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Home My WebLink AboutPermit Building 1995-07-31RESIDENTIAL PERMIT APPLICATION lnspections: 726.3769 Oftice: 726.3759 ADDRESS:=w SPFlTN FIELE) JOB NUMBEB 225 Fif rh Street Springfletd, Oregon 97477 IOCATION OF pROpOSED WOBK:_2 ASSESSOHS MAP: tor.BLOCK OWNER €_.' TAX LOI: SUBDIVISION PHON E:c CITY:STATE ZIP: ADDITION DEMOLISH OTHEB DESCBIBE WORI(: NEW _ ,:]EMODEL *_ ADDFESS EXPI RES PHON EL CONTRACTOR'S NAME M ECHAN ICA L: ELECTRICAL: PLUMBINGI GENERAL: CONST. CONTRACTOR, _ OFFICE USE -OUAD AFEA: , OF BDRMS FIANG E: " OF BLDGS: __ OCCY GROUP LAND USE;FLOOD PLAIN: ZONING CODE: SECONDABY HEAT: SQUARE FOOTAQE: CONSTR. TYPE: HEAT SOURCE: / OF UNITS: WATER I.IEATER; To request an inspection, you must call 72made the San)e worl(ing cJay, lnspections 16-3769. Thls ls a 24 hour recordlng. Altrequesled af ter 7:00 a.m, wlll bo made REQUIBED INSPECTIONS lnspectlons requestecl belore 7:00 a,m. wlll betho followlng work day. Flnal plumbing - When ailptumblng worl( ls complete. F.lnal Electrical - !!5e6 s|1etectrlcal work ls complote. Flnal Mechanlcal - When attmechanlcal work ls complete. Ternporary Elec tric Site lnspection - To be madoafter excavation, bul prior tosettlng forrI]s. U_nderslab plunrbing / Electrical /Mochanical - prioi to cover. Footlng - Af ter trenches areexc avated. Masonry - Steel locailon, bondbeams, groutlnO. Foundatlon - After forms areerected but prior to concreteplacement, Underground plunrbing _ prlor to filllnq trenctl, Undertloor plumblng/ Mechanlcal - prtor to lnsulailon or decking, Posl and Bearry.- prlor to flogrlnsulatlon or decklng, Floor lnsulation - prior to dec kl n g. Sanitary Sewcr - prior to f llling trench. Slorm Sewer - prior to f illlng t ren ch. Water Llne - prlor to filling trench. Rough Plurnbing - prlor to cover. Rough Mochanlcal - prlor tocover. Rough Electrlcal - prlor tocover, Framlng - prlor to cover, Electrlcal Servlce - Must beapproved to obtaln permanentcleclrlcal power. I Flreplace - prlor to factng - materlals and framlng lnspi ffi ; ;,:J,l,Xll? ;"IJ i?,x,, o u u,approved and bulldlng lscompleted. XSX|/,'colllns tnsulauon - prtor ro Drywall - prlor to taplng [--l Wood Stovo - Alter lnstailatlo.n, [l Ln.gf, - After flreptace approval - and lnstallailon of unlt. : Curbcul & Approaclr - After f orms are erected brrt prior loplacemont of concretc. Sidewslk & Drlveway - Af terexc.avatlon ls complete, lormsanc, sub.base materlal ln place. Fence - Whon completed. MOBILE HOME INSPECTIONS BJoctlng and Sel.Up _ When altorocktng ls complete. Plumbing Connecllons _ Whenhome l'las been connected towater and sewer. Eleclrlcal Connoction _ When ,b]::f llg, ser.up, and ptumbrnsrnspo.cilons have been approvedand the home ls connected tothe servlce panel. I Street Troee - When all roqulred...- troes are planted. Final - Af ter all requiredrnspecilons are approved andporc.hes, sklrilng, decks, andvenilng have been lnstailed. 75/'<z <,/ fl tl [] []tl tl E Lot faces Lot sq. f tg, Lot coverage Topography Total helght Lot Type - lnterior - Corner - Panhandle - Cul.de-sac ks P.L.HSE GAR ACC N s E IS THE PROPOSED WORI( IN THE HISTORICAL DISTRICI, OR ON THE HISTORICAL REGISTER? _- lf yes, thls application must be slgnedand approvcd by the Historical Coordlnator prior to pcilnit issuance. APPROVED: VALUE z-?, r /7o 6/ oJ(A) 4,13 BUILDING PERMIT -A-uo_y<'/ ,o Total Value Building Permit Fee State Surcharge Total Fee SO. FT. X $/SO. FT.ITEM Main Garage Carport BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT Thls permlt is granted on the cxprcss cor.rdiiion that the saidconstruction shall, in all respects, conform to ilre Ordinanceadopted by thc City of Sprirrgficlcj , includtng the Development Cocje, rcgulating thc construction and use ofbulldlngs, and may ttc suspended or rcvol(cd at any time upon violation of any provisions ol saicl ordinances. Recelpt Nurnbcr:___.. Plans Rcviewed t3y Da te Plan Check Fee Datc Pald Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Developmcnt Charge is cjue on all undeveloped properties wlthln thc City linrits which are being improved, ITEM Flx tu res Resldentlal Bath(s) Sanllary Sewer Water Storm Sewer Moblle Home FEE (c) N0 FT. FT. PLUMBING PERMIT Plumblng Permlt State Surcharge Total Charge ADDITIONAL COMMENTS Wood, Stove/ lnsert/Flreplace Unlt Oryer Vent (D) N0Vent Fan Mechanlcal Permlt I ssuance State Surcharge Total Permlt MECHANICAL PERMlT Fu rnaco Exhaust Hood By slgnature, I statc aniJ agree, that I have carctully examlned the completed appllcatlon and do hereby certlfy that all lnformatlon hereon is true and correct, and I turther cerilfy that any and allwork performed shall bc donc in accordance wlth the Ordlnanccs of thc City of Sprtngf ictd, and the Laws of the Stato of Orcgon pertalnlng to thc wort< descrlbed heroln, and that NO OCCUPANCy wiil be macJe of any structure wlthout perrnission of the Bull<Jirrg Safety Dlvislon. I further certlfy that only contractors and employees who are In compllance wlth ORS 701.055 wlil be used on thls prolect. I further agreo to ensure that all requirec] inspections are requested at the proper tlme, that each address ls readable from tho street, thal the permlt card ls located at the front of the property, and the approved set of plans will remaln on e slte Slgnatu Date structlon.ll tlmes durlng MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcut ' ft Demolltlon State Surcharge Total Mlscellaneous Permlts (E) I TOTAL AMOUNT DUE (excludlng clcctrtcat) (A, B, C, D, and E Comblned)G/ez o3 I 7 VALIDATION RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY -.. FT. /3,/ - 7/ WTstz3Q SPRII;GFIE.l-! FIRE DEPAi?.T11ENT FIRE DAI,IA.GE REPORT OR ELECTRICAL HAZARD 5i q5' s1b DATE:-J *rf TO: FR0l.1: SUBJECT: Building Department Spri ngf i e'ld Fi re Department Structural Damage to Bu'i1 di ng Address or'location of building J€ls P. 3l$- Name of ol.rner Type of buiiding Estimated va'lue of bui 1di ng Estimated I oss to bu'i'ldi nq Date of fire tr (Dwe'l1ing, Sto , lrlarehouse, etc.) o $30,ooo 1)b- E{ Location of damaoe in bui'ldinq (Rcof , ltla'l 'l , Exterior, Interior, etc. ) Structura'l weakness as a resu'lt of the fire l?"-{Ie,c (Burned rafters, Beams, .loists, etc.) Additjona'l pertinent information E'lectrical Hazard Q:tr/nq 'zd/,{ /a"*o*.4 ---Blu.: A, ole (l,Ji ri nq , 0utJ ets , etc . cc 1s S i qned ?vJ 0,4- 1- 71- 0 SPF'I .ELO Tne following prolect as submined-has the ft:llorving ,"I'^ri, tiiiJ?5.inot require spocittc iano ii53 approval, zoning l-'P& Pfr?J-hrLA a225 FTTTH STREET SPRINGFIELD, OREGON 97 INSPECf,ION REQUEST: 7?6*rEilff OFPICE: 726-3759 fl/ rgi/grroN ELECTRICAI PERHIT APPLICATION M Job Numbe, q5 ) Z3L COHPI.,ETE FEE SCEEDT'I^E BELOS Nev Residential-Single or Multi-Family per dvelling unit- Service fncluded:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home- or Hodular Dvelling Sertice or Feeder s 8s.00 s 1s.00 s 40.00 3 A 1 DESCRIPTION IU' J9B netUrce lD circu;t5 at ions Sum zo-@ Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR Electrical Cont INSTALI.,ATTON ONL ractor CNo\<' \J ,Y B. Services or Feeders Installation, Alter e, //r-"1 € leclr,'\ o, Relocation: Address Q.O Bor TtAc t Ciw Suq(ar< gzqe$ Phone - Supervisor License Number 200 amps or less 201 amps to 400 amPs 401 amps to 600 amPs 601 amps to i.000 amPs Over 1.000 amps/volts Reconnect OnlY SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL 6q3 -'$373 3Se-LI. S /_ = s s0.00 s 60.00 s100.00 s130.00 $300.00 $ 40.00 s 3s.00 $ 2.00 5od Expiration Date Constr Contr. Number ?3 7n Expiration Date Signatu re of Supervising Electrician Ovners Name ,a.7o r Z Address Arrr--t Ci ty-Phone OVNER INSTAII.,ATION 3L{ /-L/1?7 The installation is being made on property I ovn vhich is not intended lor sa1e, lease or rent. Ovners Signature: DATE: ) Temporary Services or Feeders Installation, Alteration or Relocation 200 amps"or less $ 40-00 201 amps to 400 amps - S 55-00 Over 600 amps or fbOO voTts see 'B" a65If Branch Ci rcui ts . .- Nev, Alteration or Extension Per Panel C D One Circui t Each Additional Circuit or vith Service or Feeder Permi, lC E. Miscellaneous (Service/feeder not' included) -Each installation Pump or irrigation Sign/Out1ine Lighting- Limi ted Energy/Res Limited Energy/Comm -O, 6D ----7.-5d- $ $ $ s 0q 00 00 00 40 40 20 36 5 o RECEIVED B Z I,EGAL DESCRTPTION!Jnz- 11 ?1 ot:t1 o>r