HomeMy WebLinkAboutPermit Building 1993-06-18SPFlINGF!ELE)
BLOCK
0
SUBDIVISION
TAX LOT:
LOT:
JOB NUMBERRESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Of(ice: 726'3759
LOCATION OF PRO
hssEssons ruaP,
PO
it
225 Fifth Street
Spri ngfield, Oregon 97 477
PHONE
ZIP:STATE
L
s q 7v77,t
OWNER: - 7 ilo Tt)
L,Aj, ZADDRESS: ,-8+o
ctrYt ? PF|-P
ADDITION DEMOLISH OTHER
DESCRiBE WORK:
NEW _-- REMODEL
PHONEEXPIRESADDRESSCONTRACTOR'S NAME
G EN ERAL
ELECTRICAL:
CONST.
CONTRACTOR #
//
PLUMBING:
Sl
MECHANICAL:rl
,-2p L/)OUAD AREA
r OF BLDGS: .-
RANGE:
OCCY GROUP: -
# OF STORIES
_ OFFICE USE -
LAND USE
* OF UNITS:
HEAT SOURCE:
CONSTR. TYPE:s-4
FLOOD PLAIN
ZONING CODE:
# OF BDRMS
WATER HEATER:
SECONDARY HEAT:
SQUARE FOOTAGE:
To requesr an inspection, you must call 726-3769. This is a 24 hOur recordinel All inspections reques
made the same vuorking day, inspections requested after 7:00 a'm' will be made the following work
REOUIRED INSPECTIONS
ffiRough Mechanical - Prio' toIJ ccver.
i-l,4ough Electrical - Prior to
lJ COVef.
ted before 7:00 a.m. will be
day.
[--.l TemporarY Electric
ll
Site lnspection - To be made
af ter excavation, but Prior to
setting forms.
Underslab Plumbing/ Electrical I
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Stecl location, bond
beams, grouting.
Foundation - After forms are
erecled but Prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
U nderlloor
- Prior to
chanical
or deckirrg.
r lnsulalion - Prior to
decki ng
'Sanitary Sewer - Prior to filling
trench.
Slorm Sewer - Prior to filling
trench.
Water Line - Prior to filling
t ren ch
gh Plurnbing - Prior to
f .-/Final Plumbinq - When alllllJ plumbing wcrli is complete.
al Electrical - When all
eiectrical work is comPlete.
Electrical Service - Mlist be
approved to obtai n Permanent
electrical power.
Fireplace - Prior to fa-cing
materials and framing lnsP.
@traming - Prior to cover.
l/Ceiling lnsulation - Prior to
cover
f-*Final Mechanical - When allU mechanicat work is complete.
f ,, PFinal Building - When allE required !nsPections have been
approved and building is
completed.
f7(Post and Beam - Prior to floc'rU insulation or deckin0.
@DrVwall - Prior to taPing
Wood Stove - After installation.
lnsert - After f irePlace aPProval
and installation of unit.
Curbcut & APProach -' After
forn.s are erected but Prior to
placement of concrete'
Sidewalk & DriveuraY - After
ev.;avatiorl is cornPlete, torrns
arrd s.rb-base material in place.
Fcnce - When ccmPleted
Stieet Trees - Y','hen arl tequired
tr{res are Pianied.
Other
MOBILE HOME INSPE TIONS
tslocking and Set'UP - When all
blocking is comPlete.
Plumbing Conneclions - 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 and
porches, skirting, decks, and
ventin3 have been installed.
umbi
ccver.
b
O ulp E/Z
\
4
E
E
fl
n
r-lLI
[]
L]
P.L.HSE
N
S
E
Lot faces
Lot sg. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cu!-de-sac
ks IS THE PROPOSED WOBK IN THE
HIIJTOFIICAL DISTRICT, OR ON
THE HISTORICAL REGISTER? -_--,lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
ACC
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
VALUE
(A)
X $/SQ. FT.
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conlorm to the Ordinance
adopted by the City of Springfield, including the
Development Code, re1;ulating the construction and use of
buildings, and may be suspended or revo|<ed at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: --
Plans Reviewed By Date
Date Paid
Beceipt Numbt, r:--
Received By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on ;all undeveloped
properties within the City linrits which are being improved.
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FT. fi"
FT.h
FT.
(c)
No 9-
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
(D)
N0
Mechanical Permit
lssuance
State Su rcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
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 f urther certif y
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, 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 certify that only corftractors and employees who
are in compliance with ORS 701.055 will bc used on this
proiect.
I further agree to ensure that all required inspectiols are
requested at the proper time, that each address is readable
f rom the street, that the permit card is located at the f ront
of the property, and tlre approved set of plans will remain
on the site at all times during construction.
tv
Signature
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
4lo'4
€1DATE PAID
VA.LIDATION:
RECEIPT NUMBER --
AI,/iOUNT FECEIVED
RECEiVED BY
--
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
l4>!€,
GAR
4f\l-t"^
qz
CITY OF OREGO'U
SPRlltlcFIELf,
sur
quir m
225 FTYTE STRBBT
SPRTNGPTBLD, OREGON 97477
INSPBCTI0N REQT EST| 726-
OPFrcE: 726-3759
1
JOB DBSCRIFTION
tlr-"^*J.p
Permits are non-transferable and expire
if vork is not started vithin 180 days
of lssuance or lf vork is suspended for
180 days.
2 INSTALI..ATION ONLI
Electri tractor
Address
ci
BI.,BGIRICAL PER}IIT APPLICATION
City Job Nunber
3. COI{PLETB PEB SCABDULE BELOS
A. Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
-Modular Dwelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
B. Services or Peeders
Installation, AlEeratlons
or Relocation:
200 amps or less -l-201 amps to 400 amps
401 amps to 600 amps
-601 amps to 1000 amps_
Over 1000 amps/volts _Reconnect 0nly
LD{Z-
376e vlgln",
\DB
LOCATION
& tto OP INSTALI,ATIONN,2-5t1, PL-
Sum
$ s0.00
$ 60.00
$100.00
s130.00
$300.00.s 40.00'
=
Supervisor License
Expiration Date
Constr Contr.ber
Expi ra t i te
Ovners Name
Address
Ct ty
of Supervising Electrici
Phone
One Circuit
-/ Each Addltional
Circuit or vith Service
or Feeder Permi t
B.
STIBTOTAL OF ABOVB
5Z State Surcharge
TOTAL
r
c Tenporary Services or Peeders
Installatlon, Alteration or Relocation
200 amps or less '$ 40.00
201 amps to 400 amps
-
$ 55.00
over 401 to 600 amps
-
$ 80.00
Over 600 amps or 1000 vorfs see uB' affi
D. Branch Circuits
New, Alteration or Extension Per Panel
$ 3s.00
$ . 2.00OSNER
The installation is being made on
property I ovn vhich is not lntended
for sale, lease or rent.
Orners Signature:
DATB:
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/outline Lighting- S 40.00
Limited Energy/Res
-
$ 20.00
Llmited Energy/Comm $ 36.00
)0
Phone
RBCBIVBD
5
p