HomeMy WebLinkAboutPermit Building 1996-01-16l-
SPRI1{GFIELO
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
JOB NUMBER
225 Fif th Street
Springfleld, Oregon 97477
TAX LOT:
z
h,
/-
ASSESSORS MAP:/1-3-3*-tt
LOT BLOCK:
PHONE:
ZlPi
,
STATE:(F
OWNER
ADDRESS:
CITY:
L 4
./-
erDESCRIBE WORK:JJ 't/1
ADDITION DEMOLISH OTHERNEW-- REMODEL
MECHANICAL:
ADDRESS EXPI RES PHONE
ELECTRICAL:
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
CONST.
CONTRACTOR #
RANGE:
r OF BDRMS:
WATER HEATER:
- OFFIGE USE -
LAND USE:
ZONING CODE:
FLOOD PLAIN:
SOUARF- FOOTAGE:
SECONDARY HEAT:
'I OF UNITS:
OCGY GROUP:
fg OF STORIES:
OUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour rccording. All inspections requested before 7:00 a.rn. will be
made the same worklng day, lnspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prior to
cover.m Final Plumbing - When all
plumblng worl( is complete.
Site lnspectlon - To be made
after excavation, but prior to
setting forms.
Z f#l Electrlcal - Prior to W Final Electrical - When all
electrical work is complete.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Final Mechanlcal - When all
mechanical worl( is cornplete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
W Final Building - When all
required lnspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.a
tl
Framlng - Prlor to cover.
Other
Foundatlon - After forms are
erected but Prior to concrete
placement.WalltCelling lnsulatlon - Prlor to
cover.
Underground Plumblng - Prior
to filllng trench.fA orywall - Prlor to tapinglrt\t
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng'Wood Stove - After lnstallation
Post and Beam - Prlor to floor
lnsulatlon or decking.lnserl - After flreplace approvql
and lnstallatlon of unit.
Blocking and Sel-Up - When all
blocking is complete.
Floor lnsulation - Prlor to
decking.Curbcut & Approach - A{ter
forms are erected btlt Prior to
placement of concrele.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanltary Sewer - Prior to f llling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have becn apProved
and the home is connected to
the service panel.
Storm Sewer - Prlor to filling
trench.
Sidewalk & Drlveway - After
excavation is comPlete, forms
and sub-base material in Place.
Waler Llne - Prlor to filling
trench.
Fence - lVhen comPleted
Rough Plumbing - Prlor to
cover.
Stre€t Trees - When all requlred
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decl<s, and
ventlng have been installecl.
SUBDIVISION:-
fl
fl
n
E
tl
tl
E
E
w
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Ty,
-
lnterior
_- Corner
-
Panhandle
-
Cul.de-sac
Set IS THE PROPOSED WORK iN THE
HISTORICAL DISTRICT, OR ON
THE HISTOBICAL REGISTER?
-
lf yes, this application must be signedand approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
PL.HSE GAB ACC
N
S
E
VALUE
/hr//fr:ff
(A)
?:e
X $iSQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fec
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT
This permit is granted on the express condition that the saidconstruction shall, in all respects, conform to the Ordlnanceadopted by the City of Springfield, including the
Development Code, regulating the construcilon and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances.
Receipt Number:_
Plans Fleviewed By Date
Date Paid
Received By
Plan Check Fee
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City linrits which are being improved,
FEE
/6-w(c)
FT.
N0
FT.
Residcntial Bath(s)
Plumbing Permit'
State Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fix tu res
Sanitary Sewer
Water
Storrn Sewer
Mobile Home
ADD IONA OMM NTS
Wood Stove/ lnsert/ Fireplace Unil
Dryer Vent
MECHANICAL PERMIT
/qe
'State Surcharge
..Total Permit (D)
r4q ?2
No
Mechanical Permit
lssuance
Furnace
Exhaust Hood
Vent Fan
natu
truct
By slgnature, I state and agree, that I have carefully examlnedthe completed application and do hereby cerilfy that alllnformation hereon is true ancl correct, and I f urther certify
that any and ail work performed shail be done in accordance
with the Ordinances of the City of Springfield, and the Lawsof the State of Oregon pertainlng to the work describedherein, and that NO OCCUPANCy will be made of anystructure without permission of the Building Safety Division.I further certify that only contractors and employees whoare ln compliance with OFIS 701.055 will be used on thisproject.
I f urther agree to ensure that all required inspections areroquested at the proper time, that each address is
from the street, that the permit card ls located atof the property, and the approved
Date
Si
readable
the front
ans will remainon the site at all ti during c
MISCELLANEOUS PERMTTS
Mobile Home
State lssuance ,
State Surcharge
Sidewalk _--._- {t
9urbcut
----_-
ft
Demolition
State Surcharge
Total Miscellaneous permils (E)
TOTAL AMOUNT DUE (exctuding.etectric:r t) :L2.3*53(A, B, C, D, anrJ E Combined)
fB-€e
?
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
FT,
t
I
%.za
225 FTFTB STREET
SPRINGFIELD, OREGON 97 477
SPFIIh'\;F IEL.t'
ELECTRICAL PERHIT APPLICATION
Ci ty Job Nurnber 0
COHPLETE FEE SCEEDIIIJ BELOIT
Nev Residential--Single or
Multi-Family per dvelling unit.
Service Incfuded:Items Cost Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home- or
Modular Dvelling
Sertice or Feeder
$ 8s.00
s 1s.00
$ 40.00
INSPECf,ION REQUEST
OFFICE: 726-3759
: 726-31.$9 .r :, i, ,,1:
1. LOCATION OF ON
DESCRIPTION
JOB DESCRIPTION
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. CONTRACTOR INSTALI,ATION ONLY
Electrical Contractor
Address
City- Phone
Supervisor License Number
Ovners Name-
>r-i /.1,Phone I I b'{4t1
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amPs _
401 amps to 600 amPs _
601 amps to 1000 amps-
Over 1000 amps/vo1ts
Reconnect Only
One Circui t
Each Additional
Circuit or vith
or Feeder Permit
Service
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
3
A
Exoiration Date
Constr Contr. Number
Temporary Services or Feeders
Installation, Alteration or Relocation
Exoiration Date 200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amPs
0ver 600 amps or 1000-7oTEsy Signature of Supervising Electrician
D Branch Circuits
Nev, Alteration or Extension Per PaneL
Address 1 Sw^
c
s s0.00
s 60.00
$r_00. 00
s130.00
$300.00s 40.00
aSove-
$ 40.00
$ ss.00
$ 80.00
see ItBtt
s 3s.00 7s"'
00
Ci tyT
OIINTR INSTALT-ATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
0vners
DATE:
E. Miscellaneous (Service/feeder not included)
$2
-Each installation
Pump or irrigation S
sign/outline Lightitg- q
Liili ted Energy/Res
-
$
40.00
40.00
20.00
36.00
RECEIVED
ignatu
5
7 r."-'i la
1,, )*