HomeMy WebLinkAboutPermit Building 1998-04-27RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PBOPOSED WORK:
ASSESSORS MAP:
LOT:
SPRINGFIELE,
&fr,
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
TAX LOT:
SUBDIVISION:
-
BLOCK:
PHONE:
ZIP:q-L--v STATE:D)CITY:
ADDRESS:
OWNER:
ruew SREMoDEL ITION DEMOLISH OTHER
DESCRIBE WORK:
MECHANICAL:
-
ADDRESS EXPIBES PH NECONTRACTOR'S NAME
ELECTHICAL:
PLUMBING:
GENERAL:
CONST.
CONTRACTOR #
--.rnFD
.ao(
PEB\I\I
\FIHE $lvt *-
_ OFFICE USE -
LAND USE:FLOOD })LAIN:
WATER HEATER
ZONING CODE:
noF
RANGF-:
OUAD AREA:
* OF BLDGS:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To requ est an inspec il on you must cal 726-3769.Tht s a 24 h ou r before 7:00 a.m wl be
mad the sam e wo rki n s d ay,ns pect ons req ue sted af te 7 00 a.m.work d ay.
REOUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prior to
cover.
[-l Final Plumbing - When aillJ plumbing work ls complete.
Site lnspectlon - To lre made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Finat Electrlcal - When all
electrical work is complete.cover.
Underslab Plumbingl Electrical /
Mechanlca! - Prlor to cover.Electrical Servlce - Must be
approved to obtain permanent
electrlcal power.
Final Mechanlcal - When all
mechanical work ls complete.
tlng - After trenches are Final Building - When all
l-l Flreptace - Prlor to faclngu materlals and framing lnsp.
lY-tl"-lng - Prlor to cover.
-[V W"lllCeiting lnsulatlon - Prlor to)asover.
uired lnspectlons have been
Masonry - Steel locatlon, bond
beams, groutlng.
approved and building is
completed.
Foundatlon - After forms are Other
but prlor to concrete
placement.
Underground Plumblng - Prior
to fllling trench.Drywall - Prlor to taping
MOBILE HOME INSPECTIONS
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng.Wood Stovo - After lnstallatlon
M Post and Beam - Prlor to floor
f*+asutatlon or decklng.
N7 Floor lnsulalion - Prior to
PQ-deckins.
lnsert - After flreplace approvql
and installatlon of unlt.
Blocking and Set.Up - When all
blocklng is complete.
Curbcut & AJrproach - After
forms are erected but prior to
placement of concrete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Storrn Sewer - Prior to filling
trench.
Sidewall< & Driveway - After
excavation ls complete, forms
and sub-base malerial in place.
Water Llne - Prlor to lilling
trench.
Fence - When ccf,lpleted.
Rough Plumbing - Prior to
cover.
Stregt Trees - When all requlred
trees are Planted.
Final - After all required
inspections are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
??47t
r/c , ^/*
r),(
THis
# OF UNITS:
---
E
E
fl
fl
E
E
E
E
E
tl tl
tl
.,|
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type"-
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Set
P.L.HSE GAR ACC
N
s
E
r-- lS THE PROPOSED WORK lN THE .
HISTORICAL DISTRIC"T, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
BUILDING PERTflIT i
VALUE
L?3 t /,b/
W*
#,s7
(A)
dtdfifi-
SO. FT. X $/SO. FT.ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
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, 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.
Plans Fleviewed By
tr
E
Date
"3
Receipt Numbe
24Plan Check Fee:
Date Paid
Received By
BUTLDING IAIUC
AND BUILDING P
,f
PLAN CH ECK
RMIT
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Flxtures
Resldential Bath(s)
Sanitary Sgwer
Water
Storm Sewer
Moblle Home
FEE
(c)
N.
FT.
PLUMBING PERMIT
Plumbing Permlt
State Surcharge
Total Charge
. FT.
FT.
ADDITIONAL COMMENTS
Wood Stove/lnsert/ Flreplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby cerflfy that all
lnformation hereon is true ancl correct, and I f urther cerflfy
that any and all work performed shall be done in accorrJance
wlth the Ordinances of the City of Springfield, and the Laws
of the State of Oregon perlaining to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure without perrnission of the Building Safety Divislon.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all required inspections are
requested 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 remaln
Date 7-7/',//-,
Signature
on the site at all ti during construction.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut .- ft
Demolition
State Surcharge
?-4,?J
Total Miscellaneous permits
,,// , '^ '
(E)
TOTAL AMOUNT DUE (excluding electricat)(A,B,qQandECombtned)OD
VALIDATION:
BECEIPT NUMBER
DATE PAII)
d'2
O16I
AMOUNT RECEIVED -
FIECEIVED BY
i.
225 FIFTE STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST. 726-3
oFFrcE -. 726-3159
sPF--- ELo
EXPIRE IF THE WORK
PERHIT APPLICATION
NDEB THIS PERMIT E\{6wcAL r 0v?
ANDONED FOflty Job Number
-Single or
r dvelLing unit
Items Cost Sum
ess S 85.00
500
eft,
BH3 #q? - o41q
NOTIGE:
SHALL
.,fi lS AB
l";Rt,,,i3. COHPLETE FEE SCEEDULE BELOV
LOCATION OF INSTALLATION
+11
eoning'and
Service Included:v0
JOB'DESCRIPTION Date5- N-3JL i-000 sq .ft. or I
1
2. CONTRACTOR INSTALLATION ONLY
Erectrical con,.".,o. RU ildefS El€ftf f'C lfp6. Relocation:
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
sq. ft or portion
thereo f
Each Manuf/d Home. or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
200 amps or less
201 amps to 400 amps _
401 amps to 600 amPS
-
601 amps to 1000 amps-
Over 1000 amps/volts
-
Reconnect 0n1Y
200 amps''or less
201 amps to 400 amPS
-
Over 401 to 600 amPs
Over 600 amps or 1000-7ofts
B
s ls.00
$ 40.00
s s0.00
s 60.00
s 100. 00
s130.00
s300.00
s 40.00
Address fr5
Ci ty Phone
Supervisor License Number 297<>-s
lJrtdr
ZL
Expiration Date
Constr Contr. Number
Expiration Date I o -, -9E
Sign ature of Supervising Electrician
Ovners Name Gc,L:rt€l p p zrCL D
Address 4ZU A{
"
+h
20'lLc Temporary Services or Feeders
Insial]ation, Alteration or RelocationC
40. 00
55. O0
BO. OO
ee "8" a6ove
$
$
)
s
Ci ty
OIINER INSTALLATION
The installation is being made on
property I ovn r,rhich is not intended
for sale, lease or rent.
0vners Signature:
DATE:
Branch Circuits
Nev, Alteration or Extension Per Panel
$ 3s.00 35ot)
$ 2.00 2I,D
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/0ut1ine Lighting-
Limited Energy/Res _Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Admini..strative Fee
TOTAL
one Circuit I
Each Addi tional I
Circuit or vith Service,
or Feeder Permit I
i Phone 1 L) (,- l0q Y
s 40.00
s 40.00
s 20.00
s 36.00
5
RECEIVED B
,l
f-t fr?nP 4
to -l-gfa