The URL can be used to link to this page

Home My WebLink AboutPermit Building 1993-09-02I CiFtELE) RESID ENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726'3759 ?s / sy', h, JOB NUtvIBER 225 Fifth Street Springfield, Oregon 97 477 /*f /l/'oErtl FL SFuu /eto f)W LOCATION OF PROPOSED WORK: ASSESSORS MAP:TAX LOT: LOT BLOCK:SUBDIVISION: - rrfrs PHONE: OZ ZIP:STATE: ) o /l/ 6r/-&/nruOWNER: ADDRESS:3f ZtruGFt€LQCITY: 'lufl NEW - REMoDEL l'/ ADDlrtoN DEMoLISH orHER 0b8L)N /*2, PMDESCRIBE WORK: PHONEEXPIRESADDBESS )& )L)&<GENERAL: PLUMBING: ELECTRICAL: CONST. CONTRACTOR #CONTRACTOR'S NAME # OF BDBMS: - OFFICE USE _ ZONING CODE: FLOOD PLAIN WATER HEATER:RANGE: SECOI.IDARY HEAT SQUARE FOOTAGE: OUAD AREA: g OF BLDGS: LAND USE: OCCY GROUP: I OF STORIES: CONSTR. TYPE: HEAT SOURCE: Torequestanlnspectlon,youmust call 226-Sz6g.Thlslsa24hourrecording.All lnspectlonsrequestedbeforeT:o0a.m.wlll be made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day' REQUIRED INSPECTIONS l-l TemporarY Electric t__J Rough Mechanlcal - Prlor to cover. V1 rlnat Plumbing - When all fA\ptumulng work ls comPlete. X7 finat Etectrical - When all lAetectrlcal work is comPlete. Slte lnspection - To be made after excavation, but Prior to setting forms. Rough Electrical - Prior to cover. Underslab Plumbing / Electrical/ Mechanical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrlcal power. K Final Mechanical - When all mechanical work ls comPlete. Footlng - After trenches are excavated.Fireplace - Prlor to faclng materlals and framlng lnsP. V1 ftnat Building - When all la\.lequired inspections have been approved and building is completed.Masonry - Steel locatlon, bond beams, grouting.Framing - Prior to cover. Other Foundation - After forms are erected but Prlor to concrete placement. Wall/Ceiling lnsulation - Prlor to cover. Underground Plumbing - Prlor to filling trench.[-_l Drywall - Prlor to taoing. MOBILE HOME INSPE TIONS Underltoor Plumblng / Mechanical - Prior to insulatlon or decking.l-l Wood Stove - After lnstallatlon. Posl and Beam - Prior to floor insulation or decking.lnsert - After flrePlace aPProval and lnstallation of unit. I--l Blocking and Set-Up - When alllJ blocking ls complete. Floor lnsulation - Prior to decki ng.Curbcut & Approach - After forms are erected but Prior to placemerrt of concrete. Plumblng Connections - When home has been connected to water and sewer. Sanitary Sewer - Prlor to filllng trench.Electrical Connection - When blocking, set-up, and plumbing inspections have been aPProved and the home is connected to the servlce panel. Storm Sewer - Prior to fllllng trench. Sidewalk & DrivewaY - After excavation ls comPlete, forms and sub-base material in Place. Water Llne - Prlor to fllllng trench. Fence - When comPleted. Final - After all required inspectlons are approved and Rough Plumbing - Prior to cover. Slreet Trees - When all requlred trees are planted, porches, sklrting, decks, and venting have been installed. I.i t .?/r / MECHANICALT OUt/f 'N ri E D E E E t] tl E E E E B E F fl tl E E E Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type - lnterior - Corner -- Panhandle - Cul-de-sac Se 15 THE PROPOSED WOHK IN THE HISTORICAL DISTRICT, OR ON TH E H ISTOBICAL REGISTER? - lf yes, ihis appllcation must be slgned and approved by the H istorlcal Coordinator prior to permlt issuance. APPROVED: P.L.HSE GAR ACC N S W E BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT 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 bulldings, and may be suspended or revoked at any tlme upon violation of any provlsions of said ordinances. Pran check ru"t /?'/a (sfu '?Ek<') tesewed Recelpt Numbe Date Pald: Recelved VALUE (A)3 X $/SQ. FT. /,4o ?a ,qoo 2?F" Total Value Bulldlng Permlt Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport Systems f)evelopment Charge is due on all undeveloped properties withln the City limits which are being improved. SYSTEMS DEVELOPMENT C (B) HARGE (SDC) It,/A, ADDITIONAL COMMENTS ITEM Flxtures Resldentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home {'t SoQ Z-- FEE 5o@ 2f,o (c) @ N0 FT. FT. PLUMBING PERMIT Plumblng Permlt State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N0 Wood Store/ lnsert/ Flreplace Unlt Dryer Vent Mechanical Permlt lssuance State Surcharge Total Permlt I (D) MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sldewalk - ft Curbcut - tt Demolltion 8.Nd,KEn)fo f ,o Total Mlscellaneous Permlts (E) TOTAL AMOUNT DUE (excludlng electrlcal) (A, B, C, D, and E Comblned) By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all lnformatlon hereon ls true and correct, and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertainlng to the work described herein, and that NO OCCUPANCY will be made of any structure without permission ol the Building Safety Divlslon. I further certify that only contractors and employees who are ln compllance with ORS 701.055 will be used on thls prolect. I further agree to ensure that all reguired lnspections are requested at the proper time, that each address ls readable lrom the street, that the permlt card ls located at the front of the property, and the proved set ol plans wlll remaln on the slte at all times ring constructlon. I M//(), @ /o ao ,7f a5,7s 1vnatu re Date /q,lo -1q ;O VALIDATION: RECEIPT NUMB DATE PAID AMOUNT R RECEIVED I S3 t" - ele&r*{ FT. I Permit No: Address: lssued Date: R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(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 under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the icable blanks, and initial boxes 1 and 2, and either box 3A or 38 1 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. 2 3. A.l-----l My general contractor is , Contractor registration numb I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3.8 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 issuing this building permit of the name of the contractor. I hereby certity that the above information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this lorm. /r&.auQ.+-o ? q< l' c . It- u ignature Pe t Applicant Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT ,) CONSTRUCTION CONTRACTORS BOARD 0244J 8191 CITY OF SPR OFEGO'U 225 PIFTE STREET SPRTNGPIBLD, ORBGON 97477 INSPECTfON RBOIIBST: 726-3769 oPPrcE: 726-3759 I.i":' ' - speci'fic land use EI,ECTRICAL PBRI{IT APPLICATION Ci ty Job Nunber COHPI.ETB FEE SCEEDTII,E BELOV Nev Residential-Single or MuIti-FamiIy per dvelling unit. Service Included: I tems Cos t 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or -Hodular Dvelling Service or Feeder $ 8s.00 $ 1s.00 $ 40.00 zonin.J. and does not require The follcwing Proiecl as submitted has the fol seRINGrrel.o Services or Feeders Installation, Alterations or Relocation: 200 amps or less ^C201 amps to 400 amps - 401 amps to 600 amps -601 amps to 1000 amps_ 0ver 1000 amps/volts Reconnect Only qj1-1? 1 OP Permits are non-tr erable and explre if vork is not started vithin 1'80 days of lssuance or if vork ls suspended for 180 days. 2. COIITRACTOR INSTALI.ATION ONLY ieal Contractor Address ci Supervisor License Explration Date Constr Contr. Explratlon te Slgna of Supervlsing Blectrician Owners l Address Cl ty OSNER ALLATION The installatloh is beirig made on property I ovn vhlch is not intended for sale, Iease or rent. tures " Aze DATB: Temporary Services or Feeders Installation, Alteration or Relocation D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Addi tionalCircuit or with Service or Feeder Permit $ 2.00 SUBTOTAL OP ABOVB 5Z State Surcharge TOTAL 200 amps or Iess $ 40.00 201 amps to 400 amps - $ 55.00 over 401 to 6oo amps - g 8o.oo 0ver 600 amps or 1000 voTts see I'Brr a5m- A Sum B c $ so.0o $ 60.00 $100.00 $130.00 $300.00 $ 40.00 I ]?t E 5 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/outline Lighting- S 40.00 Limited Energy/Res - g 20.00 Limited Energy/Comm $ 36.00 Phone RBCEIVED oe M,q) - CITY OF OREGO'V SPRINGFIEL() m 225 FIFTE STRBBf,BI,EGTRICAL PBRHIT APPLICATION Ci ty Job Nunber sPRrNGrrELD, OREGoN 97477 INSPECTION RB0UBST: 726-3769 0PPICE: 726-3759 i( _(N* 'a1z 1. LOCATION OP I,EGAL DBSCRIPTION JOB Permits are non-transferable and expire if work is not started vithin 180 days of lssuance or lf vork ls suspended for 180 days. 2. CONMACTOR INSTALI.ATTON ONLY Elecirical Contractor Address COHPI.,ETB SCEEDTILE BELOV A. Nev Residential-Single or Multi-Family per dvelling unit. Serviee Included: I tems Cos t 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Hodular DweIIing Servlce or Feeder $ 8s.00 $ 1s.00 $ 40.00 B Services or Feeders Installation, Alterations or Relocation:? t-. rEE STETOTAL OF ABOVB 5f State Surcharge TOTAL Sum ct Phone Supervisor License Number Expiration Date Constr Contr. Number Exp iration Date Signature of Supervlsing Electrician Owners Na^er!3?ft,*2'fu?<*,% Address uty fu?zr Phone 7//9%9t OIINBR INSTALI.ATION The.installatlon is beldg made on property I ovn vhich is not intended for sale, lease or rent. 0mers Temporary Services or Feeders Installation, Alteratlon or Reloeation D. Braneh Circuits Nev, Alteration or Extension Per Pane1 One Circui t "/' Each Addi tional Circuit or vith Service or Feeder Permi t 7_7 200 amps or less $ 40.00 201. amps to 400 amps - g 55.00 over 401 to 600 amps - $ 80.00 0ver 600 amps or 1000 voT[s see rrBrr a66;il 200 amps or less 201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps_ Over 1000 amps/volts Reconnect 0nIy -Each installation Pump or irrigation Sign/OutIine Lighting- Limited Energy/Res -Limi ted Energy/Comm $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 c I $ 3s.00 $ 2.00 vr* 4 de, E. Miscellaneous (Service/feeder not ineluded) $ 40.00 $ 40.00 $ 20.00 $ 36.00 5 DATB: RBCBIVED aDO /2*'-%o' o*