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Home My WebLink AboutPermit Building 1996-06-07R ESIDENTIAL PERMIT APPLICATION lnspections:726-3769 Office: 726-3759 P'IIhlGFIELO LOCATION OF PHOPOSED WOFIK:///7 11am,.-< 5Z JoBNUMBE^@ 225 Fifth Street Sprlngfleld, Oregon 97477 fz+aa*z ASSESSORS MAP;-)TAX LOT:,4q6 zP SUBDIVISION: - ONPH,4 ztP OWNER: ADDRESS: CITY: NEW - REMODEL ADDITION DEMOLISH OTHER DESCFIIBE WORK ADDRESS EXPIRES PHONECONTRACTOB'S NAME MECHANICAL: ELECTRICAL; PLUMBING: GENERAL: CONST. CONTRACTOR # - OFFICE USE - , OF BDRMS: RANGE:WATER HEATER: FLOOD PLAIN SECONDARY HEAT: _ SOUARE FOOTAGE: '/ OFTJNITS: LAND USE:QUAD AREA: / OF BLDGS OCCY GBOUP: g OF STORIES: ZONING CODE: _ 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 bemade the sarne worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day. REOUIRED !NSPECTIONS Temporary Electrlc Rough Mechanlcal - Prlor to cover. Final Plumbing - When allplumblng worl< is complete, Slte lnspectlon - To be madc after excavatlon, but prior tosettlng forms, w Rough Electrlcal - Prlor to lQ final Electrlcal - When ail14 electrical work is complete.cover. Electrlcal Servlce - Must be approved to obtaln permanent electrlcal power. Final Mechanical - When all mechanical work ls complete. Flreplace - Prlor to faclng materlals and framlng lnsp. w Flnal Bulldlng - When allrequlred lnspectlons have been approved and building is completed. @ a Framlng - Prlor to cover. Other Wall/Celllng lnsulatlon - Prlor to cover. fA orywall - Prlor to taplng MOBILE HOME INSPECTTONS Wood Stovc - After lnstallatlon lnsert - After flreplace approvql and lnstallatlon of unlt. n Blocking and Set.Up - When ail.a blocklng ls complete. Curbcut & AJrproach - After forms are erected but prlor to placemont of concrete. Plumbing Connections - When home has been connected to water and sewer. Electrlcal Connectlon - When blocklng, set.up, and plumbing lnspections have been approved and the home is connected to the servlce panel. Sidewalk & Drlveway - After excavation ls completo, forms and sub.base material ln place. Fence - When completed Slreet Trees - When all requlred trees are planted. Flnal - After all required lnspectlons are approved andporches, sklrtlng, decks, and ventlng have been lnstalled. LOT: - BLOCK: "4 i E l-_l Underslab Plumblng/ Electrical/ - Mechanlcal - Prlor to cover. J-l Footlng - After trenches arelJ excavated. I--l Masonry - Steel locatlon, bond 'J beams, groutlng. I--l Foundatlon - After forms are - erected but prlor to concrete placement. [-l Unaerground Plumblng - PrtorlJ to fllllng trench. l-l Underlloor Plumblng/ Mechanlcal Prlor to lnsulatlon or decklng. n Post and Beam - Prlor to floor 'J lnsulatlon or decklng. I-_l Floor lnsulatlon - Prior to - decklng. l-l Sanltary Sewer - Prior to fllling 'J trench. l-l Storm Sewer - Prlor to fllllng.J trench. [--l water r-rn" ] Prtor ro filingu trench. [-l Rough Plumblng - Prior to - cover. E E Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Typ - lnterior - Corner - Panhandle - Cul-de-sac Setbacks PL.HSE GAR ACC N S E IS THE PFIOPOSED WORK 'N THE - HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTEFI? - lf yes, this applicatlon must be slgned and approved by the Historlcal Coordinator prior to permit issuance. t APPROVED: 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, inctuding the Development Code, regulating the construction and use of bulldings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee: Date Pald Receipt Number Received By: Plans Fleviewed Ely Date Systems Developmcnt Charge ls due on all undeveloped properties withln the City lirnits which are being lmproved. ADDITIONAL COMMENTS By slgnature, I state and agree, that I have caref ully examlned the completed appllcatlon 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 accordance wlth the Ordinances of the City of Springfleld, and the Laws of the State of Oregon pertalnlng to the work described hereln, and that NO OCCUPANCy will be made of any structure wlthout perrnission of the Bullding Safety Divislon. I further certlfy that only contractors and employees who aro ln compliance wlth OBS 701.055 will be used on thls proiect. I further agree to ensurc that all requlred lnspections are requested at the proper tlme, that each address ls readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans will remain on the site at all times durlng construcilon. Slg natu re VALUE ee /5.v(A) rc o X $/SO. FT. Total Value Building Permit Fee State Surcharge Total Fec BUILDING PERMIT ITEM SO. FT. Main Garage Carport SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumblng Permlt State Surcharge Total Charge Wood Stove/ lnsert / Fl replace Unit Dryer Vent MISCELLANEOUS PERMITS Mobile Home State lssuance Stato Surcharge Sldewalk - ft Curbcut - ft Demolition State Surchargg Total Miscellaneous Perrnits (E) (D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnacc Exhaust Hood TOTAL AMOUNT DUE (excluding electrical) (A, B, q D, and E Comblned) ,/Z -2a" Z^?.%DATE PA,ID AMOUNT RECEIVED RECEIVED BY VALIDATION: BECEIPT NUMBER Date f\ * e) .^^ d*os 225 FIFTE STREET oaullA4.b SPRINGFIELD, 0REGON 97 4TTtuthorlzed Sls INSPECTION REQUESTz 726-3769 OFFICE: 726-3759 1. LOCATION OF INSTALI,ATION4q\ u s{a IJGAL DESCRIPTION JOB DESCRIPT ELECTRICAL PERHTT ob Number COMPI-ETB FEE SCEEDTILE BELOV New Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost The following project as submittod has the zoning, and doea not require epecific land use approval, SPFiltr.{iFtEL.) One Circui t Each Additional 71 3 A 2u Perm J J-<& r71 r\sits are non-sferable and 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular Dvelling Service or Feeder $ Bs.0o s 15.00 s 40.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less --(-201 amps to 400 amPs _ 401, amps to 600 amps _ 601 amps to 1000 amps_ Over L000 amps/volts Reconnect Only Temporary Services or Feeders Inslallation, Alteration or Relocation 200 amps''or less 201 amps to 400 amPs -Over 40L to 600 amps 0ver 600 amps or 1000 voTEs Branch Circuits Nev, Alteration or Extension Per Panel | $ 3s.oo E Circuit or vith Servicg or Feeder Permit , 117)d$ 2.00 IO.N }, ^(s, & L ^ft ran ifo 40.00 55.00 80.00 ee "Br Sum above re if vork is not started vithin 180 days of issuance or if uork is suspended for 180 days. 2. COMRACTOR INSTAI,LATTON ONLY B. Electrical Contractor Zta.fr,',2 P,r)Address . 6o* Lbq cit ,tr,l k Phone -o"70r Supervisor License Number 3(&6-S Expiration Date b C Constr Contr. Number LqqT-c- Expiration Date Signature of Supervising Electrician Ovners Name 6rV s Address 4q)4zr-t\ Cr Ci ty Phone OVNER INSTALI.ATION The installation is being made on property I ovn vhich is not intended for sa1e, lease or rent. 0vners Signature: DATE: E. Misce]laneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/Out1ine Lighti.g- Limited Energy/Res _Limited EnergY/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Admi-nistrative Fee TOTAL 0-o $ s0.00 s 60.00 s100.00 s130.00 s300.00 $ 40.00 $ $ $ s 5c = D ra s 40.00 s 40.00 $ 20.00 $ 36.00 7?r RECETVED -t -4 5 auL( *(b ( |