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Home My WebLink AboutPermit Building 1992-05-26SP IELO RESIDENTIAL PERMIT APPLICATION I ns pr,'c t i c.rns: 726-3709 Ofli<;t:: /26'31!i9 LOCATION OF PROPOSED WORK: ASSESSOTlS MAP /7 z-%-2a efr, JOB NUMBE A -?-Z%?,Q _ - 225 Filth Strect Sprringfield, Oregorr 97477 TAX LOT:ZErZ+-6 LOT - BLOCK:SUBDIVISION OWNER ADDRESS: PHONE STATE:ztP 277>BCITY: . NEW .- REMODEL ADDITION DEMOLISH OTHER DESCRIBE WORK: - /?2s7. tdszzfr:4#?!?EXt'IRESAt)RE PI-IONE CONST. CONI'RACTOR /COI\I I BACTOR'S NAME cr r : N r-: nA L, fu4 //r.L?6,/ l,l r.tMElN(i: MECI IANICAL: F:LECTRICAL: ( TMOCCY GROUP: t l'r r _ OFFICE USE _ WATER HEATER r OF STORIES: * OF UNITS: LAND USE: s OF BLDGS: -ZONING CODE: FLOOD PLAIN: # OF BDRMS: SOUARE FOOTAGE: SECONDARY HEAT: CONSTR. TYPE: HEAT SOURCE: ouAD AREA: -sRN€r- To request an inspection, you must call 726-3769. This is a24hour recording. All 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. REOUTRED INSPECTIONS l- | Temporary EleclricII Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. f-l Site lnspection - To be madeLJ a{ter cxcavatiotr, but Prior to settin0 fornrs. Rough Electrical - Prior to Final Electrical - When all electrical work is complele.cover rl Underslab Plumbing / Electrical/ Mechanical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrical power. Final Mechanical - When all mechanical work is complete. 8,Footing - After trenches are excavated. Final Building - Wlten all Fireplace - Prior to facing materials and framing lns1r. uired inspections havL' been Masonry - Steel location, bond bearns, groutirtg. approved and builcling is completed. ffittu*'ng - Prior to cover Other f,-l,4oundation - Alter lorms are !2{ erectecl but prior to concrete' placerrrenl.Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior lo {illing trench.Drywall - Prior to taping MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After firePlace aPProval and installation of unit. Blocking and Set-Up - When all blocking is conrplete. Ftoor lnsulation - Prior to decki ng.Curbcut & Approach - A(ter 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 trenclr.Electrical Connection - When blocking, set-up, and plunrbing inspections have bocn approvcd and the lrome is connectecl to the service panel. Storm Sewer - Prior to filling Irench. Sidewalk & DrivewaY - A{ter excavation is corrtPlete, lorms arrd sub-base tllaterial in place. Water Line - Prior to filling Fence - Wher-r comPleted trench Final - After all recluired inspections are approved and porches, skirting, decks, and venting have been installed.Rough Plumbing - Prior to Slreet Trees - When all required trees are planted. L_l cover. *-b RANGE: r E fl fl r tl r fl il tl Lot faces Lot sq. ftg. Lot coverage TopographY Total height Lot Type \/ - lnterior -- Corner - Panhandle - Cul'de'sac P.L,HSE N ks 5 E GAR ACC S THE PROPOSED WORK IN THE t-?JISTORICAL DISTRICT' OR ON THE HISTORICAL REGISTER? -_--lf ycs, this application musI be signed an<j approved bY the Historical Coordinator prior to permit issuance APPFIOVED: BUILDING PERMIT ITEM SQ. FT.X $/SO. FT.VALUE Main Garase /" /4 carporr /48 -@arc2k /2s26? l/;rye,-> JZ/z'no./a./o Total Value Building Permit Fee State Surcharge Total Fee ffi540 -/6/-,s" _ 4,2! /-/4-7](A) BUTLDING 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, ancl may be suspended or revoked at any time upon violation of any provisions of said ordinances /d6.9=Plan Check Fee Date Paid Receipt Nuntber:y567 Recei By: **'ewed SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Developrnent Charge is due on all undcveloped properties within the City limits which are beirrg improved. PLUMBING ITEM Fixtures PERMIT [:EE Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home N FT. FT. FT. Plumbing Perrrtit Statc Surchargc Total Cllarqc ((, ) ADDITIONAL COMMENTS ,(nd,O a) /./zr^J- $- eAgtuO /S ru E ZX,ruA-r*/A4-d /s €Ti; ul % WtA/.?@€- MECHANICAL PERMIT Fu lnace Exhaust Hood Vent Fan No Wood Stove/ lnsert/ Fireplace Unit Dryer Vent Mechanical Permit lssuance State Surcharge Total Permit (D) By signature, I state and agree, that I have caref ully examincd the completed application and do hereby certify that all information hereon is true and correct, and I f urther certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springficld, and the Laws of the Slate of Oregon pertaining to the work dcscribcd herein, and that NO OCCUPANCY will be made of any structure without permission o{ the Building Safety Division. I further certify that only contractors and employees who are in compliance with OFIS 701.055 will be used on this proiect. I f urther agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front and tlre a pproved set of plans will rentainof the property, oa the)al/ sisnat site at tirnes during construction. U Date L MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk _-- ft Curbcut -- ft Demolition State Surcharge Total Miscellaneous Permits (E) VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT FIECEIVED FIECEIVED BY 7 TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 42-?J /Az?- 1ar'o S<-22-- *---=IrtilN(.il:lELf)qaDuqi)\ RESIDENTIAL PERMIT AI'IPLICATION lnspcr: tlottti: i :'0'3769 Ollice: Tllti'3/59 LOC^ I lOt.l (),, t,l1o[,o ASSE$SOIlS fVIAP: t 1(:1f36:j[r'(.ts. JOB NUMBEN 22li Fllllr Sttcot Sglrlrrglleld, Oregr-lrr 9/477 TAX LOT: SUBDIVISION: -_-- LOT: . ---Rl-ocr(: OWNER: --.--.lr' ADDRESS: - Cl tY: ...---- - . :19-5-L -I-Lq$bb--g- - PI-IONE: 11.t -rA A ZIP: NEW..-.--.- NEMODEI. ADDITION DEMOLIS}{ OTHER i C( DESCNIBE WOFIl(: COI TNACIOII'S NAME NDDNE$S GENEFIAL: -.- PI IONEEXPINES l3 (e€a El- EC tRlC/tL r*\[s 1rtl-l YYS 2s1qo CONST. CONTRACTOR '' PLUMBING: MEorANrcn r ' -11)l\d ["." - OFFICE USE - ]-AND USE; # OF UNITS:.-*---_--- CONSIR. TYPE:--, OUND ATIEA , OF RLDCS OCCY GIIOUI' SOUABE FOOIAGE: -- HEAT SOURCE:SECONDARY HEAT; 'y OF BDRMS: ..--. . - , OF STORIESi: ..----- \ WA[ER I lEA"l l:R: FLOOD PLAIN: ZONING CODE: RANGE: 'l'o rcituc:;t ;rrr irisJroctlon, you ,,t'rs! ca!l 72$ 3769. Iltls ls a 24 ltotrr recordlng. All lrrspecllotrs requestetl hcfcre 7:OO lr.rn. will bc rnatlc tlrc :;;rrrrr.r worklirg rlay, lnsJrer:ll<;ns rcrlueste<l afler 7:OO a.trt. wlll be mado llte followlng work day. REOIJIRED !NSPECTIONS d Flrral Plunrbing'- Wherr all plurnblng worl< ls contplele.[--l terntror iuy Eleclric Slte lnsSrecllon - To be tnade aIler exr;avalion, lrul Prlor lo sclllrl0 iurnrs. Undcrslirb Plurrrblrrgl Eleclrlcal I Mecharrical - Ptior lo cover. Foolirrg - Aller lrencltes are cxcavalr-'tl. Masonry - Sleel locallon, bond bearrrs, groullng. Found:rlion - Aftor fornts are erecle(l l)ut prlor lo concrele placelrrcnl. Unttcrground Plumblng - frrlor lo lillllrg lrenclr. Unclerlloor Plttrrrblngl Mochattlcal - l'rlor lo lnsulali<lrt or docklng. Posl arrtl Boanr - Prlor lo lloor lnstrlalion ot <lcckltrg. Floor lrrsulallorr - Prlor lo decklrtg. Sarrllary Sewer - Prlor to lilllrtg lren(:lt. Slorrrr Sower - Prlor lo lllllttg lr enclr. Waler Llrte - Prlor lo fllllttg lrench. gh Mechanical - Prlor lo cover. Rorrgh Eleclrlcal - Prlor lo cover. Eleclrlcal Servlce - Musl be approved !o obtaln Perrnanent eler:trlcal powcr. Flroplace - Pllor lo laclrrg rrralerlals and lratnlng lttsp. Framlng - l)rlor lo cover. WalllCelllnO Insulallon - Prlor to cover. Drywall - Prlor to taplng. Wood Slove - Aller lnstallallon. lnserl - Allcr llreplaco aplrroval anrl lnstallallon ol unlt. Curbcul & Approach - Aller lorrrrs are orr,.cled bul ;rrlor lo placemenl ol concrete. Sklewalk & Drlveway - Allc,r excavatlon ls corrr;rlole, lorrrts an<l sub.base ,natorlal lrr place. | ---l Ferrce - Wlterr cotnPleterl. Slreel Trees - Wlten all requlred lrees are gllanled. Flnal Eleclrlcal - When all electrlcal wotl< ls cotnl>lcte. al Mechanlcal - Wlrcn all rnecltanlcal work ls cortpletc. Flnal Bulldlrrg - Wlterr all re<lulred lns;rccllons lrave been approved and bull<!lrrg ls cornplele(1. Olhcr --- MOBILE HOME INSPECTIONS l:] E l:l l:] l-_l Blocklng and Sel.Up - When alllJ blocklng ls complolc. ' lt, Plunrblng Corutecllorrs - Wherr hotne has beerr corrneclcd lo walor and sowcr. Eleclrlcal Corrnecllon - Wlrorr blor:l<lng, sol-ulr, anrl lrlurrrblrrglns;rocllons lrave bocn apJrrovr:tl an<J llre trorno ls conrroclcd lo tlre servlcc panel. Fhral - After all rerlulrcd Irrspecllons uro approvcd antl porchos, sklrtlng, decks, anrt ventlng have been lnstallcd. llough l'lurnbhtg - Prlor lo cover. tl 5 tl r_1 r tl t_l Lol l;tces Lol s(1. ,lg. Lot covolaoo Topograplry Tolal helght Lot Ty -..--- lttlorlor _--_ Cortror - Panhandle -- Cul-de"sac Seltracks IJSE ACC ts l l tE t,ftoPostD woBl( lll l llt: I illil()HtcAL l)t{-iTfilcT, on otl I I tE I ilS IORICAL nEGIS lCn? .--... -.-. _ ll yr:o, lltls aplllloallorr otttsl lrt.l ril0n(l(l :rn<l allproved by lltc l-lislollcal C<)ordirrator pri()r lo peilltil lssuance. APPROVEO: i PL, _N_ S w E BUILDING VALUE, PLAN CHECI( AND BUILDING PERMIT Tlrls permlt ls granted on llte express condillorl tltat llte said construclion shall, in all respecls, conlorm lo tlre Ortlinltnce aclopted by tlrc City ol Springllclcl, int;ltrtlitrg tlle Doveloprnenl Corle, regulating llte constructiott atrcl use ol buildlngs, an<J nray lte suspenderl or levoketl al any lillle upon vlolatlon o( any provisiotts ol said orrlirtances. Plan Clrock Foo: --,--.-.--- Recelpl Nurnber:--. [);r lcPlans Fcvlewr:tl By Date Pald Rocelve<l By: VALUE (A) x $/so. FT. Tolal Value Bulldlng Permll Fes Sl:rk.l Sttrclt:tr1;e lbtal Fec BUILDING PERMIT ITEM SO. FT. Main Garage , Carport Syslerlrs Dcvclolltttt.'rtl Clrar'1;e is <lttc on all trrlrlcvclollctl 1:roperlies willtill llrc City litrtits wlticlr ate bctrtg llllllrove(l'SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTSPLUMBING PERMIT Nc FEE FT. FT.til FT. (c) Plumblng Permll Slale Surcltargo Tolal Charge ITEM Flxlures flesldonllal Balh(s) Sanltaly Sewer Waler Storm Sewer'1 Mobile Homo Woo<J Slovo/ lnsert/Flreplace Unlt Dryer Vent MECHANICAL PEBMIT () <-) (D) No Meclranlcal Permll lssuance Slale Surcharge Tolal Permlt Furnace Exhausl l{ood Venl Fan By slgnature, I sl:rte atrd agree, llral I ltavc careltrlly exatnined llreconrpletetlapl;licatlonancldolrerebyccltilytlratall lnformallon ltcrr;on ls lt'rro and corlecl, and I lrrrllrr:r cerlily thalanyan<.lallworkpcrlortnt,dslrallbr:dorrcina(;()ol(lallc(] wlth the Orclinances ol the City ol Sprin0lield' 'rrr(l llle Laws ol the State of Otcgotr pertainlng to the w()rl( dcscribecl Irereln, ancl tltat NO OCCUPANCY will be ttradr: ol any structule witlrout pertt-rissiotr ol tlre Builrling Salely Division' I Jurtlrer certlty that ollly colltractors ancl ctrtployecs wlto are ln colnpllar]ce witll ORS 7O'1 055 wlll be trse<l on lhis prolect. I lurther agree lo ensrlre tllat all required lnsl:ections are requestc(l at tlle proper tlme, thal eaclt adclress is readable lrom the street, lhat the permit card ls localr:<l al tlte llonl of the property, and lhe approvecl set oI planli will re tlraln Slgnatttrtl 1Dalo )B {_: on tlte slle at all t es <Jurltrg construcllon MISCELLANEOUS PERMITS Mobilo Home Slale lssuance Slalo 6urcharge Sl<lewalk ---.- ll Culbcul - lt Dotnollllotr Slalo Surclraroo Toral Mlscellaneous Pertnlls (E) 'qr) D __. EIVE D VALIDAI'tON: TIECEIPT NUMI]EI.I DATE PAI AMOUNT RECEIVEITOTAL AMOUNT DUE (exclucllng electrlcal) (A, B, C, Q anc| E Comblned) -- I CITY OF OFEGO'V SPRINGFIELD . , , ... f ilqulre sPeciric land :s r N -to -1"L .'--..' t; \::i..,r.,;a 1 OF 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 EIect cal Contractor Address ci e Supervisor Li r Expiration Dat Constr Con Expirat S an 0vners Nr Address City ! OSNER The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. 0vners Signature: DATB: EIJCTRICAL PERHIT APPLICATION City Job Number COHPLETB PEE SCEBDTILE BBLOS Nev Residential-Single or MuIti-Family per dvelling unit. Service Included: Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or -Modular DvelIing Service or Feeder $ 8s.00 $ 1s.00 s 40.00 LL*225 YTFIE STRBET SPRTNGPIEID, OREGoN 97477 INSPBCTION RBQUBST: 726-3769 OPFICE: 726-3759 A B. Services or FeedersInstallation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps_ 0ver 1000 amps/volts Reconnect Only Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 40.00 201 amps to 400 amps - $ 55.00 over 401 to 600 amps - $ s0.00 Over 600 amps or 1000ftTts see uB" affi Sum $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 c B. Miscellaneous (Service/feeder not included) Br anbh Circuits , Alteration or Extension Per Panel STIBTOTAL OP ABOVE 5Z State Surcharge TOTAL One Circuit $ 35.00 Each Additional Circuit or vith Servicea or Feeder Permit _fl $ 2.00 -Each installation Pump or irrigation Sign/OutIine Lighting- Limited Energy/Res Limited Energy/Comm # $ s .00 .00 .00 .00 40 40 20 of Supervlsing Blect Number Date RBCEIVBD 5 36 Aie 225 FIFTTI STRBEf, SPRINGFIELD, OREGON 97477 INSPEGTION REQUBSTz 726-3769 OFPICE: 726-3759 ELECTRICAL PERHIT APPLICATION . .. .. ir.-,r.;.: ...;-:!_\:l.jljtinf 1. LOCATION OT JOB f Permits are non-transferable and expireif vork is not started within 180 days of issuance or if vork is suspended for 180 days. 2. COI|TRACTOR INSTALITTION ONLY Electrical Contractor Address ci Phone Supervisor License Number Expiration Date Constr Contr. Number iration Date q)0 -_.COHPLETE FEE SCTIEDULE BELOV Nev Residential-Single or ily per dvelling unit. Service Included: I tems Cos t 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf 'd llome or Modular Dvelling Service or Feeder $ Bs.oo s 40.00 Services or Feeders Installation, Alterations or Relocation: VJ'irr. r:'tt(j "t'citY Job Number l Sum s 1s.00 B 200 amps or less i 201 amps to 400 amps _ 401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect Only <o oo not included) 40. 00 40. oo 20. o0 $ s0.00 $ 60.00 $100.00 $130.00 s300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation Exp Signature of Supervising Blectrician 200 amps or less $ 40.00 201 amps to /r00 amps _ $ 55.00 over 401 to 600 amps _ $ 80.00 Over 600 amps or 1000 volts see nBil above Owners Name Address 1 QL.1 TL,.,,t.rx^ I clry <--r,*cl Phone ') LIL'<a+l T OSNER INSTALI,ATION The installatlon is being made on property I own vhich is not intended for sa1e, Iease or rent. ture: rn:- rolr.\\qr RECEIPT *: D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Aclditional Circui t or vi th Service or Feeder Permit /O S 2.00 2COe E Miscellaneous ( Service/feeder -Each installation Pump or irrigation $ Sign/outline Lighting- S Limi ted Energy/Res $ Limited Energy/Comm S STETOTAL OII ABOVB 5Z State Surcharge TOTAL RECEIVED BY: 5 13.sO IAGAL DESCRIPTION i1 c') trL-l n oo-)oo ,I Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registratioi underORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: Permit No:q )ou1 0 Address: lssued by CIs Date 'llBb R OFFIGE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONS!BILITIES I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. My general contractor is , Contractor registration number-. WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 1 2 3 OR A I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the construction contractors Board. 3.8 I will be my own general contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understandthe lnlormation Notice to Property Owners about Construction Responsibilities on thereverse side of this form. ,0- t3_qtgnaturemt Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8t91 .fl rr NOTE: This lnformation Notice to Property Owners About Construction Flesponsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature INFOhilATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES lf you are acting as your own contractor to construct a new home or make a substantial impfoVerTient to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contractors Qgard to do labor in constructing or assisting in the construction or improvement ol a residential structure, you will, in most instances, be ruled to be an "employer" and the peopie you hire will be "employees". As the employer, you must comply with the following: Oregon's Withhotding Tax Law: As an employer, you must withhold income taxes from employee wages at uwitlbeliableforthetaxpaymentsevenifyoudon'tactuallywithholdthe tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390. Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance mployees'Formoreinformation,calltheoregonEmploymentDivisionDHR at 378-3224. Workers' Compensation lnsurance: As an employer, you are subject to the Oregon Workers' Compensation pensationinsuranceforyouremployees'lfyoufailtoobtainworkerS, compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. ymentevenifyoudidn'tactuallywithholdthetax.Formoreinformation,call the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AHEAS OF CONCERN: Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections and lnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and om SU ch as falling tools, paint overspray, water damage from pipe punc- tures, fire, or work that must be re-done. Time to Supervise Employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work ol rough-tn and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. lf you have additional questions, write to Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 o24N 10124189 ST'RINGFIEL(} RESIDENTIAL PERMIT APPLICATION lnspcctiotrs;: / 26-3769 Ollice: 72.6-3749 uo, NUMBE ^ 2-ob7d 225 Filth Stre(]t Springlield, Oregon 97 477 LOCAIION Ol l'tlOPtJSt-D WOfIK: -.- ASSESSoRS MAP:- /1O2- ??a7 frunsTa,J_,(a__ 3G Le-TAX LOT:Z-q-O_- LOT: - -- -BLOCK: -SUBDIVISION:*----- OWNER: -,., ADDRtrSS: CITY: ----- - EANbt-AaceLLL PHONE ;Ar'?e; -6rH STAT[--: - .)a .'r,-?2474 DESCRIBE WORK: ..-.AN-|AAry,(atu- t' arKffiE--- NEW -_ REMODEL - - ADDITION DEMOLISH OTHEFI CONTRACTOIT'S NAMF,ADDIIESS CONST. CONTBACTOFI l/EXPI RES PHONE GENERAL: -- PLUMBING:/gD: /aaue. jo-D @hsr/4- E44- 4,aBF7" - -5444 - 6A7=47t7 MFCI.IANICAL. ..- ELECTRICAL _ OFFICE USE _ OUAD AREA:LAND USE: / OF UNITS:- - -.-- CONSTR. TYPE: ,., FLOOD PLAIN: ZONING CODE: --# OF BDRMS: .---- SECONDARY HEAT: SOUARE FOOTAGE: - , OF BLDC;S, -- OCCY GN()UP; , oF sToFilEt;. _ __ WATER HEATER: - HENT SOURCE RANGE: To rcqucst an inspection, you must call 726-3769. This is a24 nour recording. All inspections requested before 7:00 a.m. will tre macle ttle'sarrre workirrg day, inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS Temporary Electric E Rough Mechanical - Prior to cover. ffi finat Plumbing - When allHplurrrbin0 worl( is conrplcte. Site lnspection - To be tnade af ter ext:avation, but prior to settirrg lorrtrs.&;*t Electrical - Prior to 5[Final Elecllical - When all electrical work is conrl)lete. K U:*:: :, uo-pffi,,:, ::,J:; ",,Electrical Service - Must be approved to obtain permanent electrical power. f/ finat Mechanical - Wlren all .Hrnechanical work is cornl)lete. -Vf finat Building - When all frrequired inspections havc becrr approved and builcling is cornpleted. Footing - Afler trenches are excavat()d.Fireplace - Prior lo facing materials and framing lnsp. Masonry - Str:cl locatiort, bond bearrrs, grouting. ffi t'o'*t.tg - Prior to cover' Olher - Foundation - Af tcr forrns are erectL'(l l)ut prior to concrete placenr{:rl l. Wall/Ceiling lnsul;ttion - Prior to cover. Underglound Pltrnrbing - Prior to Iilliri1.l trenclr.,ffiot'*ull - Prior to taping' MOBILE HOME INSPECTIONS Underlloor Plurnbing/ Mechanical - [r1i111 to insulation or tlet;king.Wood Stove - Af ter installation Posl an(l Beanr - Prlor to lloor insulitti()n or dc<;kit'tg.lnserl - Aftr.lr fireplace approval and installation of unit. Blocking and Set-Up - Whcn all blocking is cornplcte. Floor lnsulaliorr - Prior to decki ng.Curbcut & Approach - After forrns are erected l-:ut prior to placement of concrete. Plunrbing Connectior-rs - Wlterr Itome lras been conneoted tc) wate r and scwer. Sanitary Sewer - Prior to fillirrg trenc h.Eleclrical Connection - Whcn blocl<ing, set-Lr[), anrl plurnbing inspections lrave been .rl)provil(i and the horne is conne'cted to the service panel. Sidewalk & Driveway - After excavation is conrlllete, forms and sub-base nraterial in place. Water Line - Prior lo fillirrg trench.[l Fence - When cornpleted Slreet Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, ancl venting have been installe(j. t__l Rough Plumbing - Prior to fl r r] I tl Slorrn Sewer - Prior to lilling trench. r r Lot faces Lot sq. ftg. Lot coverage TopograPhY Total height Lot Type \v - lnterior ---- Corner -- Panhandle -_ Cul'de-sac Setbac HSE GAR ACC N S E IS THE PROPOSED WORK IN THE -HISTORICAL DISTRICT, OFI ON THE HISTORICAL FIEGISTER? - lf ycs, tlris appllcatlorr nlust l)c slgnccl and apProvecl bY the llistorical CoorcJinator prior to permit issuance' APPROVED 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, regulaling the conslruclion ancl use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances' Plan Check Fee: -=- Receipt Number:-- ,. Plans Reviewed BY Date Paid Received z#= VALUE (A) BUILDING PERMIT Total Value Building Permit Fee State Surcharge Total Fee SQ, FT. X $/SO. FT.ITEM Main Garage Carport Systems Developnrent Charge is due on all unclevcloped properties within the City limits which are being itnproved'SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtu res Ftesidential Bath(s) SanitarY Sewer Water Storm Sewer Mobile Home PLUMBING PERMIT _472f N0 FT. FT. (c) c-o2 4 5:'_?:z FEE Plumbing Permit State Surcharge Total Charge Wooci Stove/ lnsert/ Fireplace Unit Dryer Vctrt MECHANICAL PERMIT N0 Mechanical Permit oo 75 (D) 7s Issuance State Surcharge Total Permit Furnace Exhaust Hood Vent Fan By slgnature, I state an<J agree, that I have caref ully examined the completed application and do hereby certify that all lnformationhereonistrueandcorrect,andlftrrllrr:r'ccrtify that any antl all work performed shall be done itr ac<;<'rrdance with the Ordinances of the City of Springfielcl, an(l llre Laws ofthcstateofOrcgonpertalningtotlrc*t)1111161;6tillr''tl herein, and that NO OCCUPANCY will bo tttadc of any structure without permission of the Building Safety Division I f urther certify thal only contractors and ernl;loyees who are in 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 permit card is located at the front s will remain the gnat Date MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk ---- ft Curbcut -.--- (t Demolition State Surcharge Total Miscellaneous Permits (E) RECETPT NUMBER -52-/-3 VALIDATION doDATE PAID AMOUNT FIECEIVED RECEIVED BYTOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) ryAAO/-z P.l . ;,{877--,a-;-__ FI. Z.50 oo -U!il--I td oo / Jt of the property, and the approved set of