HomeMy WebLinkAboutPermit Building 1998-03-19GFIELE,RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Olfice: 726-3759
LOCATION OF PROPOSED WORK:
JoBNUMBEaIE€E€P-
225 Fifth Street
Sprlngfleld, Oregon 97477
Sc.3ztu tua
ASSESSORS MAP:TAX LOT:
SUBDIVISION: -LOT BLOCK:
ONE:
ZIP:STATE:
OWNER:
ADDRESS:
CITY:
ADDITION DEMOLISH OTHEFI
DESCRIBE WOFIK:
NEW- REMODEL
DDRESS EXPIRES PHONE44tzCONTBACTOR'S NAME
ELECTRICAL:
MECHANICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
RANGE:
_ OFFICE USE -
LAND USE:
WATER HEATER
ZONING CODE:
FLOOD I]LAIN:QUAD AREA:
# OF BLDGS
SECONDARY HEAT
SOUARE. FOOTAGE:
# OF BDRMS:-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 lnspectlons requested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED TNSPECTIONS
l--l remporary Electric Rough Mechanlcal - Prior to
cover.
Flnal Plumbing - When all
plumbing worl( is complete.
Slte lnspectlon - To be made
after excavation, but prior to
setting forms.
w Rough Electrical - Prior to W Final Electrlcal - When all
electrical work is complete,cover.
Underslab Plumblng/ Electrlcal /
Mechanlcat - Prior to cover.
Electrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Final Mechanlcal - When all
mechanical work ls complete.
Foollng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
fr Flnal Building - When all
required lnspectlons have been
approved and building is
completecl.Masonry - Steel locatlon, bond
beams, groutlng.w
w
Framlng - Prlor to cover.
Foundallon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Celling lnsulatlon - Prlor to
cover.
Underground Plumbing - Prior
to filling trench.Wow*"ll - Prlor to taplng'
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng.Wood Stovo - After lnstallation.
Posl and Beam - Prlor to lloor
lnsulatlon or decking.lnserl - After flreplace approval
and lnstallatlon of unit.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approaclr - 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 fllling
trench.Eleclrical Connection - When
blocking, set-up, and plumblng
lnspections have been approved
and the home is connected to
the servlce panel.
Storrn Sewer - Prior to fllling
trench.
Sidewalk & Driveway - After
excavation ls complete, forms
and sub-base material in place.
Water Llne - Prlor to filling
trench.
Fence - When cclrpleted
Street Trees - When all requlred
trees are planted.
Final - After all required
inspectlons are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.
Rough Plumblng - Prlor to
cover.
# OF UNITS:
-
E
E
tl
E
tl
w
tl
E
E
E
tl
E
E
E
E tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Ty*-
-
lnterlor
-
Corner
-
Panhandle !
-
Cul-de-sac
Setbacks IS THE PROPO,SED WORK IN THE .
.H;!?IOHICAL OISTRICT, OR ON
THE HISTORICAL REGISTER?
lf yes,+thls,applicatlon must be slgned
and agilr6ved by the Historlcat
Coordinator prior to peimit issuance.
APPROVED:
P,L. .HSEi GAR ACC
N
.. g.
S
E
BUTLDING PERIVIIT ;
SO. FT.VALUE
(A)
v2o/qaa
-
3tu
_86eF
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
':, 't
X $/SQ. FT.
Thls permit is granted on the express condition that the sald
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.
Receipt Number:_
Plans Reviewed By Date
Plan Check Fee:
Date Paid
Received By
BUTLDING VALUE
AND BUILDING P
, i5tRru cHEcK
ERMIT
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Slorm Sewer
Moblle Home
FEE
(c)
N.
FT.
PLUMBING PERMIT
FT.
FT.
Plumbing Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMTT
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 cerilfy that all
lnformatlon hereon is true ancl correct, and I f urther cerflfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs 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 wlthout perrnission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
proiect.
I further agree to ensure that all required lnspections are
reguested 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 will remain
Signature
Date
on the site mes ng constructlon
MISCELLANEOUS PERMTTS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, Q and E Combtned)
DATE PAII)
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
FIECEIPT NUMBER
3q2.
C'TY OF OREGOA'
A
225 FIFTE STREET
SPRINGFIELD,
INSPECTION REQTIEST:
OFFICE: 726-3759
1 OF ON
,J IJ
')
JOB"
Permits are non-trahsferab le and expire
if vork is not started vithin 1"80 days
of issuance or if vork is suspended for
LBO days.
2. CONTRACTOR INSTALLATION ONLY
SP} .}FIELO
ELECTRICAL PBRI{IT APPLICATION
iollowino oroiec't as oubmitted has thr
ing and-d;es-not regulre epocillc landTHB
(
Electrical Contractor
Address
C t S 0-\n ciTrun .,Jrrn-
NOT ty o Nunber
200 amps''or I
201 amps to 4
Over 40L to 6
Over 600 amps
30
40.00
s5. oo
80.00
ee ItBn aEove
-r-u--Supervisor License Number
Expiration Date o-r-q8
Constr Contr. Number .1 s4q
Expir:ation Date g-l-q?
Si of Supervising Electrician
0wners Name
Add ress
b8^-4rqo
COHPLETE PEE SCEEDT'LE BELOII
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 Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 8s.00
s 1s.00
s 40.00
Services or Feeders
InstalIation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amPs
-
40L amps to 600 amPs
-
601 amps to 1000 amPs-
Over L000 amPs/volts
Reconnect OniY
C.Temporary Services or Feeders
Insta1lation, Alteration or Relocation
Ci ty
Ci ty one
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent'
0rners Signature:
JnI\d Phone 7 4l -*A3b
fgn
A
Sum
B
s s0.00
s 60.00
s100.00
s130. 00
s300.00s 40.00
$
$
$
s
psam
ess
00
00
or
amDs
1000 volts
D. Branch Circuits
SUBTOTAL OF ABOVE
5% State Surcharge
32 Administrative Fee
TOTAL
Nev, Alteration or Extension Per Panel
one Circuit I S 35'00 35e'.-o
Each Additional
Circuit or vith Service
or Feeder Permi t I $ 2.00 A'OO
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/0ut1ine Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
3,1 .
s 40.00
s 40.00
$ 20.00
s 36.00
5
DATB:
RECEIVED
o-(t.9 5
q13
I6
'
A.S
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