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HomeMy WebLinkAboutPermit Building 1995-02-23RESIDENTIAL PERMIT APPLICATION lnspectlons: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WOFK:- ASSESSOHS MAP: LOT: IELD JOB NUMBEB 225 Fifth Street Sprlngfleld, Oregon 97477L TAX LOT: BLOCK:SUBDIVISION:- lon, you must call 726'3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll beng day, lnspections requested after 7:00 a.m, wlll be made the followlng work day. REQUIRED INSPECTIONS Slte lnspectlon - To after excavailon, but o?i"nio" ffi;;"t: Electrlcal - Prlor to l!filnar Etectrtcat - when alt settlng forms. Felectrlcal work is complete. n Underslab Ptumblng/Electrical/ - Mechanlcal - Prlor to cover. To request an lnspectl made the same workl f] TemPorary Etecrrtc Footlng - After trenches are excavated. Foundatlon - After forms are erected but prlor to concrete placement. Underground Plumblng - prior to fllllng trench. Post and Boam - Prlor to floor lnsulatlon or decklng. Rough Mechanlcal - prlor to cover. Electrlcal Servlce - Must be approved to obtaln permanent olectrlcal power. Flreplace - Prlor to faclng materlals and framlng lnsp. Flnal Plumblng - When allplumblng work ls complete, Flnal Mechanical - When allmechanlcal work ls complete. K flftnat Buitding - When al )f--requlred lnspectlons have been/ approved and bullding is completed.l-l Masonry - Steel locailon, bond - beams, groutlng. N I-l Underlloor Plumblng/Mechanlcat Prlor to lnsulatlon or decklng. E' Wall/Celllng lnsulatlon - Prlor to cover. Drywall - Prlor to taplng Wood Stovo - After lnstallatlon. lnserl - After flreplace approval and lnstallatlon of unlt. Curbcut & Approach - After forms are erected but prlor toplacemcnt of concrete. Sidewalk & Drlvewav - After excavatlon ls complete, forms and sub.base materlal ln place. Fence - When completed Street Trees - When all requlred trees aig ptanted. Other MOBILE HOME INSPE TIONS Blocklng and Sot.Up - When ailblocklng ls complete, Plumbing Connecllons - When home has been connected to water and sewer. Electrical Conneclion - Whenblocking, set.up, and plumbtng lnspectlons have been approved and the home ls connected tothe servlce panel. Flnal - After all required inspectlons are approved andporches, sklrtlng, decks, and ventlng have been lnstalled. ffit"'ntng - Prlor to cover. N .K fY ftoor lnsulatlon - prtor tolAdecklng. [-l Sanltary Sewer - Prtor to filting - trench. n Storm Sewer - prlor to filling - trench. _l Water Llne - Prlor to filllngJ trench. Rough Plumblng - Prior to cover. PHONE: STATE:6k 9e,(-, - ./)/- ztP, a7/ 7 7CITY: ADDRESS: OWNER: NEW - REMoDEL ADDrrroN _-tz"oe MOLISH OTHER DESCRIBE WORK: ADDRESS EXPIRES PHONEL CONTRACTOR'S NAME MECHANICAL: ELEfiBICAL: PLUMBING: GENERAL: CONST. CONTBACTOR ' - t\ \ \ I OF BLDGS: \) QUAD ABEA:AQ ft)- oFFtcE usE - , OF BDRMS A OF UNITS: LAND USE: ZONING CODE: FLOOD PLAIN: 4..3 I SECONDARY HEAI: SOUABE FOOTAGE:WATER HEATEB; OCCY GROUP: r OF STORIES: CONSTR. TYPE: HEAT SOURCE: l O 3 .O z+2.e18?./o t,z RANGE: tl tf Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type -- lnterior - Corner - Panhandle ._- Cul-de.sac IS THE PROPOSED WORK TN THE . HISTORICAL DISTRIG'r, OR ON THE HISTORICAL REGISTER? -- lf yes, thls appllcailon must be slgnedand approved by the Hlstorlcal Coordlnator prlor to permit lssuance. APPROVED: ADDITIONAL COMMENTS P.L.HSE GAR ACC N S E BUILDING PERMIT VALUE 5./?91'7' z?e ,72 o :€ A? (A) Zo SO. FT. X $/SQ, FT.ITEM Maln Garage Carport 4-z) g" t Total Value Building Permit Fee State Surcharge Total Fee Fy.t_LqtNG VALUE, PLAN CHECKAND BUILDINC PENMif - Thls permit is granted on the express condrtron that the sardconstructlon shall, ln all respecis, conform io the Ordlnanceadopted by the Ciry . of Spif ngtf eiJ, incrudtng theDevetopmenr code, reguratrng irr" "ln"til"iron and use ofbulldings, and may be suspended or revoked at any trmeupon violailon of any provisions of sald orJln.n""". D/ ewedan SI Date Pald: Recelpt Number: Recelved Plan Check Fee: EMS DEVELOPMENT CHARGE (S b(B) DC) 7/. SYST Systems Development Charge ls due on all undevelopedpropertles within the City limlts whlch are belng lmproved. ITEM Flxtures Resldential Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT FEE No FT. FT. FT. (c) Plumblng permit State Surcharge Tctal Charge Wood Stove/ lnsert/Flreplace Unlt Dryer Vent MECHANICAL PERMIT - (D) N0 Mechanical permlt lssuance State Surcharge Total Permlt Fu rnace Exhaust Hood Vent Fan By slgnature, I state and agree, that I have carefully examlnedthe completed applicailon and do hereby cerilfy that alllnformatlon hereon is true and correct, and I f urther cerilfythat any and all work performed shall be done ln accordancewlth the Ordinanccs of the Clty of Sprlngfield, and the Lawsof the Stale of Oregon pertalnlng to tho work descrlbedhereln, and that NO OCCUPANCy wlll be made of anystructure wlthout permission of the Bulldlng Safety Dlvlslon.I further certlfy that only contractors anOimptoyees whoare ln compllance wtth ORS 70.1.055 wlll be used on thlsprolect. I (urther agree to ensuro that all requlred lnsrequested at the proper ilme, that each from the street, that the permlt card lsof the property, and the approved seton the slte at all times durlng const Date pectlons are address ls readable located at the front of plans wlll remaln ructlon. Xnn^ru MISCELLANEOUS PERMTTS Moblle Home State lssuance State Surcharge Sidewalk tt Curbcut (t Demoliilon State Surcharge Total Mlscellaneous Permits (E) TOTAL AMOUNT DUE(A, B, C, e and E Com VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT R FIECEIVED ] ECEIVED(exctudrns erecrricar) /n:i Sl blned) BY ?/ CEP- ri:a ' Co - - ATTACHMENI- Bi 'rBN0.7to .z CITY OF SPRINGFIELD SYSTEMS DEVELOPMENI CHARGE WORKSHEET (COHMERCIAL & RESIDENTIAL) NA}4E OR COMPAI'IY:5z-*-" LOCATION:/o//-J/. 7a <1" DEVELOPMENT TYPE: BUILDING SiZE:x 1. STORM NRAINAGF IMPERVIOUS SQ. FT. 2. SANITARY SFWER-CITY NO. OF PFU'S (See Reverse) TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x - x $436.i9 x - x s436.19 x - x $436.19 4. SANITARY SEh]FR-HW|'4C SIZ X $0.209 PER SQ. FT.$ 7O. ra X $43.26 PER PFU $17.19 PER PFU + $10 Hl^lMC ADMiN.FEE Above) $ $c $ $ SUBTOTAL (ADD iTEMS 1,2. & 3)5 3O,za Ft 3 NO. OF PFU'S (Use PFU Total F Item 2 M|^IMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL-MWHC SDC SUBTOTAL (ADD ITEMS 1.2.3 & 4)S 7O,r a 5. ANMTNISTATIVF FFFS BASF.CIIARGE (ABOVE) X .05 s /.fd 2 -,ts- 7{ is. 82 . SDC Coordi nat or Date: TOTAI SDC GrO lJJh $,s/ CITY OF OFEGO'V 225 FIFTE STREET spproyal, SPRINGFIELD OREGoN 97477 INSPECTTON REQIBSTt 726-3769 OFFICE: 726-3759 SPllIHGFIELt, PERI{IT APPLICATION 7a ?7o/33 City Job Number 3. COHPTETE FEE SCEEDULE BELOV ial-Single or Multi-Family per dvelling unit. Service fncluded: The fcllowing proioct zoning, and ooes"not L ')- 1. L'CATT,N oF lNsTAll6'1fpfr"rlzec i^it tt. ?Tl-t LEGAL DESCRIPTION/703 3< /2- o,/200 JOB DESCRIPTION Q1a'stot),t-€ Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspented for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor trvaENE FLEl-TfZtC Address t7-i; VlarJza€. Ci ty €ot4gNE Phone 3+4 '357o1 Supe rvisor License Number /ry1? S Exp iration Date /o-rc' Constr Contr. Number Zo. ZZI>C Expiration Date /0.15 Signature of Supervising Electrician 0wners Name Addr"ss city-Phone b$?e-&o<g OI,INER INSTALLATION The installation is being made on property f ovn vhich is not intended for sa1e, lease or rent. Owners Signature: DATE: RECBI L000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Martuf 'd Home or Modular Dvelling Service or Feeder Services or Feeders Installation, Alterations or Relocation: Items Cost Sum s 85.00 $ 1s.00 s 40.00 $ s0.00 s 60.00 $100.00 $1 30. 0o s300.00 $ 40.00 B C 200 amps or 201 amps to 401 amps to 601 amps to Over 1000 a Reconnect 0 Iess 600 amps 1000 amps mps /voI ts nly Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 4 201 amps to 4oo amps - $ 5 over 401 to 6oo amps - $ I Over 600 amps or 1000 voTEs see a86il6- 0.00 5. 00 0.00l'Bil D. Branch Circuits E Nev, Alteration or Extension Per Panel oneCircuit t- $35.00 s{f Each Addi tional Circuit or vith Service or Feeder Permit Z S 2.00 W Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utI ine Light ing_ Limited Energy/Res Limited Energy/Comm $ 40.00 s 40.00 $ zo.oo $ 36.00 5 SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL 6c) o zRBCEIVED B \ v ) Rtm ,qi1rirl!1rria-- ri ! Ir .{i. .k i:i Li ' 1+1.1 N 7rH 51r IJ H$* F: :i lJ ii ililil!ll,i Atr t' i:'I tr.li'l -ilLJl{HIr.' $ u:tf\N R Lrjil rirllii-*f,.r.lil ltrlI Nt.,l:,:tl-l 7tH $II{H}::. $ 'I, it .t N G E .t li L tr " tl lt t] l-i l,] N ':)'i 4'/ 'l * If'l't'tr* f\ tr I' I T I. ttl.i I{g:l tfJriNT rrtL, 1i.11 i .,/i'.,..1 .-lL: i ..rr.r 1 ..ififi -t:l.iEl{trY. ii:I/rI5* l1f,fif t - .:1* I. .itL, trti zui''{f, LnR H:r* *l:LlH llili Ll.tllrir}'l.A IN ii$i\iriri.- iiulrr{H lll:[ fifir R3 INSULAI. 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I [i..J Y I l fi:i111 1fiJ'i 1 {i+1 "1t lt I ':{ .1 ii n /.o(,c} \, 0 o u $f;ti*li l:N lFltii,'i lri$P[f,:f lili,lti + Hl:ilti ] i{h:i.i}:N'I$ *..-HXy Ltrtrl:h;- -*Atil: Itft}}'-- sEfi** IilSPHtiT ItrN$--- **U|l'ti'iiii'{t*- - ltl"rl.H**-l{l;I"t-* IN$I] il r:: 11 i':! J:i li r; n.l T..{ 'jii:011:?'J{i tr; /i ':, '} A r:l { i\':} '} rl {1 Bi rjl 'l i, i r:iL;af it1':1 il:: tl30:t rl $50:lti'l fl ci ii 'i') l1 '..)ii*3(i3 -c}5t) 3 r)ll Lt tr., i 1 '-, '_r 4 Ii';iL130i] {irif}E.11 q 14nr:iltt 3ffffH 3{:ltlli 38 tJ llr 3 elr.l}{ 38 uli 3$ji.l]l{ 38 Ut.( 6I i{tl'[uli 61 fl:iti:1t3 t.l.-;{1'ta1'.1 ctt;/id1'j i:l Li 1l Ji'.i il Lir.rald'-rjt ,..]li(}i:iti5 rtLr(1L,aln.t r'l Lri fi r:i fi 'I' ilr{ t.) l{ I.'LIH l,l lH Nl": Id I.E HilTt.tt{ r.t l.i .:'- 1u.t 61 61 Jtf CITY OF SPR OFEGO'V 225 FIFTE SIREET SPRINGFIELD, OREGON INSPECTION REQIIEST: OFPICE: 726-3759 JOB DESCRTPTION Permits are non-transferable and expire if vork is not started vithin 1B0 days of issuance or if vork is suspended for 1B0 days. 2. COMRACTOR INSTALI,ATTON ONLY S DATE: RECEI SPEINGFIELE' BI,ECTRICAL PERI{IT APPLICATION City Job Nunber 7 5O/ 3? 3. COUPI,ETB FEE SCMDTILE BELO}I A Nev Residential-Single or MuLti-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 $ Bs.oo $ 1s.00 $ 40.00 B Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps -40L amps to 600 amps _ 601 amps to 1000 amps- Over 1000 amps/volts Reconnect 0niY $ s0.00 s 60.00 $100. 00 $130. 00 $300. 00 $ 40.00 Electrical Contractor Address Ci tv Phone Supervisor License Number Exp iration Date Signature of Supervising Electrician Ovners Name fcts*) r€ze Address cir.y 5/n Phone 1c,186'lr&,)b OHNER INSTALI..ATION The installation is being made on E' property I ovn vhich is not j.ntended for sale, lease or rent. .:..,:tt-j\ |pe) -'t s747T' z-:/*'7 5 726,.37:6?,: ,":,-ii.l..{.: i:-. A}n \ 1 TOCATION OF INST.ON LEGAL DESCRTPTION/7a3 3f /L b/zae Sum Expiration Date Constr Contr. Number Temporary Services or Feeders Installation, Alteration or Relocationc 200 amps or less 201 amps to 400 amps -0ver 40L to 600 amps Over 600 amps or 1000Til[s SUBTOTAL OF ABOVE 5Z State Sureharge 3Z Administrative Fee TOTAL 40.00 55.00 80.00 ee rrBrr aSove 3S-777 $ $ $ s b D. Branch Circuits Nev, Alteration or Extension Per Panel one circuit ts $ 35.00 ZLtu Each Additional Circuit or vith Service or Feeder Permit - $ 2'00 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ sign/outline Lighting- $Limited Energy/Res $ 40.00 40.00 20.00 36.00 RECEIYED 6lk aS