HomeMy WebLinkAboutPermit Building 1992-08-31IELt)
RESIDENT!AL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726'3759
I-OC/\TION OF PROPOSED WOtlK:
JOB NUMBER
225 Fiflh Street
Springfield, Oregon 97 477
ASSESSOFIS MAP:/7o z /q ?j TAX LOT /207-
LOT:BLOCK:SUBDIVISION
PHONE:OWNEFI:
ADDRF-SS
STATE 7_tPCITY:
To request an inspection, you must call 726-376g. This is a24 hour recording. All inspections requested before 7:o0 a.m. will be
rnacle the same working clay, inspections requested after 7:00 a.m. wlll be made the following work day'
REQUIRED INSPECTIONS
Temporary Electric Rouglr Meclranical - Prior to
cover"
Final Plumbirrg - When all
plumblng worl< is complete.
&€tfle-
Site lnspection - To be mader
af ter excavation, but Prior to
selting fornts.
Underslab Plumbing/ Electrical /
Mechanical - F)rior to cover.
Footing - Af ter trenches are
excavated.
Masonry - Steel location, bond
beams, groLrting.
Foundation - After forms are
erected but prior to concrete
placernent.
Underground Plumbing - Prior
to filling trench.
Underlloor Plumb
- Prior to insulation or ec
Post and Beam - Prior to floor
insulation or decking.
Floor lnsulation - Prior to
decking.
Sanilary Sewer - Prior to filling
trench.
Slorm Sewer - prior to fillinc;trench.
W*ater Line - prlor to fillingtrench.
w Rough Electrical - Prior to
cover,
Eleclrical Service - Must be
arpproved to obtain permanent
c'lectrical power.
Fireplace - Prior to faclng
materials and framlng lnsp.
Framing - Prior to cover,
Wall/Ceiling lnsulation - Prior to
cover.
Final Electrical - When all
electrical worl( is complete.
Final Mechanical - When all
mechanical worl( is comJrlete.
w
n
w
w
m
W
w
E
w
f,7 orv*utl - Prior to tapirrg.
Wood Stove - After installation
lnsert - After flreplace approval
and installation of unit.
Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
Final Building - When all
required inspections have been
approved and building is
completed.
Other
MOBILE HOME !NSPECTTONS
Sidewalk & Driveway - Afterexcavation is complete, formsirnr, sub-Lr,.rse ntat(,ria, in place.
Fence - When completed.
aDESCRIBE WORK:
DEMOLISH OTHERNEW ----_-- REMODEL ADDITION
CONTRACTOR,S NA,VIE - ADDRESS;;.;;: -&blaEs &ru-D
CONST.R#EXPIRES PFION E
S
NT
ELFELECTRICAI.
PL.UMISING
MECHANICALi +---
FLOOD PLAIN
I5E
ZONING CODE tj\w
# OF BDRMSOCCY GIIOUP: -.
c OF BLDGS: -.
OUAD AREA
SECONDARY HEAT:
SOUARE FOOTAGE:
LAND USE:
OFFICE USE -
\\\ \
RANGE:
CONSTR. TYPE
HEAT SOURCE:
t, Ot- STORIES: - -\
WATEN HEAI-ER:
fJ ff;.rrn Plumbins - Prior ro i-l .1*uu, Trees - when alr requrred
-
trees are ltlantod-
\I
Vti/
_q?rc45_
E
t_l
fl
w
tl
[-l Blocklng and Ser.Up - When ail
-
blocklng ls complete.
[---| Plumbing Connections - When
'J home has been connected to
water and sewer,
I pleclrlcal Connection _ When__, Drocking, set-up, and plumbinornspections haye been approv;dand the homc is connected tothe servlce panel.
x ffiir,, i:,";;': ;;?;J!u,o u n,p-orches, sktrrtno, ,i.itJ, #o"venilng have beln ,nst;il;i.
lS'tH{-: F'tloPOSED WORK lN THE
HIS'TORICAL DISTRICT, OR ON
TFIE HISTOFIICAL REGISTEFI?
-
lf vcs, this application must be signed
and approved bY the Historical
Coordin;rtor prior to permit issuance.
AF'PROVED
}.ISEP.L.
N
S
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total height
Lot Type
--
lnterior
-
Corner
-.
Panhandle
-
Cul-de-sacE
ACC
E
ks
GAtl
erl
BUTLDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is grantecJ on the express condltion that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Developrnent Code, regulatirrg the construction and use of
builclirrlls, and rnay be suspended or revol(ed :lt any time
upon violalion of :trry provisions of said ordinances'
Date
9:DZ.<-
Date Paid
Receipt Nurttber:--
Recei
Plan Check Fee: -.-4a,-4s
BUILDING PERMIT
VALUE
3919-10
U.z7(A)
/{z
SQ. FT.ITEM
Main *a|nr.
Garage
Carport
x $/so. FT.
laf
Total Value
Building Permit Fee
State Surcharge
Total Fee
22/:*7"7
Systcrrrs Dcveloptttcnt Clt:rt gc is clue on.'rll ttrtclcvclopcd
proportios witl)in tlrt; City lirrrits wl'riclr are [,rcirr1; itrlprr:votl.
SYSTEMS DEVELO PJV'I ENT C//46 (B)
HARGE (SDC)
DITION COMME
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
No
FT.
FT.
FT
(c)
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flrelll;rce Unit
./o-o
(D)
N0
,ffir7 -/5=
Vent Fan
Dryer Vetrt
Mechanical Permit
lssuance
State Surcharge
Total Permit
M ECHANICAL PERMIT
Furnace
Exhaust Hood
By signature, I :;tato :rnd ;r1;ree, tllat I havc c:rrr-'(ully exanritrcd
the cornplctccl apl)lication and do lrereby certify that all
informalion hereon is true and correct, antl I ftrrtlrcr certify
tllat any and all woll< pctftlrrtccl shall bo dorrc it-t ;tt;t;orrlattcr'
with the Ordinarrces ot the City of Springficld, and tlte Laws
of thc Statc of OreJ;orr pcrtaining to the worll rlcscribccl
Itcrcin, attcl tlrat NO OCCLIPANCY will [rt: ttt:rdr: of atty
structure without pernlission of the Building Safety Division'
I further certily that only contractors and cmployees who
are in cc:nlpliarlce with OFIS 701.055 will be trsed on this
proiect.
I further agree to onsure that all required inspections are
requested at tlre proper time, that each adtlress is readable
from the street, th;rt the permit card is located at the front
Sig trat u
Date
and the aPProvedof the ProPertY'
.uring comeson the si
f plans will remainMISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk --.----. ft
Curbcut
-
tl
Demolition
State Surchargc
(E)
To tal Miscellaneous Permits
/22-%calilelectudngEDTUN(excAMOUlOTAL
Comb\ned)EandD,B,C,(A
VALIDATION:
RECEIPT NUMBEII -
DATE PAID., -
AMOUNT RECEIVED
RECEIVED BY - -
sr"ilNGFrEL(,
Jr
'!.1,o,,-,
''r:.,.,
225 FITTB STREET
SPRINGFIEU), ORBGON 97477
INSPECTI0N REQTBST: 726-3769
OFFICE: 726-3759
:,I i..
SCEEDULE BBLOV
IAGAL DESGRIPTION/22-,q^23 , e,/zaz
A.sidential-Single or
MuIti per dr,relling unit.
Service fnc
I tens
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Hanuf'd Home or
-Modular Dvelling
Service or Feeder
B. Services or Feeders
Installation, Alterations or
Reloca t ion :
Cos t
$ 8s.00
$ 1s.00
$ 40.00
Sum
JOB DESCRIPTI
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALI.ATION ONLY
Electrical Contractor
Address
Ci Phone
Supervisor License Ntimber
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Ovners Name
Address e
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/vo1ts
Reconnect 0n1y
Temporary Services or'FeedersInstallation, Alteration or Relocation
c
$ s0.00
$ 60.00
$r00.00
$130.00
$300.00
$ 40.00
a56E
40.00
55.00
80.00
,e trBr
200 amps or Less $
201 amps to 400 .mps
-
$
Over 401 to 600 amps _ $
Over 600 amps or 1000 volts se
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circui t -/ S 35.00 :.4y't
Each Addi tional
Circuit or vith Service
or Feeder PermitOIINER INSTALI..ATION
The installation is being made on
property f ovn vhich is not intendedfor sale, Iease or rent.
DATE:
PT
6a:>
Ci ty Phone 7/4)- ?2,87
E. Miscellaneous (Service/feeder not included)
-Eacl: installation
Pump or irrigation $Sign/outline Lighting- $Limited Energy/Res
-
$
Limi ted Energy/Comm S
$ 2.00
00
00
00
00
40
40
20
36
5 SI,BTOTAL OT ABOVE
5Z State Surcharge
TOTAL
RECEIVBD B
t
elR
ir,APPLICATION
4,la
1. LOCATION OP INSTALIJTTION/_a-<-_ / T rrr-