HomeMy WebLinkAboutPermit Building 1998-07-17RESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOI
IELE,
JOBNUMBE^M
225 Fifth Street
Spring{leld, Oregon 97477
a
TAX LOT
BLOCK:SUBDIVISION:
PHONE:
ZIP:a<STATE:CITY:
ADDRESS:
OWNEB:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
PLUMBING:
ADDRESS EXPIRES ,$ PHONECONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
GENERAL:
CONST.
CONTRACTOR #
RANGE:
I OF BDRMS:
_ OFFICE USE -
LAND USE:
WATER HEATEFI:
ZONING CODE:
FLOOD PLAIN
r OF UNITS:
OUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE. FOOTAGE:
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All Inspections requested before 7:00 a.m. will be
made the same worklng day, lnspections requested after 7:00 a.m. will be made the following work day.
REOUIRED INSPECTIONS
Temporary Electric Rough Mechanlcal - Prior to
cover.
l--l final Plumbing - When alllJ plumbing worl< ls complete.
tf,Tfinat Electrlcat - When all
JA electrical work is complete.,Km"lSlte lnspection - To lre made
after excavation, but prior to
setting forms.
Underslab Plumbing / Electrical /
Mechanical - Prior to cover,
Footlng - After trenches are
excavated.
Foundatlon - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filllng trench.
Underlloor Plumblng/ Mechanical
- Prior to lnsulatlon or decking'
Post and Beam - Prlor to floor
lnsulatlon or decking.
Floor lnsulation - Prior to
decl<ing.
Sanitary Sewer - Prior to filling
trench.
Stonn Sewer - Prior to filling
trench.
Water Llne - Prlor tre filling
trench.
Rough Plumbing - Prior to
cover.
h Electrical - Prior to
Eleclrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flreplace - Prior to facing
materlals and framing lnsp.
Wall/Ceiling lnsulation - Prior to
cover.
Final Mechanical - When all
mechanical work ls complete.
I-_l Orywall - Prior to taping
Wood Stove - After lnstallatlon
lnsert - After flreplace aPProval
and installation of unlt.
Curbcut & A;:prroach - After
forms are erected bttt Prior to
placement of concrete.
Sidewalt< & Driveway - Atter
excavation is comPlete, forms
and sub-base material in Place.
l-l Fence - When coiriPleted.
{itreet Treos - When all required
trees are Planted.
Flnal Buildlng - When all
required lnspectlons have been
approved and building is
completed.
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When all
blocklng ls complete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Eleclrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
inspections are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.
tr
ffo,nu, ,^ ^(. f - f
\r*t) ,4*L-zc-4'z_-
( .a.B\
E
E
Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prior to cover.
E
E
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E
E
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Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
P.L.HSE GAR ACC
N
S
E
S THE PROPOSED WORK TN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permlt issuance.
APPROVED:
Total Value
Building Permit Fee
State Surcharge U,3 3 *
Total Fee
BUTLDING PERMIT
VALUE
ru,
ro3
(A)/_z,e:_
:'
ITEM
Main
Garage
Carport
SQ. FT. X $/SQ. FT.
BUTLDING VALUE, PTRTT CHECK
AND BUILDING PERMIT
This permit is granted on the cxpress condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City ol 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.
Receipt Numoer: 72 fO -f
PIans Byewe 7 iz2e
Received
*L 6
7J
Date Paid
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City linrits which are being improved.
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N.
FT.
FT.
Plumbing Permlt
State Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fixtures
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby cerilfy that all
lnformation hereon is true ancl correct, and I f urther cerflfy
that any and all work performed shall be done in accordance
with the Ordinahces of the City of Springfield, and the Lawsof the State of Oregon pertaining 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 thisproiect.
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 frontof the property, and the approved set of plans will remaln
on the site at all time s durin s
Date
struction
\
Slgnatu
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-_
ft
Curbcut -.-- ft
Demolition
State Surcharge
Total Miscellaneous permits (E)
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, D, and E Combtned)
%
3DA OL
/2 ,83AMOUNT RECEIV ED
---RECEIVED BY
DATE PAIi)
VALIDATION:
FIECEIPT NUMBER
Lot Tyf '-
-
lnterlor
-_
Corner
.- Panhandle
-
Cul-de-sac
//6P-
-28
- FT.
) - \)-th
. ._ ELEVATION CERTIFICA_ ?#*!";i5,,,,!i.?3i
. .:DERAL EMERGENCY MANAGET,ENT AT-.NCY
NATIONAL FLOOD INSURANCE PROGBAM
ATIENIION: Use ol this cerlificate does nol provftlo a walver ol lhe f,ood insurance purdrase requiremenl. This lorm is usad only lo
provide clevalion inforrnalion necossary lo onsuro compliance wilh apfrlicablo community ltoodplain managemenl ordinancos. lo
delernrine the proper insurance premium rale. and/or lo suqrori a requesl lor a Letler ot Map Amendment or Revision (LOMA or LOMR)
lnslrucllons tor completlng thls lorm can be lound on lhe lollowlng peges.
SECNON A PNOPENTY INFONMANON
N('ILDING OWNEN'S NAME
DEAN & GAYLE HELFR]CH
ron lNsun^r.rcE coirP NY usE
coa..P NYNAlcNUMt'En
fOtICY NUMOEN
Sl nEE I ADOnESS (lncftxtinq Apl., Unil. Sulle andbr Bkl6. Nun'$od On P.O. ,IOUIE Ailt 6OX ,{t MOEfi
2587 NORTH 1gth STREET
OI I lEn DESCFIPIION (Lol and Bloc{< Numbors, ale.f
OREGOIJ 97477SPRTNGF_rELq_ . _
CIIY SIAIE ZIP COOE
sEcnoil B FLq)D lNsunANcE R/\TE MAP (FlRMl INFORMATION
Provirie lhe lollowing lrom lhe proper FIRM (See lnslructions):
7. lndicale lhe elevalion dalum sysfem us6d on the FIRM lor Base Flood Elevations (BFE):{Xk{GVD'29 fJOrn"r (describe on back)
8. For Zones A or V, where no BFE ls provlded on the FIRM, and the community has eslablished a BFE lor lhis building sile, indicale
lhe community's BFE: l-l-l-l-t-l.Ll leet NCvo 1or olher FlflM dalum-see Section B, ltem 7).
SECNON C BUILDING ELEVANON INFORMANON
1. Using lhe Elevalion Cerlilicate instruc-tions, lndcale the diagram number lrom lhe diagrams found on Pages 5 and 6 that best
describes lhe subjecl building's relerence level 8
2(a). FIRM Zones Al-A30, AE, AH, and A (with BFE). The top ol the relerence level lloor lrom lhe selecied diagram is al an elevalion
.f I I -l 1l?-l1l . [3 teet NGVD (or olher FIRM datum-see Sec{ion B, ltem 7).
F). FlnM Zones Vl-V30. VE, and V (with BFE). The bottom ol lhe lowesl horizonlal slruclural member ol the relerence level lrom
the selecled diagram, ls at an elevallon ol I I I I I l.Ll teet NGVD (or other FltrM dalum-*ee Section B, ltem 7).
(c), FlnM Zone A (without BFE). The lloor used as lhe reterence levelfrom the selected diagram is I I l.U feel above t] or
' below L-] (cne* one) lhe highesl grade adiacent to lhe building.
(d). FlnM Zone AO. The lloor usd as the relerence level lrom the selecled diagram k I I I .l -l leet above f] or below [-] (cnect
one) lhe highesl grade adiacent lo the building. lt no llood depth number is avaiiable. is lhe building's lowesl lloor (reference
level) elevaled ln ac,c.ordance with lhe community's lloodplain nianagement ordinance? f] Ves fJ tto I Unkno*n
3. lndicite lhe elevation dalum system used ln deleminlng the above relerence level elevations: g>fuGvD'29 D Olher (describe
under Commenls on Page 2). (NOTE: ll the elevaliort datun used ln measurirtg the elevalions is dillerenl lhan lhal usd on
the FIRM [see Sec:lion B. llem 4, lhed dnwd the elevetiffi lo lln datum syslem usd on lhe FIRM and show lhe ontlersion
equalion under Commenls on Page 2.)
4. Elevalion referonce mark used appears on FIRM: E vrs>{X}Xo (See lnstructions on Page 4)
5. The relerence levelelevalion ls based on, E}<actudconstnrction I consmaion drawings
(NOIE: llse ol anstruction dahings ls only valid ll lha hrUig M ml Jel have the relercne level lloor in plae, in whbh
case lhis @diliab will only be ttalid lu the hildry &niq tfro odursd ot @kh.rtiffi. A mFllanslrudion Eleuation Cetliliale
will be reguired once m1slruclion ls o@ele.)
6. The elevation ol lhe lowest grtde lmmedlately adiaent to the building ts: I I l+ F lZl.lX I leet NGVD (or other FIBM dalum-see
Secti6n B,llent 7).
SECflON D GOIIMUNTTY INFORilANON
l. ll lhe communlty offlc{al rosponslble lot vailylng bulUtrq daaUorc spedfies 0rat the iol€roflcs levellndicated ln Sedkm C, llem I
ls not lhe'lowesl lloor'es dellned ln the comrtunlt/olloddeln meila06m6nl ordnenco. the elevalion ol the buiUing's lowosl
lloor' as delined by the ordlnarrce ls: I I I I I l.U t"et NGVI (ot other FIFM daturn+ee Sec-tion 8. llem 7).
2. Date ol lhe slart ol conslruc'tlon or substantlal lrnprwement
l. couMuNllY Nt'MOrn
41 5591
2. PANEL MITOEN
c370
3. SUTFIX
C
a. o tG of FmM tNoEx
,{
5. FrnM ZONC
A-6DECEMBER -18, 1 5
6. BASE I
(i. AO
450.
rlo(x) EtEvAlroN
Zms. Ga dopthl5 (450.5)
,#*iZ/4d ZaF *
SEE REVENSE SIOE FOR OON ]IHUATIOIIf tMA ?oem Cl-rl, MAY 90 REPIACCS At-l- PRtVTOUS tDrf IONS
SECTIONE CERTIFICATION
Tlris cerlilicarion is to be signed by a land surveyor, engineor, or architecl wlro is autlrorized by slale or local law to cerlily elovalion
inrorrnarion when the "rlr-lliii-.'ii'fiililJ,iil2';;;r"i-Aad,
AE. AH, A (wiur BFE),vl-v30,vE, and v (wirlr BFE)is required'
communiry oriciars "d;;;;ilh;;ii;.ib, r.o9a1iaw or ordinanco ro provi<ie lloodpliin managomonl inlorrnation' mav also sisn tho
cerriricarion. ln rre caso;i il;;/ictin,i e ("iiliort a FEMA or corirmuniry issurid BFE), a building ollicial' a Property owoor' or ao
""^"ii-rlit"sentative
may also sign the corlilication'
Relerence leveldiagrams 6, 7 arul g - Dislinguishing Fealuros-llthecortilier is unable lo corlily lo br€akaway/non'broakaway wall'
sncrosuro sizo, rocarion or servicin_g equipmont,'i;;;;;;, wa[ openiogs, oiinrinirt,od.aroafo'aturo(s), lhen list the F€aluro(s) not
inctuded ln rtre cerriticau"n *ir.i i"mhbnr. u"rii.- fr,o'aiagrain nqriber, soction c, ltom l, musl still bs snterod'
l cediry lhat the intormarion in secrions g and c on lhis cerriticate rcNesenls nty bost ortorts. .ro^interpret-tlp data available'
l undersrand that any rarse statement may oo p,i,i"iiii-iy tine or in piirn ronr under ta u.s. codo. section t00l '
I
f\
CHARLES W. GUILE L5.472 (OREGON)
f"fCelfSe NUMBEF (or Allir Soalf
GUILE & ASSOCIATES, COCESTIFIER'S NAME
LAND SURVEYOR CHARLES W.
TITLE52 CENTENNIAL LOOP
^DORESS
SIGNA
COMPANY NAME
EUGENE OREGON 97401
DECEMBER 10, 1996
DATE
STATE
1-541 -343-9855
P}IONE
ztP
Coples should be made ol this Certllicale lor;l) communlly otliclal, 2| lnsuranco FgenucomPany, and 3) bulldlng owner.
ELEVATIONS AS DENOTED HEREON ARE BASED ON LANE COUNTY'S
COMMENTS
RlVER TRAVERSE SURVEY MONUMENT NUMBER ''RT 797''HAVING A RECORDED
ELEVATTON OF 453.26, '1929 ELEVATTON DATA'
REGISTERID
SURVEYORLA
| 8t''
GUILE
Tho diagrams abovo illustrato the points at whiclr the elevations sltould bs moasurod in A Zonos and V Zonos
Elevations lor allA Zonss should be measurod at tho top ol lhe rolorenco lovellloor.
Elevations lor all V Zones should bo meiasurod at tho bottorn ol tho lowosl horizonlal structural momber.
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-Front vard to House 10 feet
-Front yard to Garage 18 feet
-iii" vi.a to House or Garage 5 feet
-n"ii i..a to Eouse or Garage 10 feet
P.U.E. IiAY CEANGT SETBACKS
lryy!? oNLy FoR REstDENTlAr, AccESsoRy usEill .'.:aC l.ti..: WrTH ART,C.E lO Or-ti.-""spR,NGFrEtD orviloe,wxi a-d; ,,..
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