HomeMy WebLinkAboutPermit Building 1992-03-09NAL
APPLICATION
tionsr 726-3769
(ice:726-3759
-OCATION OF PROPOSED WORK:
ASSESSORS MAP:/7'@ 3:av-
JOB NUMBER 4z
225 Flfth Street
Sprl ngfl el d, O re gon 97 47 7
3o 3tf TAX LOT:
LOT ___-- BLOCK:SUBDIVISION:
PHONE:
ztPSTATE:
5 lL *
OWNER:
CITY:
ADDITION DEMOLISH OTHER
Jt.
'/o -1DESCRIBE WORK:
-/
NEW )/- NEMODEL
PHONEADDNESS
'72?v327
/-t-
f.qCONTRACTOR'S EXPIRES
MECHANICAL
ELECTRICAL:
CONST.
CONTRACTOR #
fi*ut,GENERAL:
PLUMBING
T-\\\D-- OFFICE U
I.AND USE.:FLOOD PLAIN:
ZONING CODE:
r OF BDRMS:
WATEN HEATER
OCCY CROUP: -.
# OF STORIES
RANGE:
r OF UNITS:
SECONDARY HEAT
SQUARE FOOTAGE:
OUAD AREA:
I OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:-
To request an inspection, you must call 726'3769. Thls ls a24hour recording' All I
madethesameworklngday,inspectionsrequestedafterT:00a.m.wlllbemade'
nspectlons requested before 7:00 a.m, wlll be
the followlng work day.
Final Plumbing - When all
plumblng work ls comPlete.
Final Electrlcal - When all
electrical work is comPlete.
l7l remnorarY Electric
Slte tnspection - To be made
arf ter excavation, but Prior to
settlng forms.
Underslab Plumbing / Elsctrical/
Mechanical - Prior to cover.
Footlng - After trenches are
excavated.
Masonry - Steel lss6li66, frond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumbing/ Mechanical
- Prior to insulatlon or decklng.
Post and Beam - Prlor to floor
insulation or decking.
REOUIRED INSPECTIONS
[f :;*t: Mechanrcar - Prror to m
m f#: Electricat - Prlor to B
w
ry
Electrlcal Service - Must be
approved to obtain Permanent
electrlcal Power.
Flreplace - Prior to faclng
nraterlals and framlng lnsp'
Framing - Prior to cover,
Final Mechanlcal - When all
mechanlcal work is complete.
Flnal Bulldlng - When all
requlred lnspectlons have been
approved and building is
completed.
Other
MOBILE HOME INSPE TIONS
Blocklng and Set-UP - When all
blocklng ls comPlete.
Plumblng Connectlons - When
home has been connected to
water and sewer.
B
m
m
w
a
w
V
w
w
n
E]
w
w
Rough Plumbing - Prior to
cov€r.m
Wall/Celllng lnsulation - Prlor to
cover.
l-[l DrYwall - Prior to taolng
Wood Stove - After installatlon.
lnserl - After flrePlace aPProval
and lnstallatlon of unlt'
Curbcut &APProach - After
forrns are erected but Prlor to
placement of concrete.
Sldewalk & DrlvewaY - After
excavation ls complete, forms
and sub-base materlal ln Place.
Fence - When completed.
Street Trees - When ali requlibd
trees are Planted.
Floor lnsulatlon - Prlor to
decklng.
i':rifl:;;"i#)z'wH/
Storm Sewer - Prior to flllrn0iiiin.p 6ftgaZa@
Wator Llne - Prlor to fllling
trench.
,
. U/p:ttz--Eea-?-
4zrz vADDRESS:
I
I
t
APPROVED:TopograPhY
Total height
adopted by the Clty of Sprlngfleld, including the
Development Code, regulating the constructlon and uso of
buildings, an<J nray be suspended or revoked at any time
upon violation of any provisions of sald ordinances'
pran crrecx r"u, Z8-i Zg -
By:
//-Zo-aZ
Date
Flecei pt Numbe
LAN Kcf,iHcPLUAE,VGIDNtuLB M TRPEGNDLUBNAD
Sthe daiot''lti atrhconSSditheo11exrantedpremThsSper
nan0rcl cemcontortoalnreshalructionnstspectsco
Flecei
VALUE
$lLze ?l/oy-zet*n
(A)
BUI LDING PERMIT
SQ. FT.
/4-xGE7z
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
/atu2g?u7?.fa
4,ee//62v3
x $/so. FT.
Systems Development Charge is due on all undeveloped
properties within the City limits which are belng improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)&tarr AAA (B)
ITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Motrile Home
PLUMBING PERMIT
FEE
No
oO/6a.
FT.
FT.
FT.
/6t-*(c)
J@3
8,G
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
Jro
/, j?
N" 7rl 3
1.fr
c?
a
(D)v?.6v
A,MECHANICAL PERMIT
Mechanical Permit
lssuance
State Surcharge
Total Permit
?Z-P/a.*
Furnace
Exhaust Hogd
Vent Fan
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
wlth the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertalnlng to the work described
hereln, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify lhat only contractors and employees who
are ln compliance with OHS 701.055 wlll be used on this
project.
I f urther agree to cnsure that all required inspections are
requested at the proper tlnre, that oach address is readable
from the street, tlrat the permlt card ls located at the front
of the property, and the approved set of plans wlll remain
Slgnature
Date
on the si t() at all tirrre ring construction
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut % n
Wk^"ftarre.-,Ee@ka
Total Mlscellaneous Permits (E)
r,
"?wabaa
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Combined)/d69-"7
ala lqt
# "J'7za
I leo(r-:lq
DATE PAID
AMOUNT BECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
taces
Lot sq.
Lot
I nterior
C6rner
*- Panhandle
-
Cul'de-sao
signed
torical
IN
l{ is
issuanct;'
IS
the
Date Paid:
t
CP,
INSPBCTION RBQTIBST:
0FFICE: 726-3759
225 FI,WU SI3BET
SPRINGFIELD, oREGoN 974
:'.'
77 UUb APPLTCATTON
R Ci ty Job Number Ctl tS 4b
3. COHPI.BTE IIBB SCMDULE BELOII
tial-Single or
Hulti-Family per dvelling unit.
Service fncluded:
I tems Cos t
$ 8s.00
$ 1s.00
$ 40.00
c-
Services or Feeders
Installation, Alterations or
Reloca t ion:
726-3769')
-).
C)
. t 0-?3
1.LOCATION OP
a!r 19
IJGAL DESCRIPTION
t1 ea eq L+e o)zl5
JOB
Address 3l zc lD //-tb
?, in e)to pnone 3{31 35 3
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Serviee or Feed'er
200 amps or less
201 amps to 400 amps _
401 amps to 600 amps _
601 amps to 1000 amps-
0ver 1000 amps/volts
Reconnect Oniy
B
$100.00
$130.00
$300.00
$ 40.00
r Feeders
tion or Relocation
Sum
not included)
40.00
40. 00
20.00
40 ,oaI Ocr
$ s0.00
$ 60.00
Ci ty
-/
Superv-isor License Ndmber
Exp iration Date /a-l- 7s
The installatlon is being made on
property I own which is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
RECEIPT *:
200 amps or less I $ 40.00 q[)"
Over 401 tb 600 amps
-
$ 80.00
Over 600 amps or 1000 volts see rrB'r above
c
Constr Contr. Nunbec 3 135/fns talla t ion t tera
Expiration Date
tuE Blectrician
D. Branch Circuits
0vners Name
Address ,? qf g A/ )o@ Nev, Alteration or Extension Per Panel
Ci ty
one Circuit S 35.00
Each Additional
Circuit or with Service
or Feeder Permit S 2.00OITNER INSTALI,ATION
E l'liscellaneous (Service/feeder
-Each installation
Prrmp or irrigation $
Sign/OutIine Lighting_ S
Limi ted Energy/Res _ S
Limi ted Energy/Comm $
STETOTAL OF ABOVE
5tr State Surcharge
TOTAL
RECBIVED
3)q I qz 5
42 CIc
Permits are non-transferable and expire
lf vork is not started vithin 180 days
of lssuance or if work ls suspended for
180 days.
2. CO}T]RACTOR INSTALI.ATION ONLY
Electricar contrac ,o, B, / / . ffe"fr,'
I haa tho followinS qr
225 FIFTE STRBEf,
SPRTNGFTEIJ, oREGoN 97477
INSPECTION RBQT EST: 726-3769
OPPTCE: 726-3759 *€
LDR
- r6-?3
s5
BLBCTRICAL PERHIT APPLI CATION
Cl ty Job Number qe I L+b
1. LOCATION OP INST
IJGAL DESCRIPTION
DESCRIPTION
Permlts are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork ls suspended for
180 days.
2. CONTRACTOR INSTALI^ATION ONLY
Electrical Contractor
Address .? 2c, /-4-)-ti'
Ci ty f ,/r) 0j1a Pt on"34j /-353
Superv-isor License Ntimber VSoS
Expiration Date /a'/- ?s
Constr Contr. Number ,r/35/
Exp iratlon o^t. 1* /- 7S
4()sing trieian
0vners Name
Address a.+ 7I )b/h
Ci ty Phone
OIJNER INSTALI.ATION
The installation is being made on
property I own which is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:3/qlq a
RECEIPT *:
A+-t9 N
ALI..ATION'
n,Lw Al,
COHPIJTE TEE SCMDULE BELOV
Nev Residential-Single or
Hultl-Family per dvelling unit.
Service fncluded:Items Cost
A
Sum
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular DveI).ing
Service or Feed'er
B. Services or Feeders
Insta1lation, Alteratlons or
C_ Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconneet 0nIy
I g as.oo 9s oo
$ 40.00
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
c Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
Over 401 to 600 amps _ $ 80.00
0ver 600 amps or 1000 volts see "8" above
D. Branch Circuits
Nev, Alteratlon or Extension Per Panel
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit
$ 3s.00
$ 2.00 _
E. l'liscellaneous (Service/feeder not included)
-Each installation
Pnmp or irrigation
Sign/outtine Lighting-
Limi ted Energy/Res
Limited Energy/Comm
SUBTOTAT OP ABOVB
5Z State Surcharge
TOTAL
oo
$ 40.00
$ 40.00
s 20.00
s 36.00
RECEIVED BY:
1
5
i4 <d
The
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I
Yo r-
- 7- -' - J?3n
.- HA'(D BR\DGE F.OAD A-.., J A
2
APR 1 7" 1971
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NOTE sEE GHECKLTST oN REvERSE slDE
OWNER
ADDRESS
MAR 22 1971
LAIiE COUIIW
PLANNING
+\l
v 0irttER
coNEl-TloLr=,'.
I, No Por'*rl.. o F o, t,rL - g,..t
drrpcto\ tlsten^ shq,t\
*it{^l^ Bo fecl o€ {dc
f r"re oC Lol * l -A Z,
DO NOT WRITE IN I HI5 SPACE
by tire Lanr County Land Dcvel opment
Reyielv Conimiiiee 0n.1.
LEE IIjLLER,
Approved as a minor subdivision fa <,c terrrcrg G
bg eo,- 1|p.*g
-$€11J{331"hcr:,travl1
MINOR SUBDIVISION
r5TAX LOT(S) z
ESSORS /MAP 11 o
sEcrroN =t'/+ Ssc. z*
NSHIP 1-l S. AaxCE
GU\NER E EhITTON15r W, I.Z'TU srF{eET
EUGEl.leT OBEa()N
R 8Y
t'l '
Ycaeb
Servrca thhnn
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PH )NE :CALE l"= I OO/NUMBER M !i -? l- Z I
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- KANCH ,