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HomeMy WebLinkAboutPermit Building 1998-05-28!NGFIELD qpzk7 Z3/u o/7 033Lt ./o o 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>