HomeMy WebLinkAboutPermit Building 1997-03-12RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
SPFlInrGFIELtr)
Qfi,
JoBNUMBEa@
225 Fifth Strcet
SpringflelcJ, Oregon 97477
LOCATToN oF PROPOSED WoRK: SAZ2_/>e
ASSESSORS MAP:
LOT:
TAX LOT:
BLOCK:SUBDIVISION: __ -
PHONE: ?- /
STATE ZIPCITY:
ADDRESS
OWNER
REMODEL { ADDITION DEMOLIS}.I OTHER
DESCRIBE WORt(:
NEW
--
ADDRESS EXPIIl ES PHON E
4tt-
L:"t
CONTFIACTOR'S NAME CONSI.
CONTRACTOR,
G ENERAL:
PLUMBING
MECHANICA
ELECTRICAL:
_ OFFICE USE _
r O[: BDRMS:
WATER HEATER
ZONING CODE:
FLOOD I)LAINLAND USE:
# OF UNITS
SECONDANY HEAT:
SOUANL:. FOOTNGE:
CONSTN. TYPE
HEAT SOURCE:
RANGF.:
OCCY GROUP:
r OF STORIES:
To request an inspection, you must call 726-3769. Thls ls a 24 hour rccorctlng. All inspections requestecl be[ore 7:00 a.rn, will bemade the sante worklng day, lnspections requested after 7:00 a.m. will be made the following worl< day.
REQUIRED TNSPECTIONS
i--l Temporary Electric m Rough Mochanlcat - prior to aZ::ienr 6.pnSite lnspection - To be madc
after excavation, but prior tosetting forrns.
Underslab Plumbing / Electrical/
Mechanical - Prior to cover.
Footing - Af ter trenches are
excavated.
Masonry - Steel locatlon, bonct
beams, groutlng.
Foundatlon - After forms are
erected but prior to concrete
placement.
Underground Plumbing - prior
to filllng trench.
Underlloor Plumbing/ Mechanlcal
- Prior to lnsulatlon or decl(ing.
Post and Beam - Prior to floor
lnsulation or decking.
Floor lnsulation - Prior to
deckl ng.
Sanitary Sewer - Prior to fllling
trench.
Slorm Sewer - [)rior to fllling
trench.
Waler Line _. Prlor to filling
trench.
w Rough Plumbing - Prior to
cover.
Rouglr Elcctrical - Prior to
cover.
Electrical Servlce - Must be
approved to obtain pcrrrlancnt
electrlcal power.
Flreplace - Prlor to faclngl
materlals and frarnirrg lnsp.
W "o*tng - Prior to cover
Wall/Ceiling lnsulalion - prior to
c ove r.
Final Plurrrbirrg - When allpluml:ing wort( is complete.
Final Electrical - When allelectrical work is complete.W
m
Final Mechanical - When all
li:ffiryy'ornprete
Final Builcting - When allrequired lnspectlons have beenapprovcd and buil<llrrg is"ryE byaa*-
[Pl Drywall - Prior to tapins
I Wood Stovc - Aftor lnstail;rrion.
lnserl - After flreplace approvql
and installatlon of unit.
Curbcut & A1:prroach - Af ter
forms are erected bUt prior lo
placerncr.r t of concrctc:.
Sidewalk & Driveway, - Af ter
excavittion is complete, fornrs
and sutr.base matarial in placc..
Fence - When completed
{ilreot Trccs - Whr: n all requireci
trees are planted.
Otl-rer
MOBILE I-IOME INSPESTIONS
Blocking and Set.Up - When altblocl<int; is cornplete.
Plumbin.q Connections - Whenhome has been connected lo
watcr ancj scv,/er.
Electrical Connection - When[.lockino, sct.up, and plumbing
inspcclic>ns llavc) bccn approvccl;rnd tlre ltornL' is connected tothe service panel.
Final - AIter all requiredinspections are approvecj andporchcs, sklrting, cJecks, andventinO have been installed.
,AZ _?'t ^
OUAD AREA:
r OF BLDGS:
E
E
tl
tl
E
E
tl w
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
_- Interior
--
Corner
--- Panhandle
-
Cul-de-sac
S I<s .. , HE PROPOSED WORK iN THE
HISTORICAL DISTRICT, OH ON
TI_IE H ISTORICAL REGISTER?
It yes, this application must be slgned
arrd approved by the Historical
Coordinator prior to permit issuance.
APPROVED
PL,HSE GAR
N
c
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pcrrrit is grar.rted on thc express condition thaI the said
construction shall, in all respects, con[orm 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 r.u, /6, 2f,
Date Paid: -7-dZ:22-
Receipt Nurnbcr:-.? /A 7 .^
Plans Rcviewcd By Date
Z_Received By .4---r>
VALU E
/??,"-a
(A)
,-Ft>Q
Ea:e?
42
x s/so. r--T.
Total Valuc
Building Permit Fee
State Surcharge
Total Fcc
BUILDING PERMIT
ITEM SO, FT.
M ain
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within tlre City linrits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
t{
tL,
2
F'I.
CT
FT.
..PLUMBING PERMIT
FEE
2e--
Plumblng Permit
State Surcharge
Total Charge
r?aE
21 .1a
MECHANICAL PERMIT
Fu rnace
Exhaust Hood 7M
Vent Fan N0
Wood Stove/ lnsert/Flreplace Urlit
Dryer Vent 2-cra2
By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certlfy that all
information hereorr is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinanccs of thc City of Springfield, and the Laws
of thc State oI Orcgon perlairrlng to thc work described
herein, and that NO OCCUPANCY will be made of any
structure without pertnission of the Builditrg Safety Division.
I f urther certi(y that only contractors and employees who
are in cornpliance witl'r ORS 701.055 will be used on this
proiect.
lfurther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
(rom the street, that the permit card ls located at the front
of the property, and the approved set of plans will remain
on tlre site at times du const ru c
Slgnat
Date
Q
Mechanical Permit
I s su ance
State Surchars]e
Total Permit
ap
t
(D)Zei.2a
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk .---.- tt
Curbcut
---
ft
Demolition
State Surcharge
Total Miscellaneous Pertnits (E)
TOTAL AMOUNT DUE (excluding electrioal)
(A, B, C, D, and E Combincd)
DATE PAID 7=17'77
VALIDATION:
RECEIPT NUMBE,R 2/82)
?,/,ef
BECEIVED BY
AMOUNT RECEIVED
sfrr\ . , iFjt€L()
following
uso
ELECI]RICAL PERHIT APPLICATION
ob Number
225 FIFTE STREET
SPRINGFIELD, OREGON 97417
INSPECTTON REQTIEST:
0FFICE: 726-3159
1 0
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3. coHpr.srE-F-Es
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JOB DESCRIPTION
t
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. CONTRACTOR INSTALLATION OI{LY
Electrical Contractor
Address
Ci ty_ Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Sigaature of Supervising Electrician
Ovners N
Addres
Ci Phone ,@8 I
SCMDULE BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service rncludedt ,,ur. cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home. or
Modular DvelIing
Service or Feeder
s 8s.00
$ 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
Temporary Services or Feeders
Installation, Al-teration or Relocation
200 amps''or less
201 amps to 400 amps
-Over 401- to 600 amps
-0ver 600 amps or L000-7ofTs
It
A
B
C
Sum
tt aSove
s s0.00
s 60.00
$100.00
s130. 00
$300.00s 40.00
s 40.0
s ss.o
$ 80.0
see t'B
0
0
0
I
D. Branch Circuits
Nev, Alteration or Extension Per Panel
s 3s.00 39,AOne Circui t _--.1|_Each Additional
Circuit or vith Serviceor Feeder Permi, 7OVNER TNSTALLATTON
The installation is being madproperty I ovn vhich is not iforsaIe, lease or rent. {t
E. Miscellaneous (Service/feeder not
$2 00 1,
included )
le on
n tendedolL,
t,4s4 s
-Each installation
Pump or irrigation
Sign/Ou11 ine Ligh ting-
Lrmr ted Energy/Res .-
Llmr ted Energy/Comm
40.00
40.00
20.00
36.00
$
s
$
s
?
BRECETYED
re:
/r
5 SUBTOTAL OF ABOYE
)(. State Surcharge3Z_Adninistrative FeeTOTAL
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _60L amps to 1000 amps_
Over 1000 amps/voIts _Reconnect 0n1y
,€DRl)