HomeMy WebLinkAboutPermit Building 1991-07-28-E';)ENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 SPRINGFIELE, JOB NUMBER Zfr, 225 Fifth Street Spri ngfield, Oregon 97 477 LOCATION OF PROPOSED WORK:5 ASSESSORS MAP:TAX LOT: LOT:z 2 /tne a/R BLOCK:SUBDIVISION OWNER J PHONE:7q7 88.?7 ADDRESS:l9t7 D-/7 CITY:z STATE:ztP (5/taz a4 9DESCRIBE WORK:a o NEW X REMODEL ADDITION X DEMOLISH )( OTHER CONTRACTOR'S NAME ADDRESS CONST. CONTRACTOR #EXPIRES PHONE GENERAL: PLUMBING era MECHANICAL: - ELECTRICAL: - - OFFICE USE _ OUAD AREA: # OF BLDGS LAND USE:FLOOD PLAIN * OF UNITS:ZONING CODE: OCCY GROUP: r OF STORIES: CONSTR. TYPE: HEAT SOURCE: * OF BDRMS: WATER HEATER:RANGE: SECONDARY HEAT: SQUARE FOOTAGE: To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. lXlCinal Plumbins - When allG plumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. X'f*tl Erectricar - Prior to ff;gfl;';;ll? ;"Hitill Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Eleclrical Service - Must be approved to obtain permanent electrical power. Final Mechanical - When all mechanical work is complete. Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing lnsp. lYfrinat Building - when all,Q required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.FfFraming - Prior to cover. [71'wattlCeiling lnsulation - Prior toGcover. pg[DrVwall - Prior to tapins. Other Foundation - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and installation of unit. Blocking and Set.Up - When all blocking is complete. Floor lnsulalion - Prior to decking.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary 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. Storm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Water Line - Prior to filling trench. Fence - When completed. Slreet Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed.a Rough Plumbing - Prior to cover. fP ?zztz 7 rr tl E r E E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac ks PL,HSE GAR ACC N S E THE PROPOSED WORK IN TI-.'q -HISTORICAL DISTRICT, OFI ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the H istorical Coordinator prior to permit issuance. APPROVED: BUILDING PERMIT ITEM SQ. FT.X $/SQ. FT. 3f .7ct VALUE Main Garage Carport tt q{A 7 g z,/c 5sA /2.00 71 777.2.: (t/*/f @) 4A,xn7,96Total Value &fl fo _retuBuilding Permit Fee State Su rcharge tR .r8 Reuewnl ra,<Total Fee o/_I 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, 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. Plan Check Fee ;1+.*-.oytd Z # Date Paid:? Receipt Numbe Received v: 7-z 4 -7r eviewed By Date SYSTEMS DEVELOPMENT CHARGE (SDC) (B) l:( Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. PLUMBING PERMIT ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE N0 7 /6n -oo FT. FT. FT. Plumbing Permit State Surcharge Total Charge 16 e, oo fi,6D (c)/68.cc' ADDITIONAL COMMENTS MECHANICAL PERMIT Fu rnace Exhaust Hood ?,eo Vent Fan No3 74 c' Wood Stove/ lnsert/ Fireplace Unit Dryer Vent 6 .oo Mechanical Permit lssuance State Surcharge Total Permit 2c1, coO lc.co /.7o (D) By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information hereon is true and correct, and I f urther certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertainlng to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I f urther agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain ont mes during construction. sig Dat a -L MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State SurchargePbrrtf-, -.r€u /67,46 Total Miscellaneous Permits (E) VALIDATION RECEIPT NUM DATE PAID AMOUNT RECEI RECEIVED BY ,> TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) ,/2/24 357o ) ,aaC'TY OF ST'tItNGFII:LI) 225 FIFTB STRBEf, SPRINGFIEIJ, ORBGON INSPBCTION REQTIEST: oFPICE: 726-3759 1 Ci ty Supe 'I 97 477 726-3769 ,ject as submitted has the f IBLECTRICAL PERHIT APPLICATIONnot require specilic land u9e City Job Number 3. COHPIJTE PEE SCEEDULE BELOV II.Ail Services or Feeders Installation, Alterations or Relocation: 200 amps or less -L20L amps to 400 amps _ 401 amps to 600 amps _ 601 amps to 1000 amps_ 0ver 1000 amps/volts Reconnect Only f,lie Phone rvlsor cense Number Constr Contr. Number OF Permits are non-transferable expi reif vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. COMRI\CTOR INSTALI.,ATION ONLY Electrical Contract Address' ential-Single or MuIti-FamiIy 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 Dwelling Service or Feeder s 8s.00 s 1s.00 $ 40.00 Sum lLtr 7 $ s0.00 $ 60.00 $100.00 $130. 00 $300.00 $ 40.00 B. c Expiration Date \D \ Exp iration Date t5 Temporary Services or Feeders Installation, Alteration or Relocation D. Branch Circuits Nev, Alteratlon or Extension Per Panel One Circuit $ 35.00 Each Addi tional Circuit or vith Service , or Feeder Permir I $ 2.00 -/' 200 amps or less $ 40.00 201 amps to 4oo amps - $ 55.00 Over 600 amps or 1000 volts see rrBrr above Signature of rs ing Electrician Address Yh cityS\N PhoneT OIINER INSTALT.ATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: DATE: RECET E. Miscellaneous (Service/feeder not inc -Each ins taIIat ion Pump or irrigation Sign/Out1ine Lighting- Limi ted Energy/Res Limited Energy/Comm SUBTOTAL OP ABOVE 5Z State Surcharge TOTAL A / Iuded ) 40 40 20 36 $ s s $ .00 .00 .00 .00 d5 RECEIVED B qtl) a = ]+J-t83' st,rttNGFtr:Lu L.0bsll I 225 FIFTB STREET SPRTNGFTELD, oREGoN 97477 INSPECTI0N RBQIESTz 726-3769 OFPICE: 726-3759 ELBCTRICAL PERHIT APPLICATION >otz-,City Job Number COHPI,.ETE" PgB SCEEDULE BELOV Nev Residential-Single or HuIti-FamiIy per dvelling unit. Service Included: Items Cost L000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or Modular DveIIing Service or Feeder S 40.00 416lot)ab 1 Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. COI,ITRACTOR INST ONLY Electrical Contractor Addres Ci ty Phone Supervisor cense Number Expiration Date Constr Contr. Number Expiration Date of sing Blectrician rs Services or Feeders Installation, Alterations or Relocat ion : 200 amps or less A 201 amps to 400 amps * 401 amps to 600 amps _ 601 amps to 1000 amps_ 0ver 1000 amps/volts Reconnect Only IOCATION OPlqla,.A A Sum J B. c $ $ $ $ $ $ s0.00 60.00 100.00 130.00 300.00 40.00 ee rBil above loom Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 201. amps to 400 amps _ $ over 401 to 600 amps - $ 0ver 600 amps or 1000 volts s 40.00 55.00 80.00 Address Ci ty Phone TION The installation is being made on property f ovn vhich is not intended for sale, lease or rent. Omers Signature: DATE: RECEIPT D. Branch Circuits New, Alteration or Extension Per Panel One Circuit S 35.00 Each Additional Circuit or vith Service. aA or Feeder Permi t Jl-7 $ 2.00 -32"' Miscellaneous (Service/feeder not included) -Each installation Ptrmp or irrigation Sign/outline Lighting- Limited Energy/Res Limi ted Energy/Comm 5. SIJBTOTAL OF ABOVB 5f State Surcharge TOTAL \-{^ E $ $ $ $ 40. 40. 20. 00 00 00 00 G) ORECO'U RECEIVED BY: ol 36 'izecj S I a , Permit No: Address: lssued by Date:qt R OFFICE USE ON STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRIJCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. 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 permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 28: ,.';F- | own, reside in, or will reside in the completed structure 2. A. f-l My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B l-lr- |I will be my own general contractor. lf I hire subcoptractors, I witl hire only subcontractors reoistered with theConstruction Contractors Board. lf I chanoe my mind and to nire a oeneialcontractor, lwill contract with a contrattor-who is reoistered witn theGonstruction Contractors Board and I will immediately-notifv the officeissuing this building permit of the name of the contraitor. ' I hereby certify that the above information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. \u, ^-!*u *h fq vSignatureof@Date U CONSTRUCTION CONTRACTORS BOARD 0244J 1t90 COPY TO ISSUING AGENCY PERMIT FILE I PY TO APPLICANT @s