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Home My WebLink AboutPermit Building 1995-05-01SPRI}.GFIELE,RESIDENTIAL PERMIT APPLICATION lnspectlons: 726-3769 Office: 726.3759 JOB NUMBER 225 Fif th Street Sprlngfleld, Oregon g7 477 LOCATION OF PROPOSED WOBK: ASSESSOBS MAP:TAX LOI LOT: - BLOCK:SUBDIVISION PHONE: ztPSTATE: OWNER: ADDRESS: CITY: NEW - BEMODEL ADDITION DEMOLISH OTHER DESCRIBE WORK: ADDRESS EXPIRES PHONE CONST. CONTRACTOR #CONTRACTOB'S NAME GENERAL: PLUMBING: MECHANICAL: ELECTRICAL: r OF BDRMS: - OFF]CE USE - FLOOD PLAIN QUAD AREA: r OF BLDGS: SECONDABY HEAT SQUARE FOOTAGE: OCCY GROUP: I OF STOFIIES: CONSTR. TYPE: HEAT SOURCE: LAND USE: WATER HEAi|'ER: _ , OF UNITS: - ZONING CODE: - To request an lnspectlon, you must call , made the same worklng day, lnspectlon 726'3769' Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll bes requested after 7:00 a.m. wlll be made the followlng work day. REOUIRED TNSPECTIONS Temporary Electrlc Rough Mechanlcal - prlor to cover.Flnal Plumbing - When allplumblng work ls complete. Slte lnspectlon - To be madsafter excavatlon, but prlor tosettlng forms. m Rough Eleclrlcal - prlor to w Flnal Eleclrical - When ailelectrlcal work is complete. cover. [-l Underslab plumblng/ Electrical/ - Mechanlcal - prlor to cover,Electrlcal Servlce - Must beapproved to obtaln permanent olectrlcal power. [-_l finat Mechanlcal - When ail - mechanical work ls complele. Footlng - After trenches are excavated,fff Flnal Buitdtng - When ail 1- requlred lnspectlons have beenapproved and bulldlng lscompleted.[-l Masonry - Steet tocatton, bondu beams, groutlng. Flreplace - Prlor to faclng materlals and framlng Insp. [-_l Framlng - prtor to cover. Foundatlon - After forms are erected but prlor to concreteplacement. Othsr Wall/Celllng lnsutatlon - prlor to cover. E l'Jfliffi!"i.3l"ln'."olns - Prior *f orvwan - prror to tapins. Underfloor Plumblng/ Mechanlcal - Prlor to, lnsulatlon or decklng. Post bnd Boam - Prlor to floorlnsulatlon or decklng. MOBILE HOME INSPE TIONS Wood Stovo - After lnstallatlon l--l lnsert - After flreplace approval - and lnstallatlon of unlt. Blocklng and Sel.Up - When ailblocklng ls complete. Ftoor lnsulallon 4 Prlor to decklng.Curbcut & Approach - After forms are erected but prlor toplacoment of concrete. PJumbing Connectlons - Whenhome has been connected towater and sewer. Sanitary Sewer - Prlor to fllling trench. n Storm Sewer - prior to fiillng - trench. Sldewalk & Drlveway - Afterexcavation ls complete, forms and sub.base material ln place. Fence - When completed. Electrlcal Connection - Whenblocking, set-up, and plumblng Inspections have been approvedand the home ls connected tothe servlce panel,E E Water Llne - Prlor to fllling trench. Final - After all requiredinspections are approved andporches, sklrting, decks, andventing have been lnstalled. Rough Plumbing - Prior to cover.Streel Trees - When all requlred trees are planted. D )q> : ,i f;? ::;I1r Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot T - lnterlor -- Corner - Panhandle - Cul-de-sac ks IS THE PROPOSED WORK TN THE - HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, thls applicailon must be slgnedand approved by the Historlcal Coordinator prlor to permlt issuance. APPROVED: PL.HSE GAR ACC N S E VALUE 2t //(A) X $/SQ. FT. " ?eztz2 e- re4F Main Carport Garage Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SO. FT, BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permit is granted on the expre6s condiUon that the saidconstruction shall, ln all respects, conform to the Ordlnanceadopted by the City of Springftetd, inctudtng theDevelopment Code, regulating the construcilon and use ofbulldings, and may be suspended or revoked at any tlmeupon violation of any provisions of said oldlnances. Plans Beviewed By Date Plan Check Fee: Date Pald: Receipt Num Flecelved By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Developmcnt Charge is due on all undeveloped propertles wlthln ilre City limits which are being lmproved. ITEM Fixtures Residential Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home FEE (c) FT. N0 FT. PLUMBING PERMIT Plumblng Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fl replace Unlt Dryer Vent MECHANICAL PERMIT (D) N0 Mechanical Permit lssuance State Surcharge Total Permlt Fu rnace Exhaust Hood Vent Fan By slgnature, I state and agree, that I have carefully examlnedthe completed appllcailon and do hereby cerilfy that alllnformatlon hereon ls true and co!.rect, and I lurther cerilfy that any and all work performed shall be done in accordance wlth the Ordinances of the Clty of Sprlngf ield, and the Lawsof the State of Oregon pertalnlng to the work descrlbed hereln, and that NO OCCUPANCy wlil be made of any structure wlthout permission of the Bulldlng Safety Dlvlslon. I further certlfy that only contractors and employees who are ln compllance wlth OBS 701.055 wlll be used on thls prolect. I further agree to ensuro that all regulred lnspections are requested at the proper ilme, that each address ls readable from the street, that the permlt card ls located at the front rl cons Slgnatu Date of the property, and the roved set of plans wlll remaln on the slte at all time MISCELLANEOUS PERMTTS Moblle,Home State lssuance State Surcharge Sldewalk - ft Curbcut - ft Demolltlon State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excludlng electrical) (A, B, C, D, and E Comblned) DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER FT. RESIDENTIAL PERMIT APPLICATION lnspections: 726.3769 Qflice: 726-3759 I \ LOCATION OF PROPOSED WORK: SPrlIN IELD JOB NUMBER 225 Fif th Street Springflelcl, Oregon 91 427 ASSESSORS MAP:TAX LOT: LOT: - BLOCK:_SUBDIVISION: -.- PHONE: ZIP:STATE: OWNER: ADDRESS: CITY: NEW -- FIEMODEL ADDITION DEMOLISH OTHEB DESCRIBE WOR}(: ADDRESS EXPIBES PHONE PLUMBIN CONTRACTOR'S NAME GENERAL: MECHANICAL ELECTRICAL: CONST. CONTBACTOR ' - OFFICE USE - WATER HEATER; LAND USE; FLooD PLAIN QUAD ABEA: r OF BLDGS: SECONDARY HEAT: SQUARE FOOTAGE: , OF BDRMS: FIANGE: OCCY GROUP: r OF STORIES: CONSTR. TYPE: HEAT SOUBCE: # OF UNITS:ZONING CODE: _ To request an inspection made lhe sante worklng ' you musl call 726-3769' Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll beday, lnspections requested after 7:00 a.m, wilr be made the foilowrng work day, REQUIRED TNSPECTIONS l-_l Tornporary Etecrric Rough Mechanlcal - prlor to cover.lfl rinat ptumbtng - When ailt<+-J plumblng worl( ls complote, Slto lnspection - To be madoalter excavatlon, but prior tosottlng forrns. Rough Eleclrlcal - prlor to Final Electrlcal - When altelectrical work ls complete, cover, Underslab Plumblng / Electrical /Mechanlcal - Prlor to cover.Eloctrlcal Servlce - Must beapproved to obtaln permanent eleclrlcal power. Flnal Mechanlcal - When allmechanlcal work ls complete. Footlng - Af ter trenches are excavated. [-l Flreptace - prtor to factng - materlals and framlng lnsp. [-_l framlng - prlor to cover. Flnal Buildlng - When altrequlred lnspectlons have beenapproved and bulldlng lscompleted.Masonry - Steel locailon, boncl beams, groutlng. Foundatlon - After forms areerected but prior lo concreteplacoment. Othor Wall/Colling lnsulatlon - prlor to cover. [-l UnOerground plumbing - prior.+ lo lllllng trench.Drywall - Prlor to taplng Underlloor Plumblng/ Mechanlcal - Prlor to lnsulallon or decklng. MOBILE HOME INSPECTIONS Wood Stovo - Altor lnstallatlon. Posl and Boarry.- prlor to floorlnsulatlon or decklng.lnserl - After flreplace approvql and lnstallatlon of unlt. [--l Alocking and Sot.Up - When ail - blocklng ls complete. Floor lnsulatlon - prlor to decl<lng.Curbcut & Approach - Afterforms are erected but prior loplacemont of concrcte. Plumtring Connoctlons - Whenhome lras been connected towater and sewer.Sanltary Sewer - prior to filling t rench. Storm Sewer - Prior to lllllng trench. Sldewalk & Drlvewav - Af terexcavatlon ls complete, forms and sub.base materlal ln place. Electrical Connoction - Whenblocking, set.up, and plumblng tnspectlons have been approvedand the home is connected tothe servlce panel. Water Llno - Prlor to filling trench, Fence - When completed Rough Plurnbing - prlor to cover.w I--| Stroet Troes - When all requtred - trees are planted. E [-l f inat - Af ter ail required.J inspectlons are approved andporchos, sklrtlng, decks, andventlng have been lnstalled. . Lot {aces Lot sq. ftg. Lot coverage Topography Total helght Lot Type .- , - lnterior - Corner _- Panhandle - Cul-de-sac Set bac ks P.L.HSE GAR ACC N S E I'-S THE PROPOSED WORK IN THE HISIORICAL DISTFIICT, OR ON THE HISTORICAL REGISTER? - lf yes, thls applicatlon must be slgned and approved by the Historical Coordinator prior to permit issuance. APPROVED: VALUE l (A) X $/SO, FT, Main Carport Garage Total Value Building Qermit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SO. FT. BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permlt is granted on the cxprcss cor']ciition that the said construCtlon shall, ln all respects, conforrr to tire Ordinance adopted by thc City of Springficlct , including the Development Codc, regulating the co4struction and use of bulldings, and may be suspended or revol<cd at any time upon violation of any provisions of saici ordinances, DatePlans Rcviewed Li, --- ------ Plan Check Fee: Date Pald Recelpt Numbcr:-__... Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge ls due on all undeveloped propertles withln tlre City linrlts which are being lmproved. FEE?* F3 (c) N0 FT. 22-4 PLUMBING PERMIT Plumblng Permlt State Surcharge Total Charge /t elp " ^4oz/@ Sanltary Sower Water Slorm Sewer Moblle Home ITEM Flx tu res Flesldentlal Bath(s) ADDITIONAL COMMENTS MECHANICAL PERMIT Fu rnaco Exhaust Hood Vent Fan No -Wood Stove/ lnserl/ Flreplace Unlt Dryer Vent (D) Mechanical Permit lssuanco State Surcharge Total Permlt By slgnature, I state and agree, that I have caref ully examlned the completed application and do hereby certlfy that all lnformatlon hereon is true arrcl correct, and I f urther cerilfy that any and all work performed shall be done in accordance wlth the Ordinances of tlie Clty of Sprtngf ield, and the Laws of the State of Oregon pertalnlng to thc worl( described hereln, and that NO OCCUPANCy will be macJe of any structure wlthout perrnission of the Bullding Safety Dlvislon, I further certlfy that only contractors and employees who are In compllance wtth ORS 701.055 wlll be used on thls p rolec t. lfurther agree to ensure that all requlred lnspections are requested at the proper tlme, that each acJdress ls readable from tho street, that the permlt card ls located at the front I of the property,and the a pproved set of plans will remain atu on the slte at all ti con st ru c Slgn Date MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcut (t Demolitlon State Surcharge TOTAL AMOUNT DUE (excluding electrtcat) (A, B, C, D, and E Comblned) 3 :2?-2r€eDATE PAID AMOUNT FIECEIVED BECEIVED BY VALIDATION: FIECEIPT NUMBER C FT. FT, Total Mlscellaneous Permits (E) Permit #: Address: Issued by:Date Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exemptfrom registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 34 or 38: tr 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. F 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify thatthe above informationis correctand thatl have read and do understand thelnformation about on the reverse side of this form. of permit applicant) OR Notice to (Date) (White copy to issuing agency pennitfile, pink copy to applicant) CITY OF OREGON 225 FIFTE STREET SPRTNGFTELD, OREGoN 97 INSPECTTION REQUEST: 7 rl) OFFICE: 726-3759 &nncnre'l stsnature, SPFlIP..-IELD SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL The foilcwing prciect ss submitted has the lollowing zoning anci-dooanot requiro specific land use I,EGAI DESCRTPTION DESGRIPTION Permits are non-transferable and expire if vork is not started vithin 1B0 days of issuance or if vork is suspended for 180 days. 2. COIITRACTOR INSTALI..ATION ONLY ELectricaf Contractor Address city- Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Ovners Name Address BTE TRICAL PERHTT APPLTCATION Nn Ci ty Job Number 3. COHPTETE FEE SCEEDUrc BELOS A New Residential-Single or MuIti-Family per dvelling unit. Service Included:Items Cost L000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular Dvelling Service or Feeder s 8s.00 s 1s.00 s 40.00 B Services or Feeders Installation, Alterations or Relocation: h*,xw Sum 200 amps or less 20L amps to 400 amps -40L amps to 600 amps _601 amps to 1000 amps_ Over 1000 amps/volts Reconnect 0n1y Temporary Services or Feeders fnstallation, Alteration or Relocation 200 amps"or less S 40.00 201 amps to 400 amps - $ 55.00 over 401 to 600 amps - $ 80.00 Over 600 amps or 1000 vofts see rtStt "fifr[ s s0.00 s 60.00 s1oo.00 $130.00 s300.00 s 40.00 The install-ation is being made on property I ovn vhich is not intended for sa1e, Iease or rent. Ovners Si C D. Branch Circuits Nev, Alteration or Extension Per Panel one circuit / $ 35.00 <f,* Each Additional # Circuit or vith Serviceor Feeder Permi t / $ 2.00 ?. 4 E. Miscellaneous (Service/feeder not included) -Each ins tall-ation Pump or irrigation $Sign/0utIine Lighting- SLimited Energy/Res - SLimited Energy/Comm - $ "" fua.i#;Y*?/v47> OVNER TNSTAIT.ATION 40.00 40. 00 20.00 36.00 5 RECEIYED B ture: AT 1. LOCATTON OP INSTAII,ATIONar- * /HZb*\ tir- t apProval IELE, RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 Zfr, JoBNUMBE"@ 225 Fif th Street Springfleld, Oregon 97 477 LOCATION OF PROPOSED WOFTK: ASSESSORS MAP:e BLOCK: TAX LOT: LOT:SUBDIVISION PHONE: STATE:CITY: ADDRESS: OWNER: *?ffPW REMONEW ADDITION DEMOLISH OTHER ADDBESS EXPIRES PHONECONTRACTOR'S NAME MECHANICAL: ELECTRICAL: PLUMBING: GENERAL: CONST. CONTRACTOR # , OF BDRMS: - OFFICE USE - WATER HEATEB: ZONING CODE: FLOOD PLAIN:OUAD AREA: r OF BLDGS: SECONDABY HEAT: SQUARE FOOTAGE: LAND USE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll bemade the same worklng day, lnspections requested after 7:00 a.m. wlll be made the following work day. REOUIRED INSPECTIONS l--l Temporary Electrlc Rough Mechanlcal - Prior to cover. Slte lnspectlon - To be made after excavation, but prlor to settlng forms. Rough Electrlcal - Prior to Flnal Electrical - When all electrical work is complete.cover_ Underslab Plumblng/ Electrical / Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be approved to obtaln permanent olectrlcal power. W Final Mechanical - When all mechanical work ls complete. Footlng - After trenches are excavated.Flreplace - Prlor to faclng materlals and framlng lnsp. Final Building - When ail required lnspections have been approved and building is completed.Masonry - Steel locatlon, bond beams, groutlng.Framlng - Prlor to cover.WorherfuFoundallon - After forms are erected but prlor to concrete placement.Wall/Celling lnsulatlon - Prlor to cover. Underground Plumblng - Prior to fllllng trench.Drywall - Prlor to taping MOBILE HOME INSPECTIONSUnderlloor Plumblng / Mechanlcal - Prlor to lnsulatlon or decklng.Wood Stove - After lnstallatlon Post and Beam - Prlor to floor lnsulatlon or decklng.lnsert - After flreplace approvql and lnstallatlon of unlt. Blocking and Set.Up - When att blocking ls complete. Floor lnsulatlon * Prlor to decklng.Curbcut & Approach - After forms are erected but prlor to placement of concrete. PJumbing Connections - When home has been connected to water and sewer. Sanltary 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 - Prlor to filllng trench. Sidewalk & Drlveway - After excavation ls completc, forms and sub-base materlal ln place. Water Llne - Prlor to filling trench.[--l Fence - When completed Str€€t Trees - When all required trees are planted. Rough Plumblng - Prior to cover. 4T zre, 72{)> RANGE: [-_l Final Plumbing - When ailtJ plumbing worl< is complete. E r tl E [--l Final - After all requiredtJ inspections are approved and porches, skirting, decks, and ventlng have been installed. P.L.HSE GAR ACC N S E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Typ \-/ - lnterior - Corner - Panhandle - Cul-de-sac IS THE PROPOSED WOBK IN THE . HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this applicatlon must be slgned and approved by the Historical Coordinator prlor to permit issuance. APPROVED: VALUE (A) x $/so. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SO. FT. Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the expreos condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfietd, inctuding the Development Code, regulating the construction and use of buildings, and may be suspended gr revoked at any time upon violation of any provisions of sald ordinances. Plans Reviewed By Date Received By: Plan Check Fee: Date Paid: Receipt Nu SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) No FT. Plumblng Permit State Surcharge Total Charge PLUMBING PERMIT ITEM Fix t u res Wood Stove/ lnsert/Flreplace Unit Dryer Vent (D) @ aG, 26,>e N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit €a,zrrrn €rJ MECHANICAL PERMIT Furnace Exhaust Hood By slgnature, I state and agree, that I have carefully examlned the completed applicatlon and do hereby certlfy that all lnformatlon hereon is true and correct, and I f urther certlfy that any and all work performed shall be done in accordance with the Ordinances of the City of Sprlngfield, and the Laws of the State of Oregon pertainlng to the work descrlbed herein, and that NO OCCUPANCy will be made of any structure without permission of the Bullding Safety Divislon. I further certity that only contractors and employees who are ln compliance with ORS 701.0S5 wlll be used on thls project. I further agree to ensure that all required inspections are requested at the proper tlme, that each address ls readable from the street, that the permlt card ls located at the front on th e site at all times du Signatu Date of the property, and the a set of plans will remain structlon MISCELLANEOUS PERMITS Mobile,Home State lssuance State Surcharge Sidewalk - ft Curbcut -_ ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT OUE (excluding electricat) (A, B, C, D, and E Combined) 2e a BECEIPT NUMB f^ tu-DATE PAID AMOUNT RECEIVED RECEIVED BY FT- FT- ADDTTIONAL COMMENTS VALIDATION: Permit #: Address: Issued Da,rlt 1-9.f Statemeht: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exemptfrom registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 3,{ or 3B: B l. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (Narne) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. ts 38. I will be my own general contractor If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this huilding permit of the name of the contractor. I hereby certify thatthe information is correct and that I have read and do understand the Information about Construction Responsibilities on the reverse side of this form. permit applicant) (White copy to issuing agency pennit file, pink copy to applicant) I OR Notice to Property (Date) T 71{