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Home My WebLink AboutPermit Building 1992-07-09SPR IE,LI)l RESIDENTIAL PERMIT APPLICATION lnspections:726'3769 Office: 720'3759 /? ?fr, JOB NUMBER 225 Fifth Street Springf ield, Oregon 97477 LOCATION OF PROPOSED WORK:=,. -FcanrIs r-l 2& ASSESSORS MAP .o1 ,a7'3 ,lEb TAX LOT: BLOCK:SUBDIVISION OWNER:(at -tr q &=.*612G,*3 "7 ADDRESS ;, zlPSrArE: --49= -CI]'Y: _a?G;PHONE W /AfttNDESCNIBE WORK: ADDITION DEMOLISH OTHERNEW -X,- REMoDEL -- - ' PLUMBING: -,, MECHANICAL: EXPIRES PHONEADDRESSCONTRACTOR'S NAME ELECTRICAL: CONST. CONTRACTOR # reil^__ n.or.or* ce, Er=r Lfu< RANGE: I WATET1 HEATEFI "'ff (T - FLOOD PLAIN ZONING CODE: # OF BDRMS OUAD AREA: CONSTR. TYPE * OF UNITS: 'LAND USE: SECONDARY HEAT: SQUARE FOOTAGE: r OF BLDGS: - OCCY GFIOUP: I OF STOBIES: To request an inspection, you must call 726-376g. This is a24nour recording. All inspections requested before 7:00 a.m. will be macle the same worl<ing day, ilspections requested after 7:00 a.m. will be rnade the {ollowing work day' REQU!RED INSPECTIONS ,("*'orgrY'.Electric Vf Sitc lnsnection - To lrc matle .6Lafter cxcavirtion, but prior tcr-sett r n o {ornts. =,trAr@-S; K:;Wl Mechanicar - Prior to -F7f Rouoh Electrical - Prior tc) ,lA\.or.-r. \M Electrical Service - Must tle ,/Aapproved to obtain Permanent electrical Power. Final Plumbing - When all plurnbing worl( is comPlete. Final Electrical - When ;rll electrical work is cot-nPlete. Final Mechanical - When all mechanical worl( is complete. Final Building - When all required inspections have becn approved an<i builcling is completed. E X X ,Kx Vf Masonrv - Steel location, bondALb"u,rl", grouting. Ee nAxt. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Footing - After trenches are excavated. Foundation - After forms are erectecl but Prior to concrete placement. Underground Plumbing - Prior to lillirrg trench. Posl and Beam - Prior to floor insulalion or dccl<itrg. Xrramlng - Prior to cover. XTwuttlceiling lnsulation - Prior to Jacover. ft"*dl - Prior to taoing' Fireplace - Prior to facing materials and framing lnsP. Wood Slove - Aftcr ins;tall;ttion lnsert - After f ireplace apl)roval an(l installation c;f unit. Curbcut & APProach - Af ter forrns are erected but Prior to placement of concrete. Sidewalk & DrivewaY - Af ter excavation is comPlete, fortns and sub-base material in Place. Fence - When comPleted reet Trees - When all required rees are planted. V u,.,au.tt 4{r5Gi]E / M ec hanica I ;lr-4 - l)rior iii insttlatiotr or (lccl(lnU. >< {::'."-l;;suration - Prior to [Zsanitary Sewer - Prior to filling ,JA{ trench. {::""'*.sewer - Prior,to rirlins ]a/ wut", Line - Prior to filling /A\rencn i\7 nougt, Plumbing'- Prior to F{ covet. Other MOBILE HOME INSPECTIONS Blocking arrcl Sct-Up - Wltctl i.tll blocl<ing is cornl)lcte. Plumbing Contrectiorrs - Wlten lrorne ltas been connectecl to water and sewer. Electrical Conneclion - When blocking, set-uP, and Plurnbi ng inspections have been aPProvcd and the home is connected to the service panel. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. LI tl rl r r Lot faccs Lot sq. itg. " Lot coverage Topography Total height Lot Type -E-frGrior --- Corner - Panhandle - Cul-de-sac Setbacks 4e4 46-?' 6az% .ah-'t S THE PROPOSED WORK IN THE I-IISTORICAL DISTRICT, OR ON I'FI E HISTORICAI. REGISTER? ---"..., lf yes, this application rnust be signed anrJ approved by tl-re H i storical Coordinator prior to permit issuance. APPROVED: P.L.HSE ffi 'ACc N //G, S S' E, BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express conditiorr that the said construction shall, in all respects, conform to the Ordinance aclopted by the City of Springfield, irrcluding the Developmerrt Codc, regltrlating thc construction and r,rse of buildings, and may bc suspended or revoked at arry time upon violation of arry provisions of said orclinatrt:cs. Z_ /€ /z 77 P Plan Clreck l=ee: Rccei vcd Rt-.vi Date Paicj Rcceipt Nutrtbet': BUILDING PERMIT VALUE prut"s (A) ,/o €aZ, ,*J..f fu,Za- ?/22_ /6,%A SO. FT. X $/SO, FT. li#- *^zq- 38-z 7za/aa Total Value tsuildirrg Pcrtrtit [-cc State Surcharge Total Fcc '1sr,CP@ ITEM Main Garage //:fo,?: Systems Developtnerrt Ctlarge is due on all undevelopcd properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) 468- ADDITIONAL COMMENTS htz b,/b@ ITEM Fix t u res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE /5* /Q?" 2/7,e? 9oNo? FT. FT. (c) 2o a.;o Fr. /eo PLUMBING PERMIT Plumbing Permit State SurcharSle Total Clt:rrge Wood Stove/ lnsert / Fi replace Unit Dryer Vent MECHANICAL PERMIT 3,e?_ /5:e /o eo 7s 25.75 €ro3 (D) 4E: Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hoocj Vent Fan No/ By signature, I state arrd 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 urthe r certif y that any and all work per{ormed shall be done in accordance with the Orcjinances of the City of Springf ield, and the Laws of the State of Oregon perlaining to the worl< described. lrerein, ar.rd that'NO OCQUPANCY will be rnade of .any structure without pernlission of the Building Safety Division' I {urther certify that only contractors and enrployees who are in compliance wittl ORS 701.O55 will be used on this project. I further agree to ensure that all required inspections are requested at the proper tinre, that Signatu re Date IS ocatcrJ at the f rontfrom the street, that tlte rmit ti sdu address is readable d tlreof the prope co orlon the site plan s vu il I re rriai nMISCELLAN EOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk --------- ft Curbcut --- ft Demolition State Surcharg;e Total Miscellancous Permits (E) a7 DATE PAID VALIDATION: RECEIPT NUMBEI.I ., AMOUNT RECEIVED RECEIVED BY -- - TOTAL AMOUNT DUE (exclucling electrical) (A, B, C, D, and E Combined) Mt,tJ, *= C'TY OFEGO'U st.tilNGFrEL() 0fr 1 ON Permits are non-transferable and expireif vork is not started within 180 daysof issuance or if vork is suspended for 180 days. 2. Co!{I"+ACf,oR INSTALLATToN oNLY PERHIT APPLICATION PEE SCEEDULE BBLOV Residential-Single or dvelling unit. Service fncluded: I tems .Cos t I 1000 sq.ft. or less I $ 85.00 nach additional 500 sq. ft or portion nthereof cr $ 15.00 Each Manuf'd Home or Modular DweIIing Service or Feeder $ 40.00 Services or Feeders Installation, Alterations or Relocation: 225 FIFTB STRBEf, SPRINGFIEI.D, OREGON INSPBCf,ION REQTIEST: 0FPICE: 726-3759 ci Sot^t r{\ Supervisor 974 72 -l-, ,\ 11,.,i,:r,ri, UiOlfa i-:z,e$.i,ind 6ross i5i ELECTRICAL si Submi(tnci has lhe tollowlng roquire rpooifio Hnt{$ey Job Number qa w Sum 3D B O+SElectrical Contractor Address Y;;. Ndmber t(frtps 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 Phone s s0.00 $ 60.00 $100.00 $130. 00 $300.00 $ 40.00 Expiration Date O,t,qA Constr Contr. Number D3%q Expiration Date 4.\q Signature of Supervising Blectrician Ovners Name Address Ci ty F,ra( nO pr,on# () OITNER INSTALI,ATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: DATE: C. Temporary Serviees or Feeders Installation, Alteration or Relocation 200 amps or less I S 40.00 201 amps to 4oo amps .-- $ 55.00 over 401 to 6oo amps - g 8o.oo Over 600 amps or 1000 volts see fiBrl above D. Branch Circuits Nev, Alteratlon or Extension Per Pane1 One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit S 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utline Lighting- Limited Energy/Res Limited Energy/Comm -5. STETOTAL OP ABOVB 5Z State Surcharge TOTAL $ 40.00 s 40.00 s 20.00 s 36.00 RECEIVED BY: SPrlINGFIELC' RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Olfice: 726-3759 LOCATION OF PROPOSED WORK:Zzl JOB NUMBER 225 Flfth Street Spri ngfield, Oregon 97 477 TAX LOT:Za-?9 D Zfr, I l*OZD LOT:BLOCK SUBDIVISION PHO NE:4as 265\OWNER: ADDRESS CONTRACTOR'S NAME @w17- 0"16 ,'X ZIP:CITY:STATE: DESCRIBE WORK: NEW - L--REMoDEL ADDtrtoN DEMoLlsl-l orHER ADDRESS CONST. CONTBACTOR #EXPIRES PHONE G F.N ERAI-: PLUMBING: MECFIANICAI. ELECTRICAL OUAD AREA: _ OFFICE USE _ Rough Electrical * Prior to COVCT, Electrical Service - Must be approved to obtain permane electrical power. Firepl to no N FLOOD PLA|N ZONING CODE: # OF BDRMS Final Electrical - When all electrical is complete. .- When all complete. Site lnspection - To be made af ter excavation, but prior to setting forms. Underslab Plumbing/ Eleclrical / Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Steel location, bond beams, grouting. Foundation - After ere6ted but prior placement. Underground Plumbing - Prior to filling trench. Underf loor Plumbing / Mechanical - Prior to insulation or decking. Post and Beam - Prior to floor insulation or decki ng. Floor lnsulation - Prior to decki ng. Sanitary Sewer - Prior to fiiling trench. Storm Sewer - Prior to fiiling trench. Waler Line - Prior to filling trench. LAND USE # OF BLDGS Y OF UNITS: OCCY GROUP: S OF STORIES: CONSTR. TYPE: HEAT SOURCE: WATE,q HEATF:R:RANGE SECONDABY HEAT: SQUARE FOOTAGE: To request an inspection, you must call 726-3769. This is a 24 hour recorCing. All inspections requested before 7:00 a.m' will be made the same working day. !nspections requested after 7:00 a.m. will be maCe the following work day. REOUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. c iling lnsulation - Prior to cover. Drywall - Prior to taping Wood Stove - After installation lnsert - After firepiace approval and installation of !init. Curbcut & Approach - After forms are erected but prior to placement or concrete. Sidewalk & Driveway - After excavation is complete, fornrs and sub-base nr.lt,)rial in place. Fence - When cornpleled. Slreet Trees - When all required trees a!'e planted. Building - When all required inspections have been approved and building is completed. Other MOBILE HOME INSPE TIONS Blocking and Set-Up - When all blocking is complete. Plumbing Connections - When home has been connected to water and sewer. Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Final - After all required inspections are approved andporches, skirting, decks, and venting have been installed. r. Rough Plumbing - Prior to cover. ASSESSORS MAP: E E tl r E n E E E E E tl tl r ()/'P t tf Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Set bacl<s HSE GAR ACC lS r r;e PROPOSED WOFIK lN THE }IiSTOHICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf ycs, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVEDE P.L. N S VALUE (A) X $/SQ. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permil 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. Pran check r.., -/LK-L e62D : &€) e 2-26,-7 3 Pla iewed B Date Date Paid Rcceipt Numbcr: - Received SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Developrnent Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) FT. No FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Furnace Exhaust Hood 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 further 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 pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certity that only contractors and employees who are in compliance with ORS 701.055 will be used on this proiect. I f urther agree to ensure that all required inspections are \ Date 5 requested at the proper time,at each address is readable f rom the 51 et, that e per ,andt app ri Kisnutu,.u is located at the f ront of the p on the sit I times set of plans will remain nstruction. MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) @?o ?3se 3lv )., t4 8oo RECEIVED BY i tr)B AMOUNT RECEIVED. DATE PAID -,. VALI DATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, q D, and E Combined) EEE ___J Address: Permit No:Qto )qq nd >L!% WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 1 2 lssued by IDR OR OFFICE USE ONLY STATEMENT: TNFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS701.055(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 registration underORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: 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. Contractor registration num I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3. B.l X I 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 lssuing this building permit of the name of the contractor. ! hereby certily that o ation is correct and that I have read and understand the ln N to ners about Construction Responsibilities on the reverse this 3l u,l* t natu of mit lican Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 Date: