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Home My WebLink AboutPermit Building 1991-07-14COMMERCIAL/INDUSTRIAL - PERMIT APPLICATION 225 Fifth Street, Springfield, Oregon 97477 SPRINGFIELt,0 ,,t {gJOB NUMBER INSPECTION LINE: 726-3769 OFFICE: 726-3759 LOCATION OF PROPOSED WORK:a 2 a f? K), l7-J ct -&TAX LOT:-L/ASSESSORS MAP: PHONE: ?a ?;> ZIP: q STATE:&-rl z-CITY: ADDRESS: OWNER: NEW ZX REMODEL VALUE:ADDITION DEMOLISH OTHER DESCRIPTION OF WORK or r rfirDtNt/:. MECHANICAL: NAME ADDRESS PHONE ADDRESS PHONECONTRACTOR# r1 ARCHITECT: ELECTRICAL: CONST. CONTRACTOR'S NAME GENERAL: PLUMBING NO.FEE CHARGE Single Fixture Relocated Bldg. (new fix. addtl) Water Service ft Sanitary Sewer ft Storm Sewer ft Backf low Device TOTAL PERMIT MECHANICAL NN trtrtr .:HA FIGtr Furnace/burner & vent < 100,000 BTUs Furnace/burner & vent >100,000 BTUs Floor furnace and vent Suspended wall or f loor mounted unit heater Appliance Vent separate Stationary evap. cooi er Vent Fan/Single duct Vent f rom System apart AC or htg. Mechanical exhaust hood and duct Permit lssuance $10.00 TOTAL PERMIT - OFFICE USE _ LAND USE: g OF UNITS: HANDICAP ACCESS FLOOD PLAIN LIGHTING POWER BUDGET:OCCY GROUP: * OF STORIES: QUAD AREA: * OF BLDGS: CONSTR. TYPE: HEAT SOURCE: SQ. FT.$/SQ. FT.VALUE TOTAL VALUE OF PROJ X X X SQ. FTG MAIN SO. FTG ACCESS SQ. FTG OTHER PLAN cHEcK rer{so tl-- RCPT#DATE BY it oo BUILDING PERMIT PLU M BI NG DEMOLITION 5% State Surcharqe 5% State Su rcharqe Geaotilo 6ir'* z O 99 M EC HAN ICA L FENCE VALUE $ v- 5% State Surcharoe SIDEWALK FT, SUBTOTAL PERM ITS l?ooo PAVI NG CURBCUT FT, SYSTEMS DEVELOPMENT TOTAL PERMIT FEES EXCLUDING ELECTRICAL q ./l t-- I ZONING: WATER HEATER: REOU IRED INSPECTIONS It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call 726-3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready for inspection. Requests received before 7:00 a.m. will be made the same worki ng day, requests made after 7:OO a.m. will be made the fpllowing work day. !(, strE tNSpECTtoN: To be RoucH pLUMBING, pAVtNG: After graver is in / made after excavation, but ELECTRICAL & place but prior to placing ' prior to setup of forms. MECHANICAL: No work is to asphalt or concrete. be covered until these UNDERSLAB pLUMBING, inspections have been made SpECIAL INSpECTIONS: ln accordance ELECTRICAL & and approved. Section 306 of the State Specialty code MECHANICAL: To be made a special inspector shall be employed before any work is covered. ATTIC DRAFT STOPS & by the Owner/ Contractor duringCURTAIN WALLS construction of the following w6rk. A FOOTINGS & FOUNDATIONS: copy of the special testing reports shall To be made after trenches are FIREPLACE: Prior to placing be furnished to the Building Division. excavated and forms are facing materials and before erected, ail steel in place, but framing inspection' srRUcruRAL CoNCRETE: ln prior to placing concrete. FRAMING: To be made after excess of 2500 PS.l. (306 a.1) coNcRETE SLAB: To be the roof' all framing' fire made arter ar insrab buirding 3l::5 ::.']fi 3,?ilt"ri';;:r" 31I3,"J"'f3"t *Y5tT',rrr, ,, service equipment, conduit, and vents are'complete andpiping, accessories and otherincirlry equipment items are :i:';::l.1igl:,1'JJ;[Y:l: Bl?Xf],?E]*"T[,?,o,.tIH:".in place but before any tighte-ning operations. (306concrete is placed. TNSULATTON & VApOR a.6) BARRIER: To be made after all UNDERGROUND: Plumbing, insulation and required vapor SpRAyED ONelectrical, gas, sanitary sewer, barriers are in place but FIREpROOFING: U.B.C.storm sewei water and before any lath or gypsum Standards 43-8.drainage lines. To be made board interior wall covering isprior to covering or filling applied. S'EC'AL GRAD,NG,t re nc hes. ,NDERFL..R: p,umbins Il?:,5'i"'f;XA'J3[Hi"' ifiUEiilJii.',5Jb'i],"* electrical, mechanical. To be according to plans. chapter 29) made prior to installation of f loor insulation, decking or LATH AND/OR GYPSUM GLU'LAM BEAMS: lnspection floor sheathing. BoARD: To be made after all Certificate by an approved lathing and gypsum board, agency, furnished to the city's poST & BEAM: To be made interior and exierior, is in Building Division before prior to installation of floor place but before any beams are placed' (250'l u'Bc' insulation, decking or floor flastering is applied or before STDS' 25-10'1.1)' sheathing. - Sypsum board joints and fasteners are taped and STRUCTURAL MASONRY: (306 FLooR TNSULATIoN & finished' a'7) VAPOR BARRIERS: To be made prior to installation of decking or floor sheathing. MASONRY: Steel location, bond beams grouting or verticals in accordance with uBc 2415. RooF sHEATHTNG AND :HR3^H'",ti,tt:'of""!|'" NAILING: Prior to installing erected but prior to placing any roof covering. concrete. SIDEWALK & DRIVEWAY: Required for all concrete paving within street right of way, to be made after all excavating complete and form work and sub-base material in place. * ln addition to the inspec- tions specified, the Building Official may make or require other inspections of any construction work to ensure compliance with the Building, City or Development Code. PLANS REVIEWED BY ,4,D*ta /.C-brzt DATET By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information herein 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 Springf ield, and the Laws of the State of Oregon pertaining 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 OFIS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that project address is readable f rom the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all Signature a Date times during constructi VALIDATION AMOUNT RECEIVED: RECEIPT *:RECEIVED BY: DATE D: FINAL PLUMBING SITE PLAN REVIEW BOARD: Must be requested 2 days in advance of the date you wish inspection. All project conditions such as landscaping, parking lot stri ping, etc. must be completed before FINAL ELECTRICAL requesting this inspection. FINAL BUILDING: Requested after the final plumbing, electrical, FINAL MECHANICAL mechanical and Fire Department inspections are made and 3??ffi1;*;:? S:::?Xi:', ?'.y;":f ['i,'30"3i ffi ?if,: ;t''l,X,",on FINAL FIRE DEPARTMENT and posted on the premises. ADDtTtoNAL coMMENTSt to.oLL StI ALL G il f Ly U, t74 Ct4A?feE X A?a, 5 y'rE':tc. s!"ilN(iFtEL() t 225 FIFTH STREET SPRINGPIELD, OREGON 974 INSPBCTION REQUEST. 72 0FFICE: 726-3759 1 LOCATION OP INST IAGAL DESCRIPTION PTTON Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. CONTRACf,OR INSTALI,ATION ONLY Electrical Contractor Address city- Phone Supervisor License Ntimber Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Blectrician 0vners Name Address Ci ty Phone 7c/u--a? OTINER INSTALI..ATION The installation is being made on property I ovn vhich is not intendedfor sa1e, lease or rent. Signature: Residential-Single or Hulti-Family per dvelling unit. Service fncluded: CATION Items Cost Sum s 8s.00 $ 1s.00 s 40.00 $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 B 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular Dvelling Service or Feeder Services or Feeders Installation, Alterations or Relocat ion: 200 amps or less 201 amps to 400 amps -401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect Only C Temporary Services or Feeders Insta1lation, Alteration or Relocation 200 amps or less / S 40.00 UZz 201 amps to 4oo amps - g 55.00 -0ver 401 to 600 amps _ $ 80.00 -_ 0ver 600 amps or L000 volts see rrBrr above D. Branch Circuits Nev, Alteration or Extension Per Panel Ctne Ci rcui t $ 35.00 Each Addi tional Circuit or vith Service or Feeder Permit $ 2.00 E Miscellaneous ( Service/feeder -Each installation Pump or irrigation $ Sign/0utline Lighting- $ Limi ted Energy/Res - S Limited Energy/Comm S not included) 40. 00 40. 00 20. o0 SUBTOTAL OF ABOVE 5Z State Surcharge TOTAL 4a.e DATE: RECEI a ,OREGO'U RECEIVED BY: 5 -e''> 225 TTFTE STRBET SPRINGFTEID, OREGoN 97477 INSPECf,ION RBQTIBST: OFPICE: 726-3759 {uthod:srj 1. LOCATION OPe IJGAL DESCRIPTION JOB DBSG PTION Permits are non-transferable and expirelf work is not started withln 180 daysof issuance or if vork is suspended for 180 days. 2. COItTRACTOR INSTALI.ATION ONLY Electrical Contractor sI'tltN(;l=tELEl PBRHIT APPLICATION City Job Number ?///58 COHPIJTE FBE SCBBDUI..E BBLOS al-Sing1e orA. Nev MuIti-FamiIy per dwelling unit. Servlce Included:Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelllng Service or Feeder c-- g Bs.0o 6 $ 40.00 Address Ci ty Phone Supervisor License Number Bxpiration Date Constr Contr. Number Expiration Date Signature of Supervlslng Blectrlcian Ovners Name B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps -401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect Only c ST'BTOTAL OF ABOVB 5f State Surcharge TOTAL Temporary Services or Feeders Installation, Alteration or Relocat 2a ,Qzr KE-€? r4 FzzP.200 amps or less S 40.00 2oL amps to 4oo amps - g 55.00 0ver 401 to 600 amps _ $ 80.00 0ver 600 amps or 1000 volts see rrBrf -Each installation Pump or irrigation $ Sign/0utIine Lightine_ $ Limi ted Energy/Res $ Limited Energy/Comm S D. Branch Clrcuits New, Alteration or Extenslon Per Panel One Circuit $ 35.00 Each Addltional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 10n & affi eddress ?6fu Zfltqi+gzZ $tv Eh;Z?lZ: vnone Vy'4-?f,2 OIINER INSTALI,ATION The installation is being made on property I own vhich is not intendedfor sale, lease or rent. 0wners Signature: DATE: 40.00 40.00 20.00 36.00 5 dt' RBCEIPT *: C'TV OF OF RECEIVED BY: /?-d2-7/-aq.aa^ . II\.GFIELE, RESINENTIAL PERMIT APPLICATION lnspections: 726-3769 Of f rce: 12$-3759 JOB NUMBER 225 Fifth Street Springfielcl, Oregon 97477 LOCATION OF PROPOSED WOFIK: ASSESSORS MAP: LOT: TAX LOT:a*?a/ BLOCK:SUBDIVISION - 43 zre, ?){7 PHONE: STATE: OWNtsR ADDRESS: CITY: NEMODEL ADDITION DEMOLISH -OTHEFI DESCRIBE WORK: NEW X PLUMBINC: - * - PHONEEXPIRESADDRESSCONTRACTOR'S NAME cENEniL:'''drrygn "- MECI.IANICAL: CONST. CONTRACTOR # ' ..1-r I SE_ R. !D12-,ZONING CODE: FLOOD PLAIN: / OF UNITS CONSTR. TYPE I-IEAT SOURCE: RANGE: -oF LAND USE OCCY GROUP SECONDARY HEAI: SOUARE FOOTAGE: OF BDRMS: // ol= sTot'llES: WATER HEATER: OUAD AFIEA: // OF BLDCS: To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspections requested before 7:00 a.m. will be macle the same working clay, inspections requesled after 7:00 a.m. will be rnade the following work day. REOUIRED INSPECTIONS .E [(] w w fr w ry w ry [X Tutt PorarY Electric Site lnspection - To be matle af ter excavation, but Prior to settinq forms. Underslab Plumbing / Electrical / Mechanical - Prtor to cover. Footing - Af ter trenches are excavated. Masonry - Steel location, boncl bearns, grouting. Foundalion - After forms are erected t)ut prior to concrete placenrcn t. Underlloor Plumbing / Mechanical - Prior to insulation or decking. Posl and Beam - Prior to floor insulation or decl(ing. fV Floor lnsulation - Prior to LAJ decxing. w w M w Rough Mechanical - Prior to cover. Rough Eleclrical - Prior t<-r cover. Electrical Service - Mdst lte approved to obtain perrnanent electrical power. Fireplace - Prior to facing materials and framing lnsp. Framing - Prior to cover. Wall/Ceiling lnsulation - Prior to cover. Drywall - Prior to taptn! f-V1 Final Plumbing - When all lfJ plumbing worlr is complete. l_M Final Electrical - Wlrcn all4 electrical work is cornpletc. ry Final Mechanical - When all mechanical work is conlplete. Slorm Sewer trench.- Prior to filling Water Line - Prior to filling trench. 't Rough PlumbinQ'- Prior to. cover. Wood Stove - After installation lnsert - AIter fireplace aPProval and installation of unit. Curbcut & Approach - After forms are erected but prior to placement o{ concrete. Sidewalk & Driveway - Af ter excavation is complete, forms and sub-base material in place. Slreet Trees - When all r'equired trees are plantecl. 'Final Building - When all required inspections have been approved and building is cornpleted. Other MOBILE HOME !NSPE TIONS Blocking and Set-Up - When all blocking is complete. Plumbing Conneclions - When home has been connected to water and sewer. Eleclrical Connection - When blocking, set-up, and plunrbing inspections have been approved ancl the home is corrnecte(l to the service panel. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. ffi Underground Plumbing - Prior+ to filling trench. w San itary trench. Sewer -ilor to filling6z> 2z/{E h, a E r f-l Fence - When completed. fl Lot {aces Lot sq. ftg. Lot coverage TopographY Total heiglrt Lot Type -- lnterior ---., . Corner -- Panhandle - Cul-de-sac ks P,L.I"lSE GAR ACC N \) q S THE PROPOSED WORK II'I..I.HE HISTORICAL DISTRICT, OR ON '-. THE HISTORICAL REGISTER? ._-..- lf ycs;, tlris application tllt,st bc sigrrod :rncl ;tpprovcd by t llc Fl i s torical Coordinator prior to pcrmit issuance. APPFIOVED: H CV BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT -Ihis pcrrnit is gr;rnlr:ci ()n tllc express cotrditiorr tl)at thc said constrLlction sfrall, in all respects, conform to the Ordinance adopted by the City of Springfield, ir-rcluding the Developtnent CocJe, regulating the construction ancl use of buildings, and may be suspended or revol<t':cl at any tirne upon violation of any provisions of said ordinanccs' By 3:Q-%' Plan Clreck Fee Date Paid Flecei pt Number Recei /82"_€+ 7d€ (A) 4oeZe X $/SQ. FT. fr.? /q-/o : VALUE z€tr2ze/ 2Ey,€b Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport A7z-=q5> /*-E Systems Development Clrarge is due on all undeveloped properties within the City lirnits which are being irnproved'SYSTEMS DEVELOPMENT CHARGE (SDC) u/r?(B) ADDITIONAL COMMENTS ITEM Fixtures ResicJcrr tial Bett lt(s) Sanitary Sewer Watcr Stornr Sewer Mobile Home PLUMBING PERMIT FEE /?2-5a /?a. sa FT, FT. ZOZJS(c) ?1 v N FT. ? Plumbing Permit State Surcharge Total Charge Wootl Stove/ lrrscrt / Fireplerce Unit Dryr:r Vctrl M ECHANICAL PERMIT , 6e(i>. N0 -A-5d /e /g_ *G_=_(D) ?7 v.e ??.tu e !,__-_- Mcclr;rni r;i.tl Ptlrtrt i t lssuance State Surcharge Total Permit 4> Fu rnace Exhaust Hood Vent Fan By signature, I state and agree, that I have caref ully examined the completecj application and do lrereby certify that all in{ormation hereon is true and correct, and I f urther certify thatany:rnd;rllworl<l.rcrformeclsl'rallbcdonc.itr;rr;corrjance with the Or<Jin;rncr:s of tlrc City of SpringficltJ,;rnd tttc Laws of thr-' Statc of Orr:tlorr pr:rt;ritring; to thr: wotl< tlr::;ctilrr:tl Irt rt:itr, rrtrrl tlt;ll N() ()( )(ltlt'n NCY will lrr: ttt;ttl() o[ ;ttly structul(.. witllout pr"'ttttiL;:,;tott o{ tlre Builtiing Sa[cty Divisiott' I f urthcr ccrtify tllat orlly corllrilctors ;rtrcl r:trlllloyt)r:s wltcl are in cornpliancc witlr ORS 701.055 will t-lt-'ttscd on tltis pro jec t. I further agrce to ensule that all required inspectir'rns are requested at the proper time, that each address is readable from the street, that the permit card is locatcd at the front of the property, and ttre approved set of plans will remain on ttre ite at Signatu Date times during construction. MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk -,----- ft Curbcut -- --- ft Demolition State Surcharge Total MiscellarlL'ous Perrnits (E) VALIDATION: RECEIPT NUMBEFI/) DATE PAID 4U "zlAMOUNT RECEIVE TlECEIVI,D t]YTOTAL I\MOUNT DUE (excluding c'lectrical) (A, B, C, D, antl E- Cornlrinccl) 6++ffi 7--/2-?=__ \--I Permit No Address: Date: 6re'qlssued by OFFICE USE ONLY STATEMENT: INFORMATTON NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. 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 plicable blanks, and initial boxes 1 and 2, and either box 3A or 38 1 I own, reside in,the completed structure. WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 2 I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3.A My general contractor is Contractor registration number-. I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3.8 I will be my own general contractor. lf I hire subcontractors, lwill hire only subcontractors registered with the Construc- tion Contractors Board. !f I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. 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. v:ec.:-.z gnature rm pp cant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8t91 will resid INFOF ATION NOTICE TO pROpERTy O ,,IERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. lf you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an "employer" and the people you hire will be "employees". As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Department of Revenue at 378-33g0. Unemployment lnsurance Tax: As an em ployer, you are required to pay a tax for unemployment insurance For more information, call the Oregon Employment Division DHRpurposes on the wages of all employees. at 378-3224 Workers' Compensation lnsurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at {73-74U. U.S. lnternal Revenue Service: As an em ployer, you must withhold federal income tax from employees'wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage lnsurance; Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc- tures, fire, or work that must be re-done. Time to Supervise Employees Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. lf you have additional questions, write to Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10t24t89 225 FIFTE STREEf, SPRTNGFTEU), ORBGON 97477 INSPBCTION REQUBST: 726-3769 OPPICE: 726-3759 1. LOCATION OT IJGAL DBSCRIFTION.Z JOB Permlts are non-transferable and explre lf vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. COMRACTOR INSTALI,ATION ONLY Electrical Contractor Address ci Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervlslng Electrician Owners Name Addtess Zi?O 4tat<qt*-<C,7 ctty F4€Ve Phone7?/-?9? 7 OIINER INSTATI,ATION The installatlon is being made on property I ovn vhich is not intended for sale, Iease or rent. Onners Signature: ./ DATB: st'til,{GFtEL(, EIECTRICAL PBR}IIT APPLICATION 3. CO}IPI,RTB TBB SCEEDUI,E BBIOII A Nev Residential-Single or Multl-Family per dwelling unit. Service rncluded:Items Cost B 200 amps or less 201 amps to 400 amps -401 amps to 600 amps _ 601 amps to 1000 amPs- 0ver 1000 amps/volts - Reconnect Only C. Temporary Services or Feeders Installatlon, Alteration or Relocation 200 amps or less $ 40.00 201 amps to 400 amps - $ 55.00 Over 401 to 600 amps $ 80.00 Over 600 amps or 1000 volts see rrB[ above D. Branch Clrcuits Nev, Alteration or Extenslon Per Pane1 Each Additional Circuit or vith Service or Feeder Permit - $ 2.00 -Miscellaneous (Service/feeder not included) 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder Services or Feeders Installation, Alterations or Relocat ion: SUBTOTAL OF ABOVE 5Z State Surcharge TOTAL Sum | $ 8s.oo €f / g ls.oo E* $ 40.00 J?e.-'''€-oo /./1F Od'.7{- $ s0.00 $ 60.00 $r00.00 $130.00 $300.00 $ 40.00 B 5 -Each installation Pump or irrigation _ $ signzoutline Lightine- $ Limited Energy/Res _ $ Limited Energy/Comm $ 40.00 40.00 20.00 36.00 RECETVBD -2 city Job Yu A", ?/// # SPRINGFIELD RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PRO ASSESSORS MAP: LOT: h, JOB NUMBER 225 Fifth Street Spri ngf ield, Oregon 97 477 TAX LOT: zK: BLOCK: CITY:STATE:6tg,6l.Jr Or- OWNER ADDRESS: ztP 9')Vcr 1 PHONE:3t(ri- qDRr.,,gu * sanrupoJ *f6 crsoJ Tbqo C[ucfrnl,rr *=* l/ FTEMoDEL ADDrroN DEMOLISH OTHER LSOBc- vssoDESCRIBE WOFIK: t/ ELECTRICAL: - CONTRACTOR'S NAME EXPIRES PHONE G EN ERAL:ctssp!,)ps.neL L. SA PLUMBING MECHANICAL: CONST. CONTRACTOR #ADDRESS 7a4o chr,trLlNutT \t r _ OFFICE USE - WATER HEATER:RANGE:e LAND USE: ZONING CODE: FLOOD PLAIN * OF UNITS: SECONDARY HEAT: SQUARE FOOTAGE: # OF BDRMS: _OCCY GROUP: * OF STORIES: QUAD AREA: # OF BLDGS CONSTR. TYPE: HEAT SOUFICE: To request an inspection, you must call 726-3769. This is a24nour recording. All inspections requested before 7:00 a.m. will bemade the same working day, inspections requested after 7:00 a.m. will be made the following work day. REQU!RED INSPECTIONS fX t -porary Electric w Site lnspection - To be made after excavation, but prior to setting forms. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Steel location, bondbeams, grouting. Foundation - After forms are erected but prior to concrete placement. Rough Mechanical - Prior to cover. Rough Electrical - Prior to cover, Final Plumbing - When allplumbing work is complete. Final Mechanical - When allmechanical work is complete. Final Building - When allrequired inspections have beenapproved and building is completed. ;4 w B w w q ffi Underground plumbing - priorl.4 to filling trench. Underlloor Plumbing/ Mechanical - Prior to insulation or decking. Post and Beam - prior to floorinsulation or decking. Floor lnsulation - prior to decki ng. Water Line - Prior to filling trench. Rough Plumbing - prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. [-l Fireplace - prior to facing - materials and framing lnsp. ffi Framing - prior to cover. ffi Wall/Ceiling lnsulation - prior to*V cover. W orv*.ll - Prior to taping. l-_l Wood Stove - After instailation. Curbcut & Approach - Afterforms are erected but prior toplacement of concrete. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Fence - When completed. Street Trees - When all required trees are planted. lnsert - After fireplace approvaland installation of unit. I--l Blocking and Set.Up - When ail - blocking is compleie. MOBILE HOME !NSPECTIONS Plumbing Connections _ Whenhome has been connected towater and sewer. l-y-l Sanitary Sewer - prior to fiilingt...a trench. E i:XtS, sewer - Prior to rillins w a Electrical Connection - Whenblocking, set-up, and plumbing inspections have been approved and the home is connected tothe service panel. Final - After all requiredlnspections are approved andporches, skirting, decks, andventing have been installed. q\r\sa 6aer4 w Final Electrical - When all electrical work is complete. [-l othertt w E I Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac PL.HSE GAR ACC N S E rHE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED iewed 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. Recei pt Number: /ar2zDate Recei By: Date Paid Plan Check Fee:a/ //.< 2 ?/.oa vE7*- (A) 2 AC 1?./6 GTZ€E 7?e Total Value Building Permit Fee State Su rcharge Total Fee BU!LDING PERM!T ITEM SQ. FT. X Main Garage Carport $/SQ. FT. : VALUE a"-2o 1q ?ar.* @ Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHARGE (B) (sDc) ADDITIONAL COMMENTS ITEM Fixtures Flesidential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE 7/'za a/.7a /.% (c)?5.2a FT. FT. FT. No/ PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent .? 6e,-2.q,ra. €4 /b.52 a-"',p /.77 27-E7(D) a N0 IVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood 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 Springf ield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division' I f urther certify that only contractors and employees who are in compliance with OFIS 701.055 will be used on this project. 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 permit card is located at the f ront of the property, and the approved set of plans will remain Date on the site at all times d ring I { Signatu re tion. MISCELLANEOUS PERMITS iitroF,ila He.ne pa4q fiel/Z€b State lssuance State Surcharge //>-ot Total Miscellaneous Permits (E)/r3.o t >7 -qr/b2 ? <'oDATE PAID AMOUNT FIECEIVED BECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL I\MOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 7.* Demorition wffi/ State Surcharge I 'fr*'tvrffu-'<*r=n