HomeMy WebLinkAboutPermit Building 1998-01-19/o Le szca ut
SUBDIVISION:
JOB NUMBER Ttrvn rt
Al tt
TAX LOT o7 oASSESSORS MAP:/703 3c3/
225 Flfth Street
Sprlng f leld, Oregon 97 477
RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Offlce:726'3759
LOCAT]ON OF PROPOSED WOBK;
LOT
-
BLOCK:
{77ca u PHONE:/7
atrSTATE:ztP;
OWNER:
ADDRESS:
ClTY:
ADDITION
DESCRIBE WORK:
DEMOLISH OTHERNEW- REMODEL
PLUMBING:
MECHANICAL:
-
ELECTRlCAL:
ADDRESS
7{V f?rJ/
EXPIRES '1 PHONECONTRACTOR'S NAME
GENERAL:
CONST.
CONTRA TOR '
/ 0 6-7s?
, o F B LD@g0-Jcu-may-ojlteiE_Cepi es of thO rulgQrhg,
occ^, cRoufi{ling tt.r* center. (Note:tt}e telePhone
n u m be r loTm6oTggiori ut' ! i t)' i'GSt^tgTRnrY K
T
ication Center Those rules are set forth
PE:
ugh
WATER HEATER:
, OF STORIEg; Contpr is 1-800-332-23{la1 SOURCE:
follow rules adopted by the Oregon Utiiit+ oFFlcE usE -
QUAD
RANGE:
-- -,r r, iUU BA
To request an lnspectlon, you must call 726-3769. Thls ls a24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Eleclrlc Rough Mechanlcal - Prlor to
cover.
[-l Flnat Plumblng - When ailtJ plumblng work ls complete.
Slte lnspectlon - To be mado
after excavatlon, but prlor to
settlng lorms.
Underslab Plumblngl Electrlcal /
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placemont,
Underground Plumblng - Prlor
to fllllng trench.
Undcrlloor PlumblngI Mechanlcal
- Prlor to lnsulatlon or decklng.
Posl and Beam - Prlor to floor
lnsulatlon or decklng,
Floor lnsulatlon - Prlor to
decklng.
Sanltary Sewer - Prlor to fllllng
trench.
Storm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to fllllng
trench.
Rough Plumblng - Prlor to
cover.
Rough Electrlcal - Prlor to
cover,
Electrlcal Servlce - Must be
approved to obtaln permanent
olectrlcal power.
Flreplaco - Prlor to faclng
materlals and framlng lnsp.
Framlng - Prlor to cover.
Wall/Celllng lnsulatlon - Prlor to
cover.
Drywall - Prlor to taplng
Wood Slovo - After lnstallatlon.
lnsert - After flreplace approvql
and lnstallatlon of unlt.
Curbcut & Approaclr - After
forms are ert:cted but prlor to
placomcnt of concrete.
Sidewall< & Drlveway - After
excavation ls complete, forms
and sub-base material ln place.
Fence - lvhen coi'npleted
Slre€t Trees - When all requlred
trees are planted.
Flnal Electrlcal - When all
electrlcal work ls complete.
tl Flnal Mechanlcal - When all
mechanlcal work ls complete.
Flna! Bulldlng - When all
requlred lnspectlons have been
approved and bulldlng is
completed.
Other
MOBILE HOME INSPECTIONS
Blocklng and Set-Up - When all
blocklng ls complete.
Plumblng Connectlons - When
home has been connected to
water and sewer.
Electrlcal Connectlon - When
blocklng, set-up, and plumblng
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Flnal - After all required
lnspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
tl
E
E
tl
E
E
tl
tI
E
E
?7 qtt
afiEitTln Nl.Araa,,rr, lara, rant tiraq vnf t tO
FLOOD ITLAIN:
tf tl
tl
fl
E
E
EE
a,l
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type -
-
lnterior
-
Corner
-- Panhandle
-
Cul-de-sac
i -1d THE PROPOSED WORK TN THE.
HISTORICAL DISTRTC'I, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Hlstorlcal
Coordlnator prlor to permlt lssuance.
APPROVED:
P,L.HSE GAR ACC
N
S
E
VALUE
L.(A)
t
(t
Main
Carport
Garage
Total Value
Building Permit Fee
State Surcharge
Total Fee
X $/SO. FT.
BUILDING PERMIT
ITEM SO. FT.
/ 2q&
-ieJh
This permlt is granted on the express conditlon that the said
construction shall, ln all respects, conform to the Ordlnance
adopted by the City of Springfleld, includlng the
Development Code, regulating the constructlon and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordlnances,
Plans Reviewed By
,/ /rt
Oale
F7, q )
,JJ
Receipt Numbe
LAN CHECK
iMIT
E
D GN P
Plan Check Fee:
Date Paid
Received By:
BU I LDI NG
AND,BUIL
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties wlthin the City limits which are belng lmproved.
ITEM
Fixtures
Besidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N3
FT.
PLUMBING PERMIT
Plumbing Permlt
State Surcharoe
Total Charge
ADDITIONAL COMMENTS
Czoc t
LV
lL
J
By slgnature, I state and agree, that I have carefully examlned
the completed appllcailon and do hereby cerilfy that all
lnformation hereon is true anct correct, and I turther cerilfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Oregon perlalnlng to tho work descrlbed
herein, and that NO OCCUPANCy wlll be made of any
structure wlthout permission of the Bulldlng Safety Dlvislon.
I further certify that only contractors and employees who
are in compliance wlth ORS 701.055 wlll be used on lhls
pro ject.
I further agree to ensure that all requlred lnspecflons are
requested at the prop€r ilme, 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
Date
\,^)
7
rlng
Slgnature
on the site at all tl
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut _ ft
Demolitlon
State Surcharge
Total Mlscollanaous permits (E)
MECHANICAL PERMIT
(D)
Fu rnace
Exhaust Hood
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Totat Permlt
TOTAL AMOUNT DUE
(A, B, C, Q and E Com
(excludin g electrlcal)
blned)
L ?
d 3
tl,q?
VAI-IDATION
BECEIPT NUMBER
DATE PAID
>Z?
,{ ,/
AMOUNT RECEIVEO
RECEIVED BY
Et____
FT.
No
BESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726.3759
SP,rINGFIELD
LOCATION OF PROPOSED WORK:t 2 .il-*?**
ASSESSoRS MAP: /7e7'vz-7 / --
LOT BLOCK:
.ToBNUMBEa@
225 Fifth Street
Sprirrgfield, Oregon 97477
f irr A
SUBDIVISION:
PHoNE: -P/-A<?/ -/E/<
Tir.rlYT)Or'.zlP
Q.
STATE:
lbe ,.-1 . [)
C.
OWNER:
ADDRESS:
CITY:
LL \.*)ohto^o \DESCRIBE WORK:
NEW OTHERP
PLUMBING:
MECHANICAL:
-
eLor"e
\b
A
lor 1r4#3'I
olti c 3p,53 ))o q\5*? 12 g
CONTRACTOR'S NAME
e2tt2727, 4q;rt 5
ELECTRICAL:
GENERAL:
CONST.
CONTRACTOR #
-
ADDRESS EXPIRES .1 PHONE
D:-,; =FTG ,ooo.
RANGE:
I OF BDFIMS:
- OFFICE USE -
LAND USE:
WATEFI HEATER:
ZONING CODE:
FLOOD I)LAIN
* OF UNITS:
OUAD AREA:
* OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To reguesi aii iiispaotion, you rriLj$t caii 726-3749. Tiris is a 24 irr..rur i'ecoruirrg. xii inspections requesteo beiore 7:00 a.m. will be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be macle the following work day.
REQUIRED INSPECTIONS
Temporary Electric ,K Rough Mecharrical - Prior to
cover.K Siffil,iltYi?,?,;#l;i"il:
ffi finat Electricat - When all!€ electrical work is complete.
Prior to
MUSI bC E
E
Final Mechanical - When all
mechanical work ls complete.Mechanlcal nt
E Footlng -Final Building - When all
required lnspections have been
approved and building is
completed.
excavated
Masonry - Steel locatlon, bond
beams, groutlng.x
tr
Framlng - Prior to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.Wall/Celling lnsulatlon - Prlor to
cover.
Underground Plumblng - Prior
to fllllng trench.Drywall - Prior to taping
MOBILE HOME INSPECTIONS
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.Wood Stovo -' After lnstallation
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnsert - After flreplace approval
and installatlon oI unlt.
Blocking and Set-Up - When all
blocklng ls complete.
Floor lnsulation - Prior to
decklng.Curbcut & AJrprroach - After
forms are erected bUt prior to
placement of <:oncrete.
Plumbing Connections - When
home lras been connected to
water and sewer.
Sanltary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Stonn Sewer - Prior to fllling
trench.
Sidewall< & Driveway - After
excavation is (;omplete, folms
and sub-base malerial in place.
Water Llne - Brlor to filling
trench.
Fence - When ccinpleted.
Rough Plumblng - Prlor to
cover.
Streel Trees -. When all required
trees are planled.
Final - After all required
inspectlons are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.x
rAx Lor: OZ/e?..
I
l
SIte lnspectlon
alter
settlng forms.in OAR
Underslab
Utility
are set fonh
l--l other
tl
fl
fl
E
tl
tl
I
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type_
-
lnterior
-
Corner
-
Panhandle l
-
Cul-de-sac
Setbacks
P.L.HSE GAR ACC
N
S
E
,-.S THE PROPOSED WORK TN THE .
HISTOFIICAL DISTFII T, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applichtlon must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPBOVED:
Total Value
Building Permit Fee
State Surcharge 5,63 + 3'fu
Total Fee (A)
VALUE
',*
83
73
BUILDING PERNITT
ITEM
Main
Garage
Carport
/6,zeo-'-j6e-
SO. FT. X $/SO. FT
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.
Date
Receipt Num
E,
PE
UB L D NG CH cE KNLALI,
DAN UB LD N G MR IT
Plan Check Fee:
Date Paid
Recei
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
Plumblng Permlt
State Surcharg" rTS*t /S
/L ?oTotal Charge
<,oo
(c)
Nc
FT.
Lzo
PLUMBING PERMIT ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
/try*/4 /h)r( __
Mechanical Permit
lssuance
state surcharge , 7ft,(l-
Total Permit (D)-) ." 2rOz4a, L_
,u
No
eo
10 lo
/,b
Vent Fan
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certify that all
lnformation hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accorrJance
with the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon perlainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Buildirlg Safety Division.
I further certify that only contractors and enrployees who
are in compliance with ORS 701.O5S will be used on this
proiect.
I {urther agree to ensure that all required inspections are
requested at the proper tlme, 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
es duri construction.
Date 17
on the site at all
y'.,nn",rr"
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
--
ft
Demolitlon
Total Miscellaneous Permits (E)
75,7>
State Surc harge
4v3eTOTAL AMOUNT DUE (exctuding etectricat)
(A, B, C, D, and E Combined)
RECEIPT N
DATE PAID
AMOUNT R
RECEIVED
03 >f? f
7
7
BY
VAI-IDATION
UMBER
ECEIVED
FT.
FT.
r/J .
/
il.
225 FIrtE STREET
SPRINGFIELD, OREGON 9
INSPECf,ION REQTIEST:
OFFICE: 726-3759
1. LOCATTON ALLATION
LEGAL DESCRIPTION
ION
are on- t ran slerable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
1B0 days.
2. CONTRACTOR INSTALT.ATTON ONLY B
Erectrical contrac ror {A5TS/D€ €Lec'f/!c'
Address bX293 hog.flG€ Llr,
ciry SrQp
I Srpervisor License Number 3s/V 5
Expiration Da re l0- I ' O I
Constr Contr. Number ll777O
Expiration Date )o^v 11
si t of Su erv]'ng Electrician
0vners Name
S'}IIINGTIELc,
BLECTRICAL PBRHIT APPLICATION
City Job Number
COHPLETE FEE SCMDULE BELOV
Nev Residential-Sing1e or
MuIti-Family per dvelling unit.
Service Included:
I tems Cos t
..;Iff,li,,i:[tffiffieffiH*"d @fi
3
A
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home. or
Modular Dvelling
SerVice or Feeder
__! s Bs.oo -A"
/ $ 1s.oo Eq
s 40.00
s s0.00
s 60.00
s100.00
s130. 00
$300.00
$ 40.00
Sum
aEIEI
Services or Feeders
InstalIation, Alterations
or Relocation:
200 amps or l-ess
201 amps to 400 amps _401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect Only
200 amps"or less /
201 amps to 400 amps _Over 401 to 600 amps
Over 600 amps or 1000-irc-fEs
D. Branch Circuits
C Temporary Services or Feeders
lnstallation, Alteration or Relocation
$ 40.00
$ ss.00
$ 80.00
see irBtt
_w.P
Address
, city Phone
OVNER INSTALLATION
The installation is being made on
property I ovn which is not intended
for saIe, lease or rent.
0nners Signature:
DATE:
Nev, Alteration or Exterrsion Per Pane1
One Circuit S 35.00
Each Additiona]
Circuit or vith Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/0utline Lighting_
Limited Energy/Res
Limited Ener[y/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
s 40.00
$ 40.00
$ 20.00
s 36.00
5
RECEIVED
*
Phone )Vl^/V19
CTTYOFSPRINC JLD
Fire & Life Safety
O3 to )?
4st4t
9F.lX 3712-
DArE: / L?l-v
qt1t,FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARDflbn
TO:
FROI{:
SUBJECT:
Building Department
Springfield Fire Department
Structural Damage to Building
Address or location of buiiding /L? N. /7u Er.
Name of or^/ner 11 6.J
Type of building t-L !t
(Dwel 1i ng , Store, l{arehouse, etc. )
Estimated val ue of buil di ng
Estimated Ioss to building
Date of fire //-Z/'?(
7()oo o
9o Lt00
t,o17 oo€ QTRULTV e
(Roof, Wa11, Exterio , interior, etc.)
Structural weakness as a result of the fire ?oo€ CrputTvR
1.J / Ee.oFoo,-
(Burned raf ters , Beams, "1o'ists, etc. )
Aciditional pertinent information
Electrical Hazard N(
CC It-zi-,tt i'Ltl L 4
{
S'iqned
grtG D(e g<Vrc{
(lili ri nq , 0utl ets , etc . )
7
Location of damage in buiiding f fre?6r-\ gToaAL< A?€Ai l(tr("(17