HomeMy WebLinkAboutPermit Building 1994-05-20RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office; 726-3759
LOCATION OF PROPOSED WORK:
JOB NUMBER
225 Fifth Street
Spri ng f ield, Oregon 97 477
b41 {ffi1Uuohvf
ASSESSORS MAP:t1 01 z2 4z-TAX LOT:SZCZ>
LOT:l()BLOCK:
o-dCJ-SUBDIVISION:
PHONE:
6RSTATE:ztP , ??.1-??
OWNER:
CITY:
ADD
OTHER
DESCRIBE WORK:
ADDrroN V' DEM.LT.HNEW-. REMODEL
ADDRESS
CONST.
CONTRACTOR #E ECONTRACTOR'S N EXPIRES
MECHANICAL:
ELECTRICAL:
GENERAL:
PLUMBING
USE -
\\
WATER HEATER RANGE:
# OF BDRMS
- OFFICE
LAND USE:\t
ZONING CODE:
FLOOD PLAIN
* OF UNITS:
SECONDABY HEAT
SOUARE FOOTAGE:
OCCY GROUP:
S OF STORIES:
QUAD AREA:
# OF BLDGS
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. This ls a24 hour recording. All inspections requested before 7:OO a.m. will be
made the same working day, inspections requested after 7:00 a.m. wlll be made the following work day.
REQUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
cover.
[--l Final PlumbinglJ plumbing work - When all
is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
E Rough Electrical - Prior to l'Yl Final Electrical - When allJAelectrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Eleclrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When all
mechanical work is complete.
N Footing - After trenches are
excavated.K Final Building - When all
required inspections have been
approved and building is
completed.
Fireplace - Prlor to facing
materials and framing lnsp.
Masonry - Steel location, bond
beams, grouting.,K
X
X
Framing - Prior to cover,tr Foundation - After forms are
erected but prior to concrete
placement.Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to filling trench.Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
Underf loor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After installation.
K Post and Beam - Prior to floor
insulation or decking.lnserl - After fireplace approval
and installatlon of unit.
Blocking and Set.Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.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
lnspections 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.
Fence - When completed.
Rough Plumbing - Prior to
cover.
Streel Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
,K
6-
E tl
Other
-
E
E
E
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot TJpe v
Wtnt"rio,
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L.HSE.GAR ACC
N
S
E
-lo
r-,.J..J
f . i-HE PROPOSED WOBK lN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be slgned
and approved by the Historical
Coordinator prior to permlt lssuance.
APPROVED:
/(2so\ou.--
s,41:Bg1
X $/SQ. FT = VALUE5_ke-\'l 0P1
Total Value
Building Permit Fee
State Surcharge
Total Fee
3t
z?o+ ?fi
(A)
,
BUILDING PERMIT
ITEM
Main
Garage
Carport
SO. FT.
t*:>
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
5^2r -?/
Beceipt Numbe
Dat;------7-
Plan Check Fee
Date Paid:
Received By:
upon violatlon of any ions of said ordinances.
SYSTEMS DEVELOPMENT CHARGE (S
(B)
D Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N0
FT.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Pnw A
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
(D)
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood
N0
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 pertalning to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Divislon.
I further certify that only contractors and employees who
are ln compliance with ORS 701.055 will be used on this
project.
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 ls located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Knn.,u,
Date 7*-uq, -^ \^ ?<
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
/2 s3/r^f- "
TOTAL AMOUNT DUE (excluding electrical)
(A, B, q D, and E Combinedt // 8 r€Z L
DATE PAI
AMOUNT
FIECEIVED BY
VALIDATION:
RECEIPT NUMBER
.t
ffir+{s.6viewed 69
FT.
o' i'? f ,f- rr6-gb
i4
IsI
'l-25 $I1'-tll s'tttl':lil:'iiioi,iiittLt), oltr:Gol{ 97rr77 - -- - ^iii;i',;ii;H ituouns'r' 72'6*3't 6e
OrrtCr,t 72'6-'Jl5t)
1. LOCATI,ON INSTALLA'TION
LEGAL DESCRIPTION
2^
JOB DESCRITTION
Elcctrical Contract
Add ress
Ci ty
.jt.t ltN(;l:lt:Lu
Qfi
ILBCTRIC,tL ATPLI.CATI
Service Included:
I tems
1000 sq.ft. or less
each additional 500
sq. ft or Portlon
thereo f
Each Hanuf 'd llome or
Modtrlar DueIling
Service or [eeder
Services or Feeders
Installatlon, Alterations or
Rclocation:
ON
Cos t
$ 85.00
$ ls.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
s see rrBrr aIove
\ 4-4,
,O
cttY Jotr Nrrllrbec ?/o /6f
3. COHI'LETII I'BB SCIIEDULB IIBLOU
A. Nev Resi<lentlal-Single or
Urftf-fu*ilY Per dvelling unit'
Sum
Pernrits are non-transferable and explre
it vork is not started vlthin 180 days
;i iur,tnn.u or if vork ls suspendecl for
100 days.
2. CO}N'RACTOR INSTALIJTION ONLY B
Supervisor License Ndurber 5
Expi ra t ion Da te
Constr Cotrtr. Number
/-a--w6D I
Expiration Date
Signature of Supervising Electrician
Ouners Name
Arld rcss
Ci ty_-- Pltonc
OVNER INSTALLATION
The installation is being made on
propcrty I olrn vhictr is not intended
for sale, Iease or rent.
0vncrs Slgnattrrc:
olrn:.
RECF.I?7'
200 amps or less
201 anrps to 400 amps
--
401 amps to 600 amPs
-
601 amps to 1000 amps-
Over 1000 amPs/volts
-
Reconnect OnIY
200 amps or less
20L amps to /r00 amps
-
0ver /r01 to 600 amps _
0ver 600 amps or 1000 volt
Temporary Services or Feeders
InsiaIIatlon, Alteratlon or Relocationc.
D
$ 40.00
$ 5s.00
$ 80.00
Dranch Clrcul ts
Nev, Alteratlon or Extension Per Panel
one circul t --:-$ 35.oo -32\Iiach Addi t ional
Circui t or vi tlr Service
or Feeder Permit
-
$ 2.00
-l'liscellaneorrs (Service/feeder not included)
-Each installation
Plrmp or irrigation
Sign/0utIine Liglt ting-
Limi ted Energy/Res
SUDTOTAT OT ADOVE5l State Surchargeror\t. /32?ry.-
c4l
E
00
00
00
00
$ 40.
$ 40.
$ 20.
$ 36.
,t,i(:ri TVIiD IIY:
5
5=.zo
)
rr.,o,'u TIQ -5 D8