HomeMy WebLinkAboutPermit Building 1991-05-22SPRII\rG
SUBDIVISIONBLOCK:
ELE,
4
---7'
TAX LOT:g*+# O16,aO
LOT:D,uLP. 4zz-
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
RESIDENTIAL
PERMIT APPLICATION
lnspections:726-3769
Office: 726-3759
225 Fifth Street
Spri ngf ield, Oregon 97 477
JoB NUMBE " 7/4/88
m. ztP, A>/a}
PHONE:
STATE:
R:
ADDRESS
CITY:
NEW
-
REMODEL ADDITION DEMOLISH OTHEFI
DESCRIBE WORK:
ELECTRTCAL /v,/, €0r \
CONST.
PHONADDRESSeCONTRACTOR'S NAME
MECHANICAL:
G EN ERAL:
PLUMBING
\\5cU
r)
\
€-
_ OFFICE USE -
RANGE:
* OF BDRIVIS:
LAND USE:
* OF UNITS:
OCCY GROUP:
ZONING CODE:
FLOOD PLAIN:
WATER HEATER
* OF STORIES:SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
QUAD AREA:
* OF BLDGS:
To request an inspection, you must call 726-3769. This is a24hour recording. AII 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.
REOUIRED INSPECTIONS
fl Temporary Electricll
Site lnspection - To be made
after excavation, but prior to
setting forms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
ted.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but Prior to concrete
placement.
Underground Plumbing - Prior
to f illing trench.
Underf loor Plumbing/ Mechanical
- Prior to insulation or decking.
Post and Beam - Prior to floor
insulation or decking.
Floor lnsulation - Prior to
decking.
SanitarY Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbing - Prior to
cover.
Rough Mechanical - Prior to
cover.
Rough Electrical - Prior to
cover,
Electrical Service - Must be
approved to obtain Permanent
electrical power.
Fireplace - Prior to facing
materials and framing lnsP.
Framing - Prior to cover,
Wall/Ceiling lnsulalion - Prior to
cover.
[l Drywall - Prior to taoing
lnsert - After firePlace aPProval
and installation of unit.
Curbcut &APProach - After
forms are erected but Prior to
placement of concrete.
Final Plumbing - When all
plumbing work is complete.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.
Final Building - When all
required inspections have been
approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
pl Blocking and Set'UP - When all
F blocki ng is comPlete.
E Plumbing Connections - When
home has been connected to
water and sewer.
Sidewalk & DrivewaY - After
excavation is comPlete, forms
and sub-base material in Place'
I--1 Fence - When comoleted'
l-1rl Street Trees - When all required
I rJl tr;es are planted.
f.7 Electrical Connection - WhenlF utocxitlg, set-uP, and Plumbing
insPecti6ns have been apProved
"nd th. home is connected to
the service Panel'
I-C:l Final - After all required
L l i;;;;ctions are approved and' '""tli"s, skirting' dec\s,,11o
venting have been lnstarreu'
E
E
E
Wood Stove - After installation.
tr
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N
S
E
I HE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
VALU
gpo
l5g
,,15,l-5.Q5
(A)
BUILDING PERMIT
Total Value
SQ. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
Building Permit Fee
State Surcharge
Total Fee
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.
Plans Reviewed By Date
Fleceipt Numbe
Plan Check Fee
Date Paid
Received By:
SYSTEMS DEVELOPMENT C
(B)
HARGE (S D 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
PLUMBING PERMIT
FEE
.75
N0
FT.
FT.
FT.
]5;5(c)
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
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 further 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
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
ignatu
the site at al ,times uring construction.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk -.- ft
Curbcut
---
ft
Demolition
State Surcharge
AS
Total Miscellaneous permits
c
(E)
TOTAL AMOUNT DUE (exctuding etectricat)(A, B, C, D, and E Combined)
AMOUNT RECEI E
DATE PAID
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
(D
225 FIFTB S1AEET
SPRINGFTELD, oREcoN 97477
TNSPECTION REQTIESTt t\6_jt6g
OPFICE: 726-3759
1 OF
JOB
Permits are non-transferableif vork ls not started vithin
SPTIINGFTELO
BLECTRTCAL PERHIT APPLICATION
City Job Nunber
COHPLETB FEE SCIIEDUI,A BELOY
t
3
h Nev Residential-Sing1e orHulti-Family per dvelling unit.Service Included:
ftems Cost
1500 sq.ft. or less $ 95.00
Each additional 500
sq. ft or portion
thereof g 15.00
Each Manuf,d Home orof issuance or if vork ls suspend
L80 days.
Sum
80
expi re
days
ed for
COIiTRACIOR INSTALI..ATION ONLY
cal Contractor
Address
ci
Supervisor Li cense
Expiration Date
Constr Contr.
Expi ra t i
Signa
Ovners I'lame
Address
Ci ty ne
OIINER INSTALI..ATION
The installation is being made onproperty I ovn vhich is not intendedfor sale, lease or rent.
rs Si dL
Hodular Dvelling
Service or Feeder $ 3s.00
ts Services or Feeders (10 Branch Circuitsincluded). Insta1lation, Alterationsor Relocation:
i00 amps or less
101 amps to 400 amps
-40L amps to 600 amps
-601 amps to 1000 amps-
over 1000 amps/volts
-Reconnect 0n1y
C.Temporary Services or FeedersInstallation, Alteration or Relocation
200 amps or less $ 35.00
201 amps to 400 amps
-
$ 4O.OO
over 4o1 to 6oo amps
-
$ go.oo
0ver 600 amps or 1000 voTis see rrgn "f,ffiD. Branch Circuits
Nev, Alteration or Extension per panel
One Circuit
Tvo to ten Circuits
Each Addtrl ten orportion thereof $ 1s.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation g 36.00Sign/0utline Lighti.,g- $ 36. oOSignal Circuit orlimited energy panel S 36.00
STETOTAL OF ABOVE
5Z State Surcharge
TOTAL
$ 3s.00
$ 60.00
$ e0.00
$130. 00
$300.00
$ 3s.00
5 $ 3s.00
$ s0.00
E
PT
OFEGOff
Phone
of Supervising Electri
ber
te
RECEIVED BI:
5
,'ID
co