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Home My WebLink AboutPermit Building 1994-12-12RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 POSED WORK: SPRIl{GFIELf, z JOB NUMBER 225 Fifth Street Springfleld, Oregon 97477 TAX LOT D2z az)/7o z*3/ / LOT BLOCK:SUBDIVISION:_ PHONE: ZIP:o<CITY: ADDRESS: OWNER; NEW - REMODEL ADDITION DEMOLISH OTHEB __- DESCRIBE WORK: ADDRESS EXPIRES PHONECONTRACTOR'S NAME MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # GENERAL: PLUMBING - OFFICE USE - FLOOD PLAIN:QUAD AREA: C OF BLDGS: SECONDARY HEAT: SQUARE FOOTAGE; # OF BDRMS: _ LAND USE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: WATER HEATER:RANGE: # OF UNITS: -- ZONING CODE: To request an 1 made the sam lnspectlon, you must call 726'3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll bere worklng day, lnspections requested after 7:00 a.m. wlll be made the following work day. REQUIRED INSPECTIONS Rough Mechanlcal - prior to cover. Final Plumbing - When altplumblng work is comptete. Slte lnspectlon - To be made after excavatlon, but prior tosettlng forms. Rough Electrlcal - Prlor to Final Electrlcal - When allelectrical work is complete.cover I--l Underslab Ptumbtng/ Electrical/u Mechanlca! - Prior to cover.Eleclrical Service - Must be approved to obtain permanent electrlcal power. Flnal Mechanical - When allmechanical work ls complete. Footlng - After trenches are excavated.[-l Flreplace - prlor to faclng - materlals and framing lnsp. ffi Framing - prior to cover. E Final Building - When allrequired lnspectlons have beenapproved and building is completed.[--l Masonry - Steel locatlon, bond.J beams, groutlng. Foundatlon - After forms are erected but prlor to concrete placement.WalllCelllng lnsulatlon - Prlor to cover. Underground Plumblng - prior to fllllng trench,l-_l Drywall - prtor to taping Underlloor Plumblng/ Mechanlcal - Prlor to lnsulatlon or decklng. MOBILE HOME INSPECTIONS Wood Stove - After lnstallatlon. Post and Beam - Prlor to floor lnsulatlon or decklng.l--l lnsert - After flreplace approval - and lnstallatlon of unlt. [-l Slocking and Ser.Up - When ail - blocklng is complete. Floor lnsulation - Prior to decklng.Curbcut & Approach - After forms are erected bUt prior toplacement of concrete. Plumbing Connections - Whenhome has been connected to water and sewer. Sanitary Sewer - Prior to fllling trench. Slorm Sewer - Prlor to filling trench. Sidewalk & Driveway - After excavation ls complete, forms and sub-base material ln place. Electrical Connection - Whenblocking, set.up, and plumbing lnspections have been approvedand the home is connected tothe service panel. n Water Llne - Prtor to fi[ing - trench. f-l Rougtr Plumbing - prior tolJ cover. l--l Fence - When compteted. Street Trees - When all requlredtrees are planted. Final - After all requiredinspections are approved andporches, sklrting, decks, andventing have been installed. i ASSESSORS MAP: STATE: n femporary Etectrlc E tl Tf [-_l other l.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 rS THE PROPOSED WORK tN THE , HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be slgned and approved by the Historical Coordinator prior to permit issuance. APPBOVED: VALUE /a?" ?>d2Q274q4H:z/< 5.@ X $/SQ. FT. 4 a /,zo Total Value Building Permit Fee State Surcharge Total Fee ,?5 * ,4f (A) BUILDING PERMIT ITEM SO. FT. Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express conditlon 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 Fleviewed By Date Recel pt Numbe Plan Check Fee: Date Paid Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Flesidentlal Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge . FT. ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit M ECHANICAL PERMIT Fu rnace Exhaust Hood I further agree to ensure that all required inspections are requested at the proper time, that each address ls readable from the street, that the permit card is located at the front Y, Si, Date nd the set of plans will remaln constructlon gnatu of the property, a on the site at all MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electricat) (A, B, C, D, and E Combined) /2.2o*<)--t- zo 2DATE PAID AMOUNT RECEIVED FIECEIVED BY VALIDATION: RECEIPT NUMBEB FT. By slgnature, I state and agree, that I have carefully examlned 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 pertainlng 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 ln compliance with ORS 701.055 will be used on thls project. OF OBEGO'U a I^EGAL 5 /.--/ 7 ()2 )-o o e Permits are non-transferable and expire if work is not started vithin 1B0 days of issuance or if.vork is suspended for 180 days. 2... CONTRACTOR INSTALLATION ONLY Electrical Contractor Address ci ty-Phone 7 26732J- Supe rvisor License Number Z\S 7J Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician SP.tIl\lGFIELD land use ELECTRTCAL PERHIT APPLICATION ob Nurnber SCMDULE BELOV Nev Residential-Single or MuIti-Family per dvelling unit. Service fncluded: I tems Cos t 1000 sq.ft. or less F Each additional 500 --7- sq. ft or portion thereof Each Manuf'd Home or -Modular Dwelling Service or Feeder s 8s.00 s 1s.00 $ 40.00 Services or FeedersInstallation, Alterations or Relocation: I::,1'J',Tl!'.s:?s' 225 FIFTB STREET APPTOVAI. SPRINGFTELD, oREGoN 97477 1. LOCATION OF fNSPECTIoN REQUEST: 726-3762 - t q -0i.4 City J OFFICE: 726-3759 o're lL-:r->- l, rt- Authorized sienature l\ ' 3=- *r**-tEt () s s0.00 s 60.00 $100.00 s 3s.00 s 2.00 ,444rf/ /REloca t i on '?J' Sum B 200 amps or less 201 amps to 400 amps 401 amps to 600 amps C. Tempo ra I t v 601 amps to 1000 amps- S13O.O0over 1000 amps/volts - s300.00 Reconnect Only s 40.00 or s .00 amps .00 , amps $ 80.00r 1000lofEs see rrBrr a6ilE- Nev, Alteration or Extension Per Pane1 Ovners Name Add ress Z city q 2i.i*/r/. / Yhone d/(Jl /', OVNER INSTALL"ATION The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. t Owners Signature: DATE: RECIiTP'I' 4* One Circuit Each Addi tional Circuit or vith Serviceor Feeder Permi t _Z__2,oe E 5 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation S 40.00 sign/out1ine Lighring- S 40.00 Limited Bnergy/Res - $ 20.00 Limited Energy/Comm $ 36.00 SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTALRECEIVED B Sy',*'2>e----7:A r- -5e*-7- AB require epecilic , 600 amps o D.Branch Circuits SPRINGFIELD zcning, and does OFFICE: 726-3759 Authorizod 1. LOCATION OF T LEGAL 5 1r- / ION e Permits are non-transferable and expire if work is not started vithin 1B0 daysof issuance or if.vork is suspen-ded for 180 days. 2... COI'ITRACTOR INSTALINTION ONLY Electrical Contractor Address Z,tl /( ^n Ci ty Phone 7267tPJ- Supervisor License Number 2)S 7 J Expiration Dat e Constr Contr'. Nunrber ELECTRICAL PERHIT APPLICATION Ci ty Job Nunber 3. COHPLETE FEE SCBEDI'LE BELOV Nev Residential-Single or HuIti-Family per dvelling unit. Service fncluded: I tems Cos t 1000 sq.ft. or less # nach additional 500 -/- sq. ft or portion thereo f Each Hanuf 'd llome or -Modular Dvelling Service or Feeder s 8s.00 s 1s.00 $ 40.00 Reconnect 0n1y s 40.00 C. Tempora r de I B. Services or FeedersInstalIation, Alterationsor Relocation: 200 amps or less l/ S 5O.OO 201 amps to 400 amps - S 60.00 40L amps to 600 amps - $100.00 601 amps to 1000 amps- $130.00over 1000 amps/volrs - s300.00 not require specific use '?4' %aPProval' 225 FfFTII SIREET zonins LD? SPRINGFIELD, oREGoN 97477 jo t4-q"J fNSPECTI0N REQIIEST z 'l/ps$4691!-4't-t:*' 1 o Sum t or ,F7/r<,/4 /Rbloca t io v rn -- Eove 1 Dxpiration Date 20 o 400 amps Signature of Supervising Electrician o Over o 600 amps s 80.00 amps or 1000 voTts see rrBrr a -;(,eD 4z_ Zoo.< 0wners Add ress Name Ci / Phon" d4 OIJNER ,TION The installation is being made on property I oun vhich is not intendedfor sa1e, Iease or rent. 0rners Signature: D.Branch Circuits New, Alteration or Extension Per Pane t44n.oo+ s 55.00 One Circuit Each Additional Circuit or vith Service or Feeder Permi t _Z_ SUBTOTAL OF ABOVE 5Z State Surcharge 32 Adnrinistrative Fee 'l'0TAL $ 3s.00 $ 2.00 40,_f- E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation SSign/ourline Lighting- $ Limi ted Energy/Res - $ Limi tcd Energy/Comm $ 14,orZtu ----Z z<4 )Z 40.00 40. 00 20.00 36.00 5 DATE: RIiCETVED I} 1