HomeMy WebLinkAboutPermit Building 1998-05-28!NGFIELD qpzk7
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JOB NUMBER
LOCATION OF PBOPOSED WOFIK:
TAX LOT:ASSESSORS MAP:
RESID ENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759 225 Fifth Street
Sprlngfleld, Oregon 97477
SUBDIVISION: _--LOT:
-
BLOCK:
PHONE:
STATE:ZIP:
7 s/7 qd4
??ff?
OWNER
ADDBESS:
CITY:
DESCRIBE WORK:
NEW- REMODEL
ADDRESS
I ntD rtrHMl I S BE IF THE WORKEXPI
EXPIRES S PHONECONTRACTOR'S NAME
PLUMBING:
GENERAL:
MECHANICAL:
ELECTRICAL:
CONST-
CONTRACTOR #
ANY 180 DAY
OR IS ABANDONED FOR
RANGE:
ZONING CODE:
* OF BDRMS:
- OFFICE USE -
LAND USE:
* OF UNITS:
OUAD AREA:
* OF BLDGS:
SECONDARY HEAT:
SQUARE. FOOTAGE:
OCCY GROUP:
I'OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspecilons requested before 7:00 a.m. wlll bemade the same worklng day, lnspections requested after 7:00 a.m. will be macle the followlng work day.
REQUIRED INSPECTTONS
Temporary Electrlc Mechanical - Prior to Final Plumbing - When allplumblng worl( is complete.cover.
Slte lnspectlon - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When ail
electrical work is complete.cover.
Underslab Plumblng/ Electrical /
Mechanlcat - Prlor to cover.Electrical Service - Must be
approved to obtain permanent
electrlcal power.
Final Mechanical - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
Flnal Buildlng - When all
requlred lnspectlons have been
approved and bullding is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prior to concrete
placement.
Other
Wall/Ceiling lnsulatlon - Prlor to
cover.
Underground Plumbing - Prior
to fllllng trench.Drywall - Prlor to taplng.
E MOBILE HOME INSPECTIONSUnderlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decking.Wood Stove - After lnstallatlon
Post and Beam - Prior to floor
lnsulatlon or decking.lnsert - After fireplace approval
and Installatlon of unit.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulation - Prior to
decking.Curbcut & AJrproaclr - After
forms are erected but prior to
placement of concrete.
Plumtring Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Stonn Sewer - Prior to filling
trench.
Sidewalk & Drlveway - After
excavation is complete, forms
and sub-base material in place.
Water Llne - Prlor to filling
trench.
Fence - lvhen ccinpleted.
Street Trees - When all requlred
trees are planted.
Flnal - After all required
inspections are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
Rough Plumbing - Prior to
cover.
rl
q 7/
FE8&PplarN:
-
WATER HEATER:
fl
E tl
tl
kLot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Ty
-
lnterior
-
Corner
-
Panhandle :
-
Cul-de-sac
P.L.HSE GAR ACC
N
S
E
i IS THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
VALUE
(A)
tvlrr ' ri "t
Total Value
Building Permit Fee
State Surcharge
Total Fee
FT. X $/SQ. FT.
BUILDING PER
ITEM SO.
Main
Garage
Carport
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, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
t
E
Receipt Numbe
Plan Check Fee
Date Paid:
Received By:
Fmru cHEcK
,RMIT
BUILDTNG \ALUE
AND BUILDING P
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Fixtu res
Flesidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
FT.
FT.
(c)
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
/ft)o
.00
(D)Z u
No
L
Vent Fan
:74
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Mechanical Permit
lssuance
State Surcharge
Total Permit
By slgnature, I state and agree, that I have caretully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true ancl 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 described
herein, and that NO OCCUPANCY will be made of any
structure wlthout perrnission of the Building Safety Divislon.
I further certify that only contractors and employees who
are in cr:mpliance with ORS 701.055 will be used on thls
prolect.
I further agree to ensure that all required lnspections are
requested at the proper time, that each address ls readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will remaln
Slgnature
Date
du ri const ructon the site at It
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
--
ft
Demolition
State Surcharge
Total Miscellaneous Perrnits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Combined)
6
€{
LO
5
VALIDATION:
UMBER
AMOUNT RECEIVED
RECEIVED BY
RECEIPT N
DATE PAIt)
' .ii,i1 ll .
Nr
FT.
SPEIhrGFIELc,RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WOBK:a?(,u2a
JOB NUMBER
225 Fifth Street
Springtleld, Oregon 97477
ASSESSORS MAP:,/ 7,e7- Z^-zz TAX LOT:
LOT BLOCK:SUBDIVISION
PHONE:
STATE:
7/6 A?s7-
ZIP:?2v ?CITY:
ADDRESS
OWNER:
e\w
REMODEL X:
4
ADDITION DEMOLISH OTHER
DESCRIBE WORK;
NEW
-
MECHANICAL:
-
ELEfiRICAL:
ADDRESS EXPIRES ,1 PHONECONTRACTOR'S NAME
PLUMBING:
GENERAL:
CONST.
CONTRACTOR ''
RANGE:
r OF BDRMS:
- OFFICE USE -
LAND USE:
WATER HEATER
FLOOD I)LAINOUAD AREA:
r OF BLDGS:
SECONDAFIY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
* OF STOBIES:
CONSTR. TYPEr
HEAT SOURCE:
# OF UNITS:
---
To request an lnspectlon, you must call 726-3769. Thls ls a24hout recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same working day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
n Temporary Electrlc Rough Mechanlcal - Prior to
cover.w Final Plumbing - When alt
plumbing worl( is complete.
Slte lnspectlon - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to
coVer.Final Electrical - When all
electrical work is complete.
Underslab Plumbing/ Electrical /
Mechanlcal - Prlor to cover.Electrical Service - Must be
approved to obtain permanent
electrlcal power.
Final Mechanical - When all
mechanical work ls complete.
E Footlng - After trenches are
excavated.Flnal Building - When all
required lnspections have been
approved and building is
completed.
Flreplace - Prlor to faclng
materlals and framing lnsp.
Masonry - Steel locatlon, bond
beams, groutlng,
l-_l Framlng - Prior to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.Wall/Celling lnsulatlon - Prlor to
cover.
Underground Plumbing - Prior
to fllllng trench.Drywall - Prlor to taplng.
MOBILE HOME INSPE TTONSUnderlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decking.Wood Stove - After lnstallation
Post and Beam - Prior to floor
lnsulatlon or decking.lnserl - After flreplace approval
and installatlon ol unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulation - Prior to
decking.Curbcut & Agrproaclr - After
forms are erected but prior lo
placement of concrete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to fllling
trench.Electrical Connection - When
blocking, set.up, and plumblng
lnspections have been approved
and the home is connected to
the servlce panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Llne - Prlor to filling
trench.
Fence - When ccfipleted.
Final - After all required
lnspectlons are approved andporches, sklrtlng, decks, and
ventlng have been lnstalled.w Rough Plumbing - Prlor to
cover.
I-l Street Trees - When all requlredU trees are planted.
2ryr
e-t-e
-/
ZONING CODE:
E
E
rl
tl
t]
[---l otnerll
E
ilr
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Set
PL.TJSE GAR ACC
N
S
E
i rs THE PROPOSED WORK tN THE -
HtsToRtcAL D|STRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinalor prlor to permit issuance.
APPROVED:
BUILDING PERMIT
VALUE
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT. X $/SO. FT.ITEM
Main
Garage
Carport
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, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
Receipt Numbe
BUILDING
AND BUIL
LAN CHECK
MIT
LU E ,
EIDGNP R
Plan Check Fee:
Date Paid:
Received By:
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
Moblle Home
e?
(c)z/.6a
Nc
FT.
FEE
Plumblng Permit
State Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fixtures
. FT.
ADDITIONAL COMMENTS
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
MECHANICAL PERMIT
(D)
No
Mechanical Permit
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby cerilfy that all
lnformation hereon is true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
with the Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Oregon perlainlng to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure without perrnission of the Building Safety Divislon.
I further certify that only contractors and employees who
are In compliance with ORS 7O1.O5S will be used on this
proiect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will remaln
on the site at all times during construcilon.
Signatu re
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Perrnils (E)
Z*z*
VALIDATION:
RECEIPT NUMBER .?
DATE PA,I[)
AMOUNT RECEIVED 4a
RECEIVED BY
FT.
TOTAL AMOUNT DUE (excluding etectricat) .___--
(A, B, C, Q and E Combined)
SPR!N
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ESSORS MAP:
/1/
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
TAX LOT:
SUBDIVISION:BLOCK:
OWNER;
ADDRESS:
CITY:ZIP:STATE:
PHONE:2r'2 A
DEMOLISH OTHER
DESCRIBE WORK:
NEW
-
REMoDEL -X
ADDRESS 4
/3
2 6b7
EXPIRES ,a PHONECONTRACTOB'S NAME
MECHANICAL:
ELECTRICAL
CONST,
CONTRACTOR #
GENERAL:
PLUMBING
RANGE:
_ OFFICE USE _
LAND USE:
WATER HEATER:
ZONING CODE:
FLOOD I)LAIN
r OF UNITS:
OUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All inspections requested before 7:00 a.m. wlll be
made the same working day, lnspections reguested after 7:00 a.m. wlll be made the followlng work day.
Temporary Etectrlc
REQUIRED INSPECTIONS
l--l Rough Mechanlcal - Prior toU cover.r
x
Final Plumblng - When alt
plumbing work ls complete.
SIte lnspection - To be made
after excavatlon, but prior to
setting forms.X Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.T?l Electrlca! Servlce - Must be,l4pproved to obtain permanent
electrlcal power.
Final Mechanlcal - When all
mechanical work ls complete.
l-l Footlng - After trenches are|J excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
X Flnal Buildlng - When all
required lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.K
K
"KE
Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Celling lnsulatlon - Prlor to
cover.
Underground Plumblng - Prior
to lllllng trench.Drywall - Prlor to taplng.
MOBILE HOME INSPE TIONS
Underlloor Plumblngl Mechanlcal
- Prior to lnsulatlon or decklng.Wood Stovo - After lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnsert - After flreplace approval
and lnstallatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Curbcut & Alrproaclr - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home lras been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Storm Sewer - Prior to fllling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Llne - Prlor to filling
trench.
Fence - When ccirrpleted
$treet Trees - When all requlred
trees are planted.
Flnal - After all required
lnspectlons are approved andporches, sklrting, decks, and
ventlng have been lnstalled.
F
Qffizez
'r OF BDRMS:
-
E
tl
Floor lnsulalion - Prlor to
decking.
tl
tl
t]
E
E
tlE
E
;X::*::
Prumbrns - Prror to E
tr'. ' '''
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Ty,
* lnterlor
-
Corner
-
Panhandle
-
Cul-de-sac
backs IS THE PFIOPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
PL.HSE GAR ACC
N
S
E
SQ. FT. X $/SO. FT. : VALUE
5*
/.zt f ,7f ZIo_
AqteTzEzz-
tu(A)
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Thls pernrit is granled on the express condition that the said
construction shall, in all respects, conform to the Ordinanceadopted by the City of Springfield, including the
Development Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Fleceipt Number:_
Plans Reviewed By Date
BUILDING VALUE,
AND BUILDING PE
LAN CHECK
RMIT
Date Paid
Received By:
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Fixtures
Resldential Bath(s)
Sanitary Sgwer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
2,2f f /p r
z
N'
rI-?a l-
FT.
G,P(c)
2 a
FEE
4E@
?,60
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
(D)
Mechanical Permit
lssuance
State Surcharge
Total Permit
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 urther cerilfy
that any and all work performed shall be done in accorrJance
with the Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure wlthout perrnission of the Building Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 wlll be used on thls
proiect.
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 permit card ls located at the front
of the property, and the approved set of plans will remaln
on the site all duri construction.
lgnatu
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
--
ft
Demolitlon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, D, and E Comblned)
75 o
/
zqo ,
VALIDATION:
BECEIPT NUMBER
DATE PAID
AMOUNT REC
RECEIVED BY
wP
FT.
*r
SPFIIttGFIELE)RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
N OF PROPOSED WORK:
9Sge7a
efi,p
JOB NUMBER
225 Fifth Street
Springfleld, Oregon 97477
ttv / /u L3\r-ocarro
ASSESSORS MAP:11 oZ 1co I(O 5t ff-7r'
LOT:BLOCK:
TAX LOT
SUBDIVISION
7/E 6pwruen:PHONE:
ZIP:
_s-
STATE:a4_e_
ADDRESS
CITY:
DEMOLISH OTHER
DESCRIBE WORK:
NEW- REMODEL
EXPIRES 5 PHONECONTRACTOR'S NAME
GENERAL:
PLUMBING
MECHANICAL:
ELECTRICAL:
CONST.
CONTFIACTOR #
RANGE:
# OF BDBMS
WATER HEATER:
ZONING CODE:
FLOOD I'LAIN
* OF UNITS:
LAND USE:OUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspectlon, you must call 726-3769. Thls is a 24 hour recording. All lnspections requested before 7:00 a.m. will be
made the same worklng day, lnspections requested after 7:00 a.m. will be made the following work day.
REOUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
cover.
Flnal Plumbing - When all
plumbing work ls complete.
SIte lnspection - To be made
after excavatlon, but prior to
setting forms.
Rough Electrical - Prior to fl Flnal Electrlcal - When all
electrlcal work ls complete.cover.
Underslab Plumblng/ Electrical /
Mechanlcal - Prior to cover.
Electrical Service - Must be
approved to obtain permanent
electrlcal power.
Final Mechanlcal - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to facing
materlals and framing lnsp.
Final Building - When all
required lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prior to cover.
E Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Celling lnsutation - Prlor to
cover.
Underground Plumblng - Prior
to lilllng trench.Drywall - Prlor to taplng.
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanicat
- Prior to lnsulatlon or decking.Wood Stove - After lnstallation.
Post and Beam - Prlor to floor
lnsulation or decking.lnserl - After fireplace approvcl
and installation of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulation - Prior to
decking.Curbcut & AJ:proach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home lras been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home ls connected to
the service panel.
Storm Sewer - Prior to filling
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material ln place.
Water Line - Prior to filling
trench.
Fence - When cclrpleted.
Street Trees - When all required
trees are planted.
Flnal - After all required
inspections are approved and
porches, sklrting, decks, ancl
ventlng have been lnstalled.
Rough Plumbing - Prior to
cover.
ADDITIONtt^
-ry.
E
tl
tl E tl
E
E
tl
tl
E
E
tl
E
fl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandlel
-
Cul-de-sac
\ lS THE PROPOSED WORK tN THE -
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
PL.}.ISE GAR ACC
N
S
E
VALUE
'tBUILDTNG PERIdIT
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT. X $/SQ. FT.
This permit is granted on the cxpress condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfield, including the
Development Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances.
Plans Reviewed By Date
Receipt Numbe
BU I LDI NG
AND BUIL
LAN CHECK
MIT
E,
PE
LU
D GN R
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developraent Charge is due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
Plumbing Permlt
State Surcharge + 0.O3tZo
Total Charge
N.
.+
FT.
I
(c)
aFT. A
JT, -
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(o)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby cerilfy that all
lnformation hereon is true ancl correct, and I f urther certify
that any and all work performed shall be done in accortJance
with the Ordinanccs 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 perrnission of the Buildirlg Safety Division.
I further certify that only contractors and en.tployees who
are in compliance with ORS 701.055 wlll be used on this
proiect.
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 permlt card ls located at the front
of the property, and the approved set of plans wiil remain
on the site all
pate
n.
$isn"trru
during constru
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, D, and E Combined)
VALIDATION:
RECEIPT NUMBER
DATE P,A,ID
AMOUNT RECEIVED
"J3-?s
RECEIVED BY #'Lr)
(A)
FT@
t,Ai,ZS#n, -
OREGO'VCITY OF
us8
ELECTRTCAL PERHIT APPLICATION225 FTFTH STREET
SPRTNGFIELD, OREGON 97477
INSPECf,ION REQTEST| 726-
OFFICE: 726-3759
Dae3-
1. LOCATION OF
LEGAL DESCRIPTION
JOB DESCRTPTION
tVfu) .rilr' +Lc.ttaZ.a_-____________
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
LBO days.
2. CONTRACTOR INSTALT,I\TION ONLY
Electrical Con t'ractor (G, 6b-
Add res
*;#":- *ffimk
fygry*o*r"**&b Nunber Tgro za7
3. COHPLETE FEE SCHEDULE BELOV
A Nev Residential-Single orMulti-Family per dvelling unit.
Service Included:
I tems Cos t Sum
)
1000 sq.ft. or less
Eaclr add i t ional 500sq. ft or portion
thereo f
Each Manuf'd Home or
-Modular DvelIing
Service or Feeder
Services or Feeders
Installation, Alterationsor Relocation:
s 8s.00
$ 1s.00
s 40.00
zi t'
B.
c
200 amps or
201 amps to
401 amps to
601 amps to
Over 1000 am
Reconnect 0n
less L-/-'
400 amps
600 amps
1000 amps
ps /voI ts
s s0.00
s 60.00
s100.00
s130. 00
s300.00s 40.00
ryciw 1,4ic Phonet/z---
Supervisor License Nu
Expiration Date ,fp
mber I C7 /,;
Expiration Date ,za/ i/rr
Temporary Services or FeedersInstallation, Alteration or Relocation
200 amps''or less $201 amps to 400 amps
-
Sover 401 to 600 amps
-
$
Over 600 amps or 1000 voTEs s ee ,Btt a6ove
D. Branch Circui ts
1y
-C2
f.
40.00
55.00
80.00Signa ture.
Ovners Name
Add ress
ising Electrician
cirv.Vfr phr"" 4; -622;/
OVNER TNSTALLATION
The installation is being made onproperty I own vhich is not intendedfor saIe, Iease or rent.
Ovners Signature:
DATE:
Nev, Alteration or Extension Per Panel
One Circuit S 35.00
Each Addi tionalCircuit or vith Serviceor Feeder Permit / S Z.OO -fu
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Ou tline Lighting-
Limi ted Energy/Res
-Limited Energy/Comm
E
$+o
Sao
$zo
S36
00
00
00
00
5 SUBTOTAL OF ABOVE
52 State Surcharge
3Z Admini.strative Fee
TOTAL
52r
RBCEIVED D
7eo
SiPrlINGFIELl,
e4r7/2
Constr contr. Number 2 O'- /
SPRIh.GFIELDRESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
JOB NUMBER 2g
225 Fifth Street
Springfleld, Oregon 97477
LOCATION OF PROPOSED WOBK:I ry/Z3
ASSESSORS MAP:lt oZ Zt"Ir
LOT:BLOCK:
TAX LOI 65 tdo
PHONE:
ZIP:
t
/6-1e 7STATE:
OWNER:
ADDRESS:
CITY:
DESCRIBE WORK:
1,f
MECHANICAL:
-
A DFIESS EXPIRES ,1r PHONECONTRACTOR'S NAME
r OF BDRMS:
WATER HEATER
ZONING CODE:
- OFFICE
LAND USE:
* OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
PLUMBING:
GENERAL:
ELECTRICAL:
CONST.
CONTRACTOR #
QUAD AFIEA:
* OF BLDGST
SECONDARY HEAT:
souenr FooTAGE:
OCCY GROUP:
C OF STORIES:
FLOOD PLAIN:
To request an inspectlon, you must call 726-3769. Thls ls a24hour recordlng. All I ested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the
REQUIRED INSPECTIONS
day.
n Temporary Etectric Rough Mechanlcal - Prior to
cover.
Flnal Plumblng - When all
plumbing work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrlcal - Prior to Final Electrlcal - When alt
electrical work is complete.cover.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Electrical Service - Must be
approved to obtain permanent
electrlcal power.
Final Mechanlcal - When all
mechanlcal work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and lraming lnsp.
Final Building - When all
required lnspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.
l-l Framlng - Prior to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.WalltCelllng lnsulation - Prlor to
cover,
Underground Plumblng - Prior
to fllllng trench.A'"*"E;',,#"t*
MOBILE HOME INSPECTIONS
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng.Wood Stovo - After lnstallatlon
Posl and Beam - Prlor to floor
lnsulation or decking.lnserl - After flreplace approval
and installatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulalion - Prior to
decking.Curbcut & Alrproaclr - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home lras been connected to
water and sewer.
Sanitary 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 - Prior to fllling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base malerial in place.
Water Line - Prlor to filling
trench.
Fence - When ociripleted
Bough Plumbing - Prior to
cover.
{itr€el Trees - When all required
trees are planted.
Final - After all required
lnspectlons are approved andporches, sklrtlng, decks, and
ventlng have been lnstallecl.
SUBDIVISION: '
tl
E Other
-tl
EE
tl
fl
:1.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterior
-
Corner
-
Panhandle !
-
Cul-de-sac
S THE PROPOSED WORK TN THE .
HISTORICAL DISTFIICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPFIOVED:
PL.HSE GAR ACC
N
S
E
VALUE
(A)I to,J
4
Total Value
Building Permit Fee
State Surcharge
Total Fee
X $/SQ. FT.
BUILDING PERM!T
ITEM SO. FT,
Main
Garage
Carport
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 ofbuildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Receipt Number:_
Plans Reviewed By Date
LAN CHECK
MIT
UB LI D LUING E
NA BD IU L ID GN P
,
E R
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tlre City linrits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sgwer
Water
Storm Sewer
Mobile Home
FEE
N.
FT.
(c)
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
(D)
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed appllcation and do hereby certify that all
lnformation hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accorrJance
with the Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Orc,gon pertainlng to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure without perrnission of the Building Safety Divislon.
I further certify that only contractors and employees 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 time, that each address ls readable
from tlre street, that the permit card ls located at the front
of the property, and the approved set of plans will remaln
3 -Jo
on the site at I times du
,r.Slgnature
!r","
on.const
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, Q and E Combined)
'*,q )42-
Ot
'4-30-9qDATE PAID
AMOUNT RECEIVED
VALIDATION:
RECEIPT NUMBER
i,l
+_s.__:
FT.
FT.
No
#t
FIECEIVED BY
CITY OF ORFGO'Y
approval.
ItS
225 FTFTII STREET ',^j|r'|o/izfxl
SPRINGFTELD, oREGON 97 477
INSPECTION REQITEST z 726-3769
OFPICE: 726-3759
t ON OF INSTALLATION ,eoJ
LEGAL DESCRIPTION
17 03 3to ll D5ta-c
l&r apocfilc hnd usro
B
sl,r.rt -lELo
ELECTRICAL PERHIT APPLICATION
^ JOB DESCRIPTION
(16 6 Li/Lt Lr.LILl
orI
sq.rtion
thereo f
Each Manuf'd Home or
-Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterationsr Relocation:
or less
to 400 amps
-to 600 amps
601 amps to 1000 amps-
0ver 1000 amps/volts
-Reconnect Only
200 amps''or less
20L amps to 400 amps
-0ver 401 to 600 amps
-Over 600 amps or 1000 voTEs
ty Job Number ?go 297
FEE SCHEDULE BELOV
dential-Single or
mily per dvelling unit.
Included:
f tems Cos t
ess $ 85.00
s00
s 1s.00
s 40.00
Sum
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
1B0 days.
2. CONTRACTOR INSTALI.ATION ONLY
Electrical Contractor
Address
ciry .S ,A rt(Phone 2 z-l ^
2
2
4
s s0.00
s 60.00
s 100. 00
s130.00
s300.00
s 40.00
\:-, /-
Supervisor License Number
Expiration Date ,/e
Constr Contr. Number o Temporary Services or FeedersInstallation, Alteration or Relocation
AG ?1{-
^C
00 amps
01 amps
0L amps
t
.00
.00
.00
40
55
BO
e
/-
40.00
40.00
20.00
36.00
/4. _
t -7O
*4;,+
C
Expi ra t
Signa tu
/zion Date s
s
$
se
$
s
$
$
f Supe I Electrician
ers Name 4"rm"* b-u,rr,a-r-
Address e5 3 ffie**J
Ci ty Phone 1 q b
OVNER IN ALT^1\TION
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Addi tionalCircuit or vith Service - k 'i
or Feeder Permi t 7 $ z. ooT-4_:
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0utIine Lighting
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Admini.strative Fee
TOTAL
''Bil a55tE-
The installation is b
property I ovn wlrich
for sale, lease or re
ng made on
not intended
ei
IS
nt
E
r
DATE:
RBCEIPT
RBCEIVED
igna ture:
(5
6,1>