 will be used on thls proiect. I further agree to ensure thaf all required inspections are requested at the proper time, that each address is readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Signa Date -/a'-7€ MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut -* ft Demolition State Surchargg Total Miscellaneous Perrnils (E) VALIDATION RECEIPT NUMBER /3)g DATE PAID AMOUNT RECEIVED RECEIVED BY , ?J- TOTAL AMOUNT DUE (excluding electricat) (A, B, C, D, and E Comblned)/6J3s P,L.HSE GAR ACC N S E y',t-o ,^ TE: C5- -;-{ ? (= 7ac7;e CIIIY OF SPRINGF'IELD Fire & Life Safety TO: FR0l't: SUBJECT: FIRE DAMA.GE REPORT OR ELECTRICAL HAZARD Building DePartrnent Springfield Fire DePartment Structural Damage to Bui'l di ng DA r!, Address or location of building (1 1/x'Sr, ..>..|3/ Name of olJner lfi,,te t; t+ ,,/(: /- Type of bu'i 1d i ng Estimated value of building Estimated I oss to bu'i 1di ng (Dwe ng , Store, lnlarehouse, etc -) gc LS o0 c cS --?s-9 LDate of fire Location of damage 'in build'ing lr.r \c.ea('r- tc,-A (- (Roof , l,Ja1I, Exterior,interior, etc. ) Structural weakness as a result of the fire ,S\-' (Burned rafters, Beams, Jo ]S ts, etc. ) Additional pertinent information CC L)' Sign Electrical Hazard r t\( (l,lirinq, 0utlets, etc.) -i 't - I " -f DD OT DO NOTWRITE INTHIS SPACE CONTROL EXP.NO. NO. District oflncident 2 INCIDENT ADDRF,SS 7 71Qzz 3 OCCUPANT NAME(last, Fint, MI) nl r BUSINF,SS (lst, Fi6t, MI) 5 OWNERNAME(hst,Fist,MI) 6 FIRE REPORTEDBY (Iast, Fi6t' MI) oo -? A,:,JL t--Ir t!r!E ts-'6>r.- C)o1? aJrht{Er5 r5 4l 4 Edi;>t.t. C)oz FU r<trl€tn\lo :d r<t. a)€ t.l!E rta 1,1 U)€ o€ tt tta) zr. tru tr tr ,fl'tr n STA Radio EI v"o"t E No Alrr- R".'d Comty lq..e- b PE{onnect he/hydmnt, standpipe POR Dept. Responding D Hand-laid ho*/by&ut, standpipe E U.d"t"-in"d D Mster Strm Derie E NotClasifredAbove Undetemin€d in Flight Not Clasified I SOstoricormore 5AA ? ME"THODOF AJ,ARM Tel€phone Dir6t Muicipal A.larm System 9ll (Tie Line) D Voi". Sie*t L,luni Alarn E Notclr".iti"dabrr"D PrivatcAlamsystem 8 'OFFIRESERVICE PERSONNEL RESPONDED q 9 TYPEOFSITUATIONFOUND E StretrEFire Oths Prop. w/valw E vehicl" Fire D B*h,G*,Ir"ro I Troh, Rubbish fl other (List) El Automtic Ert. Syetem E Prennethw/tanlonly M IO ME-THODOF EXTINGUISHMENT II FD(ED PROPERTY EQUIPMENT INVOLVED INIGNITION The objec of oricin Part of mm or ara of origin Rmm of origin Fire-mttd omp. of origin Floor of origin Stretw of origin Ext4nded beyond struct!re of origin D Self-Ertinguished E Make-shiftaids E Portabt€Ertinguieher l0 to 19 fet 20 ln29 f*t t2 l3 I 203 1 5 6 7 ustion of deft oiI:s tai ir. Rags in cardboard box. MATERIAL WAS MADE OF ITEM FIRST IGNITED: Over 70 fet Below grd.r5 LEVELOFTIREORIGIN Gn& level to I fet t' veLun LOSS t?OFSTORIES 18 BUILDING (InYes) 19 CONSTRUCTION'TYPE E st".tg EXTENTOFDAMAGECONFINEDTO: Flame 2 storiG 3 to 4 storie 5 to 6 Etori€s 7 to 12 stories I 13to24sto.ie E 25b{9sbri6 30 to 49 50 to 70 fet Hearry Timber unprctet. stel Bldg 3-4 hr n Proect. Stel B ! Prct ct.ErL & Wood Int. Unp.otect. Menry Ert. & Protectcd Wod Frame Not Clasihed Above nt.Fmm I 2 3 4 5 6 Smoke ID 2E3E 4E 5[6E?E 9 No da@g€ of the typ€ (N/A) 2l Conditions 22 Follow Up Invetigation R€quct€d Y P/ N * If ye, who will investigate 9E (-r 23 Numberoflnjuris 21 ffi'"?,'i3: sFqb' /qjq ARRIVAL ZI zL INALARMTIME 23.2D96 YEAR E s,n E ttton tr tr Thur FriD w"a Tue SaturDAY OF WEEKO{ MO DAY,s ISO CLASS 2 -J9trtl7 ZIP CENSUS TRACT3{ D0B (optional) tt-Lg -3L '726 -L?A{ TELEPHONE DOB (optional)TELEPHONEADDRESS DOB (optional)TELEPHONEADDRESS TELEPHONEDOB (optional)ADDRESS I R"oi,"a E cir". $Ntl. or invBtigata # OTHER VEHICLES RESPONDED (donotincludePA's) -?<.- , OF AERIAL APPARATUS RESPONDED# OF ENGINES RESPONDED Z- E E.tl.g.i"t D Invetigation D RemvedHurd D st""any TYPE OF ACTION TAKEN Salvage Not Clasil-red MOBILE PROPERTY (Complett line M)PROPERTY COMPLEX (If appliqble) LICENSE #SERIAL #YEAR J MAKE J EQUIPMENT INVOLVED lN IG 'ITION (Complete Line E)OFFIREORIGIN C VOLTAGESERIAL #MODELMAKEAEAR ,uJ ooo 'N/Other .ooContents .00Contantso.00.00 .00.00 .00Z:c)oo 'm .00 l0o0-.t999 eq ft 5O00-9999 sq ft 50,000-99,999 sq ft 500,000 8q ft ft20,000-{9,999 ft 10,000-19,999 sq ftSIZE (Grnd Flr Only) D o'gggrqn SPRINKLER PERFORMANCE I D Equiprent operated z D Equip.shouldhaveoper.-didnot 3 E Equip. pre*nt fiE t@ smll to oper. g fl Not classified above 0 fl Undetetmined or not rePortcd 8 E No equipment pr*nt (N/A) SprinklesControlledFire: YES E lNon # of Heads Opened DE-TECTOR PERFORMANCE fl t tn mm of origin-oper. E 2 Not in mm of origin-oPer. ! 3 tnmoforigin-notoper-firet@sroll E I Not io - of origin-not oper. fire too soall [ 5 In rcom of origin-not oper. power di$onn(t E 6 Not i. m of origin-not oper. power di*on. I z Inrumoforigin-notoper.dedbattery E g Not in rum of origin-not oper' dad battary E 9 No&tectorpent ,EJ ro Uod"t *in.d Other Number of Fatalities Firc Seruie 't s.zS-? ZTitleR€port o"5-)t.?cbeTitleL frrn,*-*t - Fire Sewie Other f] ont. on bacl MODEL I n frtLo PH:(S,1 1) n & FAX COVEFI SHEET , 995-631 1 995-61 11 TOTAL PAGES INCLUDING COVEH: FL il l[\l[ I FAX: TO: fl^y K,, % (5't1) FHOM: I DAIE: FA)( #r COMMENT$: ,7 (tlf(f,A,/,,L d<*' (" -/ f1 ,?#/r/ t)-r*l q2 1 c:-s7 -. : CuefomerProiectr Soah - = -! -===t = 1 BEIE{; ea--a<<<A.e. * r====E=E EIIfiD 80Tr0t{ cltoRo TJEBS zt66 J.6t V0L4 l-7=-387 Z.!.'l8€i 6-7- 1424 S-7. 517 5.q,:.1689 l-1. 2014 3-6. 5Ll 6 - 5'' 2t66 BOtr ctloR0 spL lcEs:6'7=3x6i 1'6"-387 r{8 E. ion 7.18>>>)==t==* =====l 953291 J == Trusg Quant ity : ID:24 10 -F-? ===========a===== REACI I OII s - slzE - - F:=E====ts =E=E====ts=tt=!E=E= == APPRO/ED fOf, f'llrE( ILousttlEi lllc' JAN 0 9 lees -14 onEcoN tt, 1X44 3{6 sf+ =aE=-Ie=E Jan1v PiE. Fri.Faml Top #ch 'tr - 1 146 5 .50 5'-1146 5 .50 411 7- t_ r{* sfu 6 -1 ?^E '{ '2-1c [i"fi] EB-8fi":t3ii1ti' '=1$Hllg;ry:i*=iffij'fr*i';;;= = ::*ffiiltffiffiHft#$1ilsB+, 'H lH tlllsll:h;eo:l? -:-r/= iifi++*;i;rg$i;=*tilg#ai'i=tr:=====t=======;8ii8ioffi,3frsd ='t "' c gtll:!'ffil'il,iifii,i*i?:^tifftit:i::lllf l;;i,t-ili'l1?,i.Eli'il't=-hi;;Eiiil':ll'li-"-flll HDs oEsrGx ""'' u"l"6o'lPr'e PLAIE Itjsl 8E IIISTALII roP tlpm elr(;6 0 2l'o'L tttEl: llco(t tlf,Allfo' r0IIotl (HollD llL,'iil.,iiri^irlqrgf 'Il#l'.m;,f ff"-*'[h?'1'l1X{f H fffffii:[f'ttffi; ruA;'iii iiiu'o lPl]r,trilIr'n HB-er u a(i{e t000 rr*o' to "'*'iifri'iio i lt*t^rm r' r.,{0 ( 0}r5.^l Qtr A,FE D rllrll6 Dfgofit' ===<<<<A.CCuetomerProJ ecE Span =:====t===r CHOAo .E.S Verslon 7.1El>>>>=-=====' ! R.EIJCOfl : bEEW:3 rru6s . I"; Z6:0 - Ouantit, =EG====-E================='E ==E=[ e53263 l :===;;i-5;;=66'i]T!5?ia',i;6; ? : i8 63$'lt.tn , Illr, 1 = - = = = I = = = = - = = = = = c = = = = = - = r E =ll- = = il E = - - = = = RE CilOls - SlzE AFPftOVE0 FoR l(llEK IXDUSIRIES lxc' 1;'1230 5.50 5=.1230 5.50,o1l t. 5.' ?670 ! -4r.1670 4-1.-ltX7 BOTTO( CHOND ,.6. Z9(E 6.7' 2058 7-ls 2946 IIEBS Z-7,-481 l-7= 690 3'6. 690 L-6=-l+81 soII CKno $FLIcEs:6'7'316; J{8 5 -l -8 r 1-B7 1)!l1 on&'coi{ t5. Is 1[1 r{1 3[8 sfr sf+ 7-r I -5 9-0-59-O-5 L- HL To PK;13-4-13 At ^ r:lrc'.a -c-1a R' HL TO.PK :13-4-13 LEFT HETGHT:0-3i14 SPAII:26-o RrsE:3-6-14 Hic-tiT lterGut:0-3-14 ===E=====!E===='E==============-=====_========c===========E=E====EE======'rg====ioffiific=;?;sF[="-===$8$=S"tii:E:;;; IiH'Hffi*EHi 'finlflEH*o,-o Hgfu ,H 'H eglg*t: EiyuliS . L/z4o edtrciiomlllX U8-ril Ei '',F-' siillNa:;=iuffi:::I;ii-E-Lffi;;:::i;;;===;:;;t====:-E;A81fi6";='A:6=I;:=5:=;:=====E3=REPETITIVE STRESSES USED - *.LJ NO' OF MEMBERS E 1 DEFLECI lg1l( If . ) L.L, 0.22,0.1-0- lJ,T.L.0.!7 pLATEs ^RE xlrex xao-rg+,ici-n xuricruRro rno* AsTtl A 616 cRO A GALvAtltzEO srEEL(ExcEFI As SHGJH) ptArE rusT EE ItsrALrED ol EAct{ FACE 0F JotNI, sy!,nrEIRIcALLy(Excrpl li sxounlDEslcll coNFof,xs Htri xos oEsIGfl sPEcs, uBc'lc8o'rPl-9'l-- t07 (xoio xrm€ o tf 0.L ttfESs ilcDtl Slf' Ilto' totlol fl.loto (o{rrirouslt trtB o ltr 0-L ualtgJ tlffilr }t:AL*o' uIEr[ ]nA(H6 0F rs frffit, rst:tetilE, rft At ,{otl A!0YE. For 100(loil[ Ptfiri'\rltxl Am ftinillll lrlfrr fffifl E AttAtr lte !) rEFe r0 rPl PL'i'LJ(A1l0t{ lll3-91 rrlrll 1000 ilIs$tt (ofrffiirAtt llo tH0iiolollsll, rrl0 (oflstu eurrfto IrflrE Ejl6tl, C,ITY OF SPR OREGO'U 225 FTT'II STR.EET spRrNGFrELD, OREGON 97417(ho'1:tld INSPECTION REQUEST| 726-3769 OFFICE: 726-3759 1 OF S TION SPF.INGFiELO not require specific hnd uso ELECTRICAI PER},ITT A?PLICATION Ci ty Job Nu-mber 9ac 7Ss 3. COHPLETE FEE SCEEDIILE BELOV Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost p zoning, anc,l doos approvai. L DEScRrPrroN lg02 Aol'l A DD o,"U'1.h'4U -..\' di,^-. B"in <( Sum JOB G t [r,'k{,,.rrf u,l Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. COMRACTOR INSTALT,ATION ONLY 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder Services or Feeders Installation, Alterations or Relocation: ss L-0 amps 0 amps 00 amps_ /voI ts Electrical Contracaot C 0u U". (/.0 €k.l+:< Address e.O,b.C,- (n ci ty-Phone 6<3'q'373 Supervisor License Number 3V[q ^5 Expiration Date 7 B. C 1e 40 60 10 200 amps or 201 amps to 401 amps to 601 amps to Over 1000 Reconnec t amps 0n1y s 8s.00 s 1s.00 s 40.00 s s0.00 s 60.00 s100.00 s130.00 s300.00s 40.00 €b?" -------- ?ot Constr Contr. Number 757/O Expiration Date Signa ture of Su pervising Electrician Temporary Services or Feeders Installation, Alteration or Relocation ci ty-Phone OVNER INSTALI^ATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Orners Signature: DATE: One Circuit S 35.00 Each Additional Circuit or vith Serviceor Feeder Permi t l0 g 2.OO 4f" 200 amps"or less 201 amps to 400 amps -Over 40L to 600 amps -over 600 amps or 1000 voTT SUBTOTAL OF ABOVE 5Z State Surcharge 32 Administrative Fee TOTAL $40 $ss Seos see .00 .00 .00uBu a56iE- Ovners Name Address D. Branch Circuits Nev, Alteration or Extension Per Panel E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utIine Lighting- Limited Energy/Res -Limited Energy/Comm $ 40.00 s 40.00 $ 20.00 s 36.00 5 2aN. 3.'o2/o --_--.e.-RBCEIVED B (a ./- RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 PRINGFIELr) 2fr, JOB NUMBER ?4a7 5A 225 Fifth Street Springfleld, Oregon 97477 la,ruLOCATION OF PROPOSED WORK: ASSESSORS MAP:2 LOT:BLOCK: TAX LOT:EZ SUBDIVISION: - STATE:ZIP: .a>z*2 ?r "8 CITY: ADDRESS: OWNER: LNEWR ON - DEMOLISH OTHEFI E WORK: ADDRESS EXPIRES PHONECONTRACTOR'S NAME GENERAL: PLUMBING: MECHANICAL: ELECTRICAL: CONST, CONTRACTOR ,f FIANGE: - OFFICE USE - WATER HEATEFI r OF UNITS: OUAD AREA: * OF BLDGS: SECONDARY HEAT: SQUARE FOOTAGE: LAND USE: OCCY GROUP: C OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll bemade the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the following work day. REQUIRED !NSPECTTONS Temporary Electrlc ffi nouOh Mechanlcal - prior to - cover. l--l Rough Electrical - prior tolJ cover. Flnal Plumbing - When allplumbing worl< ls complete. Site lnspectlon - To be made after excavation, but prior to setting forms. Final Eleclrlcal - When all electrical work is complete. Underslab Plumbing/ Electrical/ Mechanlcal - Prlor to cover.Electrical Servlce - Must be approved to obtaln permanent electrlcal power. a Final Mechanlcal - When all mechanical work ls complete. Footlng - After trenches are excavated.Flreplace - Prlor to faclng materlals and framing lnsp. Final Building - When alt required lnspections have been approved and building is completed.Masonry - Steel locatlon, bond beams, groutlng. l*l Framlng - Prlor to cover. Foundatlon - After forms are erected but prlor to concrete placement. Other Wall/Celling lnsulallon - Prlor to cover. Underground Plumblng - Prior to fllllng trench.Drywall - Prlor to taplng. Underlloor Plumblng / Mechanlcal - Prior to lnsulatlon or decklng. MOBILE HOME INSPECTIONS Wood Stove - After lnstallatlon. Post and Beam - Prlor to floor insulatlon or decking.lnserl - After flreplace approval and lnstallatlon of unit. [--l Blocking and Ser.Up - When ail - blocklng ls complete. Floor lnsulalion - Prior to decking.Curbcut & Approach - After forms are erected bUt prior to placement of concrete. Plumbing Connectlons - When home has been connected to waler and sewer. Sanltary Sewer - Prior to filling trench.Electrical Conneclion - When blocking, set.up, and plumblng inspections have been approved and the home is connected to the servlce panel. Slorm Sewer - Prior to filllng trench. Sidewalk & Drlveway - After excavation ls complete, forms and sub-base material ln place. Water Llne - Prior to filling trench.n Fence - When completed. Rough Plumblng - Prlor to cover. Street Trees - When all required trees are planted. Final - After all required inspections are approved andporches, sklrtlng, decks, and ventlng have been lnstalled. 82, PHoNE: -i - 6=*s- FLOOD PLAIN: ZONING CODE: --.# OF BDRMS: _ tl E fl fl E Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type- - lnterior - Corner - Panhandle - Cul-de-sac Setbac P.L.HSE GAR ACC N s E IS THE PROPOSED WORK iN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTEFI? - lf yes, this application must be signed and approved by the Historlcal Coordinalor prior to permit issuance. APPROVED: VALUE (A) X $/SO. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT, Main Garage Carport 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 bulldings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plans Rcviewed By Date Receipt Numbe Date Paid Fleceived By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City linrits which are being improved. ITEM Fixtures Besldential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Flreplace Unit Dryer Vent No /r.* 26^za 4?zzn (D) MECHANICAL PERMIT Mechanical Permit lssuance State Surcharge Total Permit Furnace Exhaust Hood Vent Fan ft<aE By slgnature, I state and agree, that I have caref ully examlned the completed application and do hereby cerilfy that all lnformatlon 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 Sprlngfield, and the Laws of the State of Oregon pertainlng to the work descrlbed 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 ln compliance with OFIS 701.055 will be used on thls prolect. I {urther agree to ensure that all required inspections are requested at the proper time, that each address ls readable from the street, that the permlt card ls located at the front approved set of plans will remaln Slgnature Date Z-t /*?6 during co tructlon. of the property, on the site at MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surchargg Total Miscellaneous Perrnits (E) TOTAL AMOUNT DUE (excluding electricat) (A, B, C, Q and E Comblned) VALIDATION: REcErPr NUMBER _Z/ZA Z -/7% Zl-za DATE PAID AMOUNT RECEIVED RECEIVED BY Plan Check Fee: __- FT. raG SPrlI]tGFIELI) RES:D ENTIAL PERMIT APPLICATION lnspections:726-3769 Office: 726-3759 LOCATION OF PROPOSED WOHK; ASSESSOBS MAP: LOT: Zfr, 225 Fifth Street Sprlngfleld, Oregon 97 477 TAX LOT:422 7O'o SUBDIVISION: 3 k BLOCK: ZIP:o<STATE: PHoNE: 226 ' G-98 5 5, CITY: ADDRESS: OWNER: NEW - REMODEL ADDITION DEMOLISH OTHEFI DESCRIBE WORK: PHONE ao J t 7>ZoOG 2 t 2l Oc: CONTBACTOR'S NAME GENEFIAL: ADDRESS EXPIRES PLUMBING MECHANICAL: ELECTRICAL; CONST. CONTRACTOR ,' FLOOD PLAIN: ZONING CODE:_. , OF BDFIMS: ---- SECONDARY HEAT: _- _ OFFICE USE - RANGE:WATER HEATEFI:SQUARF. FOOTAGE OCCY GROUP: r OF STORIES: CONSTB. TYPE HEAT.SOURCE: LAND USE: / oFdNtTS: _-.-- To req made uest an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All inspectlons requested before 7:00 a.m, wlll bethe same worklng day, lnspections requested after 7:00 a.m, wlll be made the following work day. REOUIRED INSPECTIONS Temporary Electrlc Rough Mechanlcal - prlor to Flnal Plumbing - When altplumblng work ls complete. Underslab Plumblng/ Electrical / Mechanlcal - Prlor lo cover. l{lough Electrlcal - prtor rof- c\er. I><f Electrlcal Servlce - Must be'*r'qpproved to obtaln permanent electrlcal power. '*inrt Electrlcat - When ailr-J dtectrlcal work ls complete. [{ rtnat Mechanlcat - When ailf\echanical work ls complete. 'ffw"illCelllng tnsulatlon - prtor roLlr\cover. [l Underground Plumblng - prior.J lo fllllng trench.fr otr*ult - Prlor to taplng Footlng - After trenches are excavated, Masonry - Steel locatlon, bond beams, groutlng. Flreplace - Prlor to faclng materlals and lramlng lnsp. Framlng - Prlor to cover. Foundatlon - After forms are erected but prlor to concreteplacement. Underlloor Plumblng/ Mechanlcal - Prlor to lnsulatlon or decklng,Wood Stovo - After lnstallatlon. Post and Beam - Prlor to floor lnsulatlon or decklng. Floor lnsulallon - Prlor to decklng. Sanltary Sewer - Prior to filling trench. Storm Sewer - Prlor to fllllng trench. I Water Llne - Prlor to filllng trench,[-l Fence - When compteted Flnal Bulldlng - When a[requlred lnspecilons have beenapproved and bullding ls completed, Othor MOBILE HOME INSPE TTONS Plumbing Connectlons - Whenhome lras been connected towater and sewer. Final - After all requiredlnspecllons are approved andporches, sklrtlng, decks, andventlng have been lnstalled. l-_l lnsert - After llreplace approvst - and lnstallatlon of unlt. Blocking and Set.Up - When ailblocklng ls complete. Curbcut & Alrproach - After forms are erected but prlor toplacemcnt of concrete. Electrlcal Connection - Whenblocklng, set.up, and plumblng lnspections have been approved and the home is connected tothe servlce panel. {f;;: Prumbrns - Prior to Sidewalk & Driveway - After excavation ls completc, forms and sub.base materlal in place. $treel Trees - When all roqulred trees are planted. JoBNUMBE^ 76C7!f / Aa z- r-.^/2- ?nf ',-C /?ht QUAD AREA: r OF BLDGS: Slte lnspectlon - To be madc after excavatlon, but prior tosettlng forms. tl E fl E E tl fl t.' Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Typ v - lnterior - Corner - Panhandle - Cul-de-sac Se IS THE PROPOSED WOFIK iN THE . HISTORICAL DISTBICI, OB ON - THE HISTORICAL REGISTER? - lf yes, thls appllcatlon must be slgned and approved by the Hlstorlcal Coordlnator prlor to permit issuance. I APPROVED: P.L,HSE GAR ACC N S E VALUE r#"? 3t" *, x $/so. FT. Garage &,er Carport BUILDING PERMIT ITEM SQ, FT. Maln BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the sald construction shall, ln all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the constructlon and use of bulldings, and may be suspended or revoked at any ilme upon violation of any provislons of said ordinances. <),tx Plans Revrtwed-By Date Plan Check Fee: Datc Pald Receipt Number Received By SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Developmcnt Charge ls due on all undeveloped properties wlthin the City linrits which are belng improved. ITEM Fixtu res Resldential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home Plumblng Permlt statosurcharoe ,7J- f ,y'r Total Charge (C) )< d2 ,/1,, ./ '' ldace_z@7 N0 FT. FT. FT, 12 u PLUMBING PERMIT FEE ,nzri) ADDITIONAL COMMENTS By slgnature, I state and agree, that I have carof ully examlned the completed application and do hereby certlfy that all lnformation hereon is true ancl correct, and I lurther certl(y that any and all work performed shall be done in accordance wlth the Ordinances of the City of Sprlngfield, and the Laws of the State of Oregon pertalnlng to the work descrlbed herein, and that NO OCCUPANCY wlll be made of any structure wlthout permission of the Bulldlng Safety Divislon. I further certlfy that only contractors and employees who are ln compllance with ORS 701.055 wlll be used on this proiect. I further agroe to ensure that all required lnspections are requested at the proper tlme, that each 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 on the slte at all times durlng constructlon. slg Date Wood Stove/ lnsert/Fireplace Unit Dryer Vent MISCELLANEOUS PERMITS Moblle Home State lssuance Stato Surcharge Sldewalk - ft Curbcut -- ft Demolition State Surchargg 3go / o,oa 7/- 7- 4/- Total Miscellaneous Pertnits (D) (E) )44 //2 , f,' /,2o zbye Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood No/ /s)gVALIDATION RECEIPT NUMBER DATE PAID AMOUNT RECEIVF.D RECEIVED BY TOTAL AMOUNT DUE (excluding clectrical) (A, B, C, D, and E Comblned) /Z/,'75 Total Value Building Permit Fee statesurcharge ;r5-3 * 7l' Total Fec (A) 1/-' 1^Taez;G CTTY OF SPRINGFTELD Fire & Life Safety FIRE DAMAGE REPORT OR ELECTRICAL HAZARD Bu'ilding DePartment Springfield Fire DePartment Structural Damage to Bu'i1d'ing Address or location of bu'ilding ,;3 s,_,- nrb3/ Name of owner lfi,te 11 t+ , ,/*- - Type of bu i 1d'i ng (owe ng , Store, l,larehouse, etc. DATE: CS -f { ? (. TO: FR0t'1: SUBJECT: ) gC Est'imated val ue of bui 1di ng Estimated loss to building LS ort c) Date of fire c,S -rs-? L Location of damage 'in building lr-r I f e<: (-(.r- t c .-A (- (Roof, tnlall, Exterior, Interior, etc.) Structural weakness as a result of the fire (Burned rafters, Beams, Joists, etc.) Additional pert'inent information Electrical Hazard \ I\C (Lli ri nq , 0utl ets , etc . ) cc: sig 1-f DD OT NO.NO, CONTROL Districtof Incident 2 INCIDENTADDRESS 7il DO NOT WBITD TN TIIIS SPACE EXP. r( ST County E naioE v.rt"l fl toet -2"a FIREDEPT ALARMNO, Below grd. Not Cl,asified [ 50 storic or more sFqb- /#q Dept. Responding E Hand-laidho*/hydret,standpipe E U.d"t-io"d E M*t"rst*D*i* E NotClasifredAbove D other(List) E Automtic Ext. Systeo E Preonnet he/tank only 30 to {9 E sotozof*t to ? to 12 stori6 Unprot€ct. Ste€l Bldg fl P-tot.Ert. & Wod Int. I qnr QZ o .E? eiFJE Ftst!r!inE AP rt- b C)oa? a: F,F r<Etrt5EE tlt d-6>rr c) z FUrf!€ iql 41 t r< a)€ t.H a1 a) U)*l o,l :E rt 15(n zt- tr trtr tr trEtr 3 OCCUPANT NAME (t{st, Fist, MI) nte { BUSINESS NAME (Irst, FiEt, MD 5 OWNER NAME(Ist,FiEt, MI) 6 FIREREPORTEDBY(ksI FiEt MI) 5AA 7 ALARM 8 'OT'FIRE PERSONNEL RESPONDED g 9 TYPEOFSITUATIONFOUND ,E Struct@ Fire Otha Prcp. w/valw rO METHODOF H(TINGUISHMENT E Tehphone Diret E M*i"iprt eh.m Systcm E Private Alarm System 911 (Tie Line) E voi.r sig-t l,runi Alam C NotCtasifrcdAbove E vehicLFi.e fl B*h,c*,Iouo fl T*tt, Rubbi"t IT FIXED USE tn PROPERTY 12 I EQUIPMENT INVOLVED INIGNTTION I3 l,l HEAT t5 OFFIREORICIN Grade lev€l to 9 fet t6 VALUE I,oSS E S"tt-Ertlrgri"t"d E Make-shift,ai& l0 ta l9 fet 20lD29 feL 2 stori6 3 to ,l stories E Port ble E{inguisher Pre-connect he/hy&et. Btatrdpipe tn ORIGIN co.mbustion of deft oil.stain- Rags in cardboard box- ITEMFIRSTIGNITED: . Over ?0 fet Objets in Flight Unprotect. Munry Ext. & Wmd Int. Protected Wmd Prame Undetemined Unprotected Wood Fmme Not Clasified Above t7 I 203 1 5 6 7 OFSTORIES I t3to2tstorie E 2stolg"to.io I8 BUILDING (ln Yan) 19 CONSTRUCTIONTYPE HeaqrD st-tc 3-4 ht.fl Protect. Stel EXTENTOFDAMAGECONFINEDTO: Flame Smoke The object of origin Part of rum or arq of o.igin Rmm of origin Fire-mted omp. of origin Flor of origin Streture of origin Extended beyond structure of origin I 2 I 5 6 7 I 2 3 4 5 7 tr! Dn 4 D 9 Nodarogeofthetype(N/A) 2l (optional): 22 Follow Up Invetigation Requ6ted Y2a N * tfyg,showillinvestisat€ 9E h of lnjuries )r' AI,ARM TIME 232D 23 2L ARRIVALtr C T\E Wed E rlut ! r'i E[ s"t', ! Mo. SunDAY OF WEEKo{MO DAY ,t 7G r ,*":f ISOCI-ASSJCENSUS TRACT3{97t/77 ztP 7ZL -LSA{ TELEPHONEDOB (optional) tt-Lq -3L TELEPHONEDOB (optional)ADDRESS TELEPHONEDOB (optional)ADDRESS DOB (optional)TELEPHONEADDRESS Aid (ertinSuish or invetigst€ E ci""n INle! R"*;"ua Z# OTHER VEHICLES RESPONDED (do not include PA's) # OF AERIAL APPARATUS RESPONDED# OF ENGINES RESPONDEDL. E Ertioeuish E Invetigation O Rem"ed Haand D st""any TYPE OF ACTION TAKEN Salvage Not Clasifred MOBILE PROPERTY (Complete line M)PROPERTY COMPLEX (If applieble) LICENSE #SERIAL #MODELYEAR J MAKE ) EQUIPMENT INVOLVED IN IG .ITION (Comptete Line E) VOLTACESERIAL #MODEL,rYEAR MAKE WAS MADEOFMATERIAL Vehicle ud Contents .00 Other .00 ooo '00/.00 Cont4nts .00 zrooo .00 .00 .00 .00 .00 50,000-99899 sq ft10,000-19,999 sq ft 5O0,00O Bq ftD o-gse ft ft ft5000-9999 ft 10O0-4999 sq ft tru tr tr tr tr trtr tr I In mm of origin<per. 2 Not in rom of origin-oper. 3 In m of origin-notoper-fire te small ,l Not in m of origin-not op€r. fire too shall 5 In mm of orkin-not oper. power di*onnet 6 Not in roof o.igin-notoprr. powerdiron. 7 Inmmoforigin-notoper.dqdbattery 8 Not in @m of origin -not op€!. dead battery 9 No detetor pent ,EJ ro Undetermi.ed DE-|ECTOR PERFORMANCE Equip. should have oper.-did not Equip. pre*nt fire te eaall to oper. Notclasified above Undetermiled or not report€d No equipment pent (N/A) Sprinkles Contrclled Fire: YES E NO E SPRINKLER PERFORMANCE D!fI D tr I of Heds Opened E Equiprent opemted Fire Senie Other Report XZ-a,,rrr" (hCt 't*r-aS-? Zl,;l fte,--s{n^b e-n\Title ""5-)t.?6 Fire Seryice Other E ont. on back i/r,arslcx IN SERVICEao57 tr D I t t[l0I &FL , lI n frtLl t PH:(5tl 1)995-631 1 _EAX:(5tl 1)995-61 11 T0: flor ! TTOTAL pAGEs FHOM: 4 DAIE: FA)( #r COMMENTS: FAX : COVEFI SHEET INCLUDING COVEH: A,dL ,t/i<J {", % "rr7 *. ,/( tl €ff, q2 *\ C-J7 / C-,*--.,/,?1 ,,?#/rl _ . " -. - ;: 'l t e==(<<<A. C. 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J{8 7 -6 ===<(((A.e.E.S VefglOn 7.tB>>>>=========== [ gfi261 J -==o---E=--==<<<<R,ELCo>]))=== Cuecomer ! RELCO- !IErEsE'r*: Ipr-, 6lsnEir?-:i8 tli:li=llli:[::"]::: = = :5=-:- - = = = o = 1 = = = - E Ei = = = = = = = = = == = = = = =' E = = = = E = = = = = - - = = = = r cflono BOTIdI cHonD LEBS REACIIOIIS ' SIZE AFPftOVEO FoR l{tlEx l}lDusTRIEs lxc' iol?- l:e. &i"- - z-i.-cu 1:'1230 5'50 I,S.-Z6tr e':- iI/Si 3-?= 690 $='12!0 5'50 !-4r-2670 7-l: 294E 3'6' 690 1.5.-!047 t''6='181 5 11-11 1[1 oR$caF{ 15, I i'1,) 1[1 r{1 318 Jir .lf+ 7-r l-s 13 -4-13L. HL TO PKr LEFT.TIEIGIITI 0-3-14 SPAN:26-0 =!s====!E======== = ===5==== ======== =====5=== ==== E======EX-=====nns==== o RISE:3-5-14 TO PK :1 HEIGHT:0 3-4-13-3-14R.RI HI, GHT i,OADING MEX STRETOP L-BOTT 5. LL. DEFL . MINIMW GRADE TOP CHQRD:2*4 BOT CHORD:2*4WEBS ;2*4 E LWBERNo.1 GR DF-I, NO.1 GR DF.L STUD 91 HF L 25 PSF) D 10 7 S SE 0 0 s') 6 @ ,848.1 )) o.22TOP BOTT 0 =5E_====Eq====E $-L/240 STR. lNC. : REPETITIVE STRESS 1.15 PLATE ES USED LUMB =nr=====!=======E======q============nE=====1.15 SPACI NG : 24,0 MEMBERSiro. oF n. o. c. 1 EE L E DE tLECr IOil( tH. ) L.L' 0 -22,D' L'0. I J, T.L'0' !7 'LATES ^RE lilrEx t{20.186,.l47 il XUFACTUREO rnil ASTH A 616 GRD A GALvAlllzEg sTEEL(fxcEPI As s*.lll{) prAr. *,,,r BE ,rsTArLED ir:rcn FA.E oF JorNT, syr,*,rETRrcALLy(Excspr'i!'i'n[,r,xiuiiiiii-ioitorri iiri xos oEsI6tr sPECs' UBC'tc8o'TPl'91-- I07 (rror0 xril6 c 2f 6,L llir93 tlcill gIrIl*O, r0t10ll tl{0t0 (orartrruotlStr il(B O lrr 0.c tlttts! lltfitY ,lfrt.to. urEtll llA(116 0r m n'mi, nsr *cura, Ar: Al sllolt( ,cort. tor tooltlollf, PEll(Arl$ll AtD ttil0lltr rrfi€ tnrfl E &lAtl rEen) rEfB 16 TPI Puil"',(Alr0il Htg'gt rucre rooo mr*l tdffigrrrl $i rE(o;itx0Attrfl, lJlo (o|tstr'r eilil]fo Ilrrf,E DEstrffr. :i CITY OF OREGO'U 5I>FtIN(;F tELT) SPRINGFIELD, oREGoN 97 47 7 Adhortz€d INSPECTION REQUESTI 126-3 t6e OFFICE: 726-3759 225 FTFTE STREET 1 37*. The following project as submttted h.s the zoning, and does not roquire specilic hnd apprwal. oa"JlJ.:4 U- 3 u8€ ELECTRICAL PERHTT APPLICATION b Number COHPI^ETE FEE SCEEDT'I^E BELOV Nev Residential-Sing1e or MuIti-Family per dvelling unit. Service Included:Items Cost L000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof S 15.00 Each Manuf'd Home or -Modular Dvelling Service or Feeder $ 40.00 LOCATIotli ON OF LEGAL DESCRTPTION JOB DESCRIPTI e Permits are non-transferable and expire if vork is not started r^rithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor ti Uc,'€/ett,'< Address 80, R 2)Jo I 4-?40\ 9, ,$e u < Pnone 6{j' {373 B.Services or Feeders Installation, Alterations or Relocation: 200 amps 201 amps 401 amps 601 amps or less to 400 amps -to 600 amps _to 1.000 amps_ 0.00 5.00 0.00 "Bu a56iE- D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit S 35.00 Each Addi tional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) Ci ty Expiration Date 7 Signa ture of Supervising Electrician Sum s s0.00 s 60.00 s100. 00 s130. 00 s300.00s 40.00Supervisor License Number 3{}Y-S Over 1000 amps/vo1ts Reconnect only Exp iration Date lO, C. constr contr. nunber %a/C Temporary Services or Feeders Installation, Alteration or Relocation 200 amps''or ]ess 20L amps to 400 Over 401 to 600 Over 600 amps or SUBTOTAL OF ABOVE 5Z State Surcharge 32 Administrative Fee TOTAL I s+AEamDs ) J amps $ B 1000-voTTs see { ,(, 0vners Name Address 7-E pRzt ci ty-Yhone 12i -[;8?< OVNER INSTALI.,ATION The installation is being made on property I ovn vhich is not intended for sa1e, lease or rent. Orners Signature: DATE: -Each installation Pump or irrigation $ signzoutline Lighting- $ l:.ili ted Energy/Res - $ 40.00 40.00 20.00 36.00 o-z) ') 6;-) RECEIVED BY: /7 5 /;2,;t2 zC -1L-4+- <_e