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Home My WebLink AboutPermit 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 Jn \-\c\,.