HomeMy WebLinkAboutPermit Building 1999-10-12RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
JoBNUMBER%
225 Fifth Street
Sprlng(leld, Oregon 97477z
t,' t
TAX LOT
SUBDIVISION: -LOT
-
BLOCK:
STATE:ZIP:
7GPHONOWNER:
ADDRESS:
CITY:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ADDRESSME EXPIRES ,..1 PHONECONTRACTOR'S
ELECTRICAL:
MECHANICA
CONST.
CONTRACTOR ',
GENERAL:
PLUMBING
RANGE:
E OF BDRMS:
- OFFICE USE -
LAND USE:
WATEB HEATEFI:
FLOOD PLAIN
* OF UNITS:
OUAD AREA:
r OF BLDGS:
SECONDARY HEAT
SOUARF. FOOTAGE:
OCCY GROUP:
* OF STORIES:
ZONING CODE:
CONSTR. TYPE:
HEAT SOURCE:
To reguest an lnspectlon, you must call 726-3769, Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. will be
made the same worklng day, lnspectlons requested after 7:OO a.m. wlll be macte the followlng work day.
REQUIRED INSPECTIONS
l--l Temporary Electrlc w Rough Mechanlcal - Prlor to
cover.
fll Flnal Plumblng - When ailt/4J plumblng worl< ls complete.
fl Flnal Etectrlcal - When ail'# electrlcal work is complete.
Slte lnspectlon - To lre mado
after excavatlon, but prlor to
setting forms.7 Rough Electrlcal - Prlclr to
cover.
Underslab Plumblngl Eleclrlcal /
Mechanlcal - Prlor to cover.E Electrlcal Servlce - Must be
approved to obtaln permanent
electrloal power.
[7 Fanal Mechanical - When ail
,H mechanlcal work ls complete.
l-11 Flnal Buildlng - When ail# requlred lnspectlons have been' approved and bulldlng is
completed.
l-l Footlng - After trenches are|J excavated.Flreplace - Prlor to faclng
materlals and framlng lnsp.
Masonry - Steel locatlon, bond
beams, groutlng.w
W
W
tl
E
Framlng - Prlor to cover.
Foundatton - After forms are
erected but prlor to concrete
placemont.
Other
Wall/Celllng lnsulatlon - Prlor to
cover,
l-l UnaergrounC Plumblng - PrlorlJ to fllllng trench.Drywall - Prlor to taplng,
MOBILE HOME INSPE TIONSl-l Underlloor PlumQlnglMechanlcal
Prlor to lnsulatlon or decklng.Wood Slovo - After lnstallation,
Post and Bcam - Prlor to floer
lnsulatlon or deoklng.lnsert - Alter flreplace approval
and lnstallatlon ol unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulallon - Prlor to
decklng.Curbcut & Approach - After
forms are erected but prlor to
placomont of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.E Sanitary Sewer - Prior to fllllng
trench,Electrlcal Connectlon - When
blocklng, set-up, and plumblng
lnspectlons have been approved
and the home is connected to
the servlce panel.
Slorm Sewer - Prlor to fllllng
trench.
Sidewalk & Drlveway - After
excavatlon ls complete, forms
and sub-base material in place.
E
w
Water Llne - Prlor to filllng
trench.
Fence - When coinpleted.
Rough Plumblng - Prlor to
cover.
,Str€ol Trees - When all requlred
trees are planted.
Final - After all required
lnspectlons are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.
.- ',
EE
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type-
-
lnterior
-
Corner
.- Panhandle !
-
Cul-de-sac
IS THE PROPOE ED WORK TN THE.' HrsToBlcAL DtsTRtc'r, oR oN
THE HISTOR]CAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Historlcal
Coordlnator prlbr to permit issuance.
APP ED:
ACC'P.L.HSE GAR
N
S
E
VALUE
/@*P
(A)
FT.
ntrr i
.:38
_/?-%
Total Value
Building Permit Fee
State Surcharge
Total Fee
*277
'ih
x $/so. FT,
BUILDING PER
ITEM SO.
Maln
Garage
Carport
BUtLDlt\iG tAlUe, Fmru cHEcK
AND BUILDING PERMIT
Thls permlt is granted on the oxpress condltlon that the sald
constructlon shall, ln all respects, conform to the Ordinance
adopted by the City of Sprlngfleld, includlng 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.
Plans Reviewed By Date
Receipt Nu
Date Paid
Received By:
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties withln the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
*7i2
FEEq
(c)
Nr
FT.
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed appllcation and do hereby certify that all
lnformation hereon is true ancl correct, and I further certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure wlthout permission of the Bullding Safety Divislon.
I further certify that only contractors and employees who
are in compllance wlth ORS 701.05S wlll be used on thls
proiect.
I further agree to ensure that all requlred lnspections are
requested at the proper time, 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 remaln
Date
on the site at all times duri ng construction
Slgnatu
/ 7)7y-J)'-*
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
/r.n?
No
(D)26,52
'/2 ,-',9:re
MECHANICAL PERMIT
Mechanical Permit
lssuance
State Surcharge
Total Permit
Furnace
Exhaust Hood
Vent Fan
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)/EZ
,/2 ^/2 -99DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VAI.IDATION:
RECEIPT NUMBER
?,n
ara
Permit #:??r ?7 t-
Address 627 S fllil
Issued by:Ur/Date:o f
a
ffi
Fill in the appropriate blanks and initial boxes I and2, and either box 3,A' 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.
3,A'. My general contractor is
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
@
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certiff that the above information is correct and that I have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
/ of rr/q o
applicant)
(LVhite copy to issuing agency permil rtk,
pink copy to applicant)
OR
38. I will be my own general contractor
X (Signature
-
(Date)
6(
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement 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 permtt.
\
:;:1,)t:....i1 i,1 :'..ii, .r..r'...: r,, ..i,:!.,.-:. .,_.,.:. :r,r :.ir3:.i :r',1
:ii.'l':j-.,l::.:J.:]l...:'..'...]l.i:::].!!.l:.-.;i:..l....'|]9il::l..
'j
1:
,:.: I i r".,... i
* g'TY OF OREGON(,
Ihe tollowing proiect as submitted has the following
.zontng. and does not require specific land use
LDR ELECTRICAL PERHIT APPLICATION
225 TIFTE STREET
SPRINGFTEID, oREGoN
INSPECf,ION REQIIEST:
OFFICE: 726-3759
Ci ty
Supervi so
180
ExP iration Dat
Owners Name
Address
Ci tY
OIINER INSTALLATION
DATE:
approval.
Zoning
9*6 -17 r0 r) g?
City Job Nurnber ?7r)?_f
COHPTETE FEE SCMDUI,E BELOV
726-37694ulnorlzeo t'lgnalUre
e #iaI
T,EGAL DESCRTPTION
3
JOB
1000 sq .ft. or less
,.-9 Each add itional 500
ft or portion
Permits are non -transferable and exPire ere of
if vork is not sta rted vithin 180 daYs
of issuance or if vork is susPended for Modular 'Dvelling
Service or Feede r
-
$ 40'00
180 daYs.
1 ON OF INSTALLATTON
2. COMRACTOR INSTALI,ATION ONLY
Electrical Contractor
NOflCE:
Address
-Single or
r dvelling unit.
d:Items Cost
Nev Resident
MuI t i-Fami 1Y
Service IncI
pe
ude
Sum
,
,,,0 in
ers
terat ions
$ 8s.00
$ s0.00
s 60.00
$100. 00
$130.00
$300.00
$ 40.00
sq
th
cailil
r8nii,l Services or Feed
Installation, AI
or Relocation:
c.
Constr Con Number
Expi ra t 200 amps'
201 am
0ver 4
Si re of SuPervising Electrician Over 600
D. Branch Circuits
200 amps or less I
201 amps to 400 amPs
-
401 amPs to 600 amPs
-
601 amPs to 1000 amPs-
Over 1000 amPs/volts
-
Reconnect onIY
Temporary Services or Feeders -i;;l;ii;iionl art"ration or Rerocation
'or ress $ 19'99io aoo amPs -- $ tt'99io 6oo am-ps -T $ Bo'00
;p;-;t-ibooEft" see 'rB't above
-Each installation
Pump or irrigation --Siqn/Outline Lighting-
Liilited Energy/Res --Limited EnergY/Comm
IFTHE
PERIOD
Phone
ISNOT
at-L
.
$
$
$
$
,PS
01
Alo Nev, Alteration or Extension Per Panel
One Circuit $ 35'00
Each Additional-Cii"uit or vith^Service-, ( ,..00 3or Feeder Permit -( ) z---
Miscellaneous (Service/feeder not included)
oQ
3Y3:1ot3
The installation is being made on
piop"tty I ovn vhiih is not intended
ior-saIe, Iease or rent'
Ovners Signature:
E
5
40.00
40.00
20.00
'j'oo{t
SUBTOTAL OF ABOVE
7% State Surcharge
3Z Administrative Fee
TOTALa
RECEIVED
, $ 1s.00
t1 .{
Home.,d
iiticatiort
S frU