HomeMy WebLinkAboutPermit Building 1999-10-13IELDRESIDENTIAL
PERMIT APPLICATION
lnspections: 72A4769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT:
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
TAX LOT:
SUBDIVISION:
22/#€
BLOCK:
PHONE:
STATE:ZIP:
4]f-VE}4.{tl4 t.4OWNER:
ADDRESS:
CITY:
NEW- REMoDEL ADDrroNy- DEMoLTsH orHEndrp' a.rrun rrt
ADDRESS EXPIRES .a PHONECONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
PLUMBING:
GENERAL:
CONST.
CONTRACTOR #
_ OFFICE USE _
LAND USE:
# OF BDRMS:
WATER HEATER:
ZONING CODE:
SECONDARY HEAT: _
SOUARE FOOTAGE
* OF UNITS:
QUAD AREA:
r OF BLDGS:
RANGE:
OCCY GROUP:
I OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requested before 7:00 a.m. wlll bemade the same worklng day, lnspections requested after 7:00 a.m. wlll be macle the followlng work day.
REQUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prior to
cover.
Final Plunrbing - When allplumbing worl< is complete.
Slte lnspectlon - To be madeafter excavation, but prior tosetting forms.
Rough Electrical - prior toFcover.ffii;;i;';;$i?t', ;"H;t il:
[--l Underslab Ptumblng/ Electricat/
-
Mechanlcal - prior to cover.
I>< Footlng - After trenches are.Hexcavated.
l--l Masonry - Steet tocatlon, bond|J beams, grouilng.
Foundatlon - After forms arebut prior to concrete
placement.
Post and B€am - prlor to floorlnsulation or decking.
Floor lnsulation - prlor todecklng.
ng
Rough Plumblng - prior to
cover.
fl Flreptace - prtor to factng|J materlals and framing tnspl
L---.
J$'t"tlng - Prior to cover.
Curbctrt & Approach - Afterforms are erected but prior toplacemcnt of concrete.
Wall/Celling lnsulallon - prlor tocover.
Wood Stove - After lnstallation.
MOBILE HOME INSPE TIONS
Ef Pinat Buildins - When alGtequired insp-ecilons have beenapproved and building is
completed.
Eleclrlcal Conneclion - Whenblocklng, set.up, and plumbinglnspections have been approvedand the home is connected tothe servlce panel.
Final - After all requiredlnspections are approved andporches, sklrilng, decks, andventlng have been lnstalled.
Electrical Servlce - Must beapproved to obtain permanent
electrlcal power.
Sidewall< & Drlveway - Afterexcavation is complete, formsand sub-base material in place.
Slreet Trees - When all requiredtrees are planted.
Final Mechanical - When allmechanical work is complete.
r"tffiiill,llin'.u-o'nn - Prior p:,*^, - prror to tapins
l-l Underlloor plumblng/Mechanical
Prior to lnsulailon or decking.
lnsert - After flro.place approvgl
and installatlon of unit.
[--l elocking and Ser.Up - When ail
-
blocklng ls complete.
l-l Sanitary Sewer - prior to filtir
-
trench.
I-_l Stonn Sewer - prior to filtingIJ trench.
E llj*i.Llne - Prlor to rillins n rence - lvhen cc.rpteted
tl
.)7_3 t'n
r,EL
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r{)<?-
6a^@g4*t*z
DEScRTBEWoRK: M fu'f- ffryf4 Fr+lp.NA \ 4t (^tr*.lua*<e
FLOOD I)LAIN:
tl
tl l--l ottrer
l--l elumUing Connections - When
-
home has been connected towater and sewer.
P.L.HSE GAR ACC
N
S
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
.- Panhandle
-
Cul-de-sac
IS THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be slgned
arrd approved by the Historlcal
Coordinator prlor to permit lssuance.
APPROVED:
BUTLDING PERMIT
ITEM
Main
Garage
Carport
SQ. FT. X $/SQ. FT.VALUE
6r' ^l r9t4,2JDa
Total Value
Building Permit Fee
state surcharge 7?9+ '?te
Total Fee (A)
42-P
-4,? >, /?_
BUILDING VALUE, PLAN CHECK
AND BUILDING PERNJ]IT
This pernrit 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.
Plan Check Fee:
--Date Paid
Fleceipt Number:-
Received By
Plans Rcviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
Nc
f:T.
FT.
FT.
Plumblng Permit
State Surcharge
Total Charge (c)
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Fu rnace
Exhaust llood
Vent Fan No
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
Mechanical Permit
lssuance
State Surcharge
Total Permit (D)
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformation hereon is true and correct, and I f urthe.r certlfy
that any and all work performed shall be done in accordance
with the Ordinanccs of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Builclirrg Safety Divislon.
I further certify that only contractors and enrployees who
are in compliance with ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper tlme, that each address is readable
from tlre street, that the permlt card ls located at the front
of the property, and the approved set of plans will remain
on the si at all times during construction.
Slgnature
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Perlnits (E)
VAl-IDATION:
FIECEIPT NUMBER o?sq)
DATE PAIi)
AMOUNT RECEIVED
RECEIVED BY
26
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Combined)-7€,7t
I
fq rt c ?e a/'i/' , tt:
CITY OF OREGorv
225 FIFTE STREET
SPRTNGFIELD OREGON
INSPECTION REQTIEST:
OFFICE: 726-3759 ,ate
1. LocATroN oF rNsm{tsrttfirenaturerl
ELECTRICAL PBRHIT APPLICATION
City Jo b Nurnber a ?rts
PEE SCffiDUI^E BELOV
Nev Residential-Single or
llu:.tl-f.ri1Y Per dvelling unit'
Service Included:I tems Cos t
s 8s.001000 sq. ft.or less
onal 500Each a ti
ort FTHE,WOBKp
$ 40.00
s",ASlftrBo
Ins tallation, Alterations
or Relocation:
qq'A.
B
D
E.
I.,EGAL DESCRT Sum
I
Permits are n
if vork is no
of issuance o
L80 daYs.
Ovners Name
Address 2
s Signature:
DATE:
transferable and exPire
t started vithin 180 daYs
r- if vork is susPended for FOR
2. CONTRACTOR INSTALI-ATION ONLY
Electrical Contractor
Ci Phone
Supervisor License Number
Expiration Date- C.
Constr Contr. Number
Expi ration Date
Signature of Supervising Electrician
Temporary Services or Feeders -i;;I;il;iion, etteration or Relocation
200 amps"or less $ 19'99ioi ffi; io aoo amPs
- i ::'99o;;'lbi io ooo amPs --- $ 8o'oo
0ver 600 "*p" or-i56oEfT" """ r'3r' a6fre-
Branch Circui ts ; .'
20t
20
40
0
1
1
amp
amp
amP
s
s
s
or lessio a00 amps
-to 600 amPs
-
to 1000 amPS-
, amps/volts
-
s s0.00
s 60.00
$100.00
$130.00
s300.00
$ 40.00
601 am
Over 1
ps
000
Reconnect OnlY
ci ty e. P*rolrtetrt Ynonel 41 -5O€B
OIINER INSTALLATION
The installation is being made on
p.op"tty I ovn vhiih is not intended
for sale, Iease or rent'
Nev, Alteration or Extension Per Panel
one circuit tl $ 35'oo tr
Each Additional
Circuit or vith Service;;-r;;J"; Permit $ 2'oo
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
s 40.00
$ 40.00
$ 20.00
$ 36.00
5 SUBTOTAL OF ABOVE
7% State Surcharge
3Z Administrative Fee
TOTALRECEIVED
DA