HomeMy WebLinkAboutPermit Building 1991-12-29SPR!NGFTELD
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
JOB NUMBER ?///p
h,E
225 Fifth Street
Springfield, Oregon 97 477
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:/- az^/a^ ?/TAX LOT:4,//A?
LOT:BLOCK:SUBDIVISION
OWNER:PHON E:
ADDRESS:
CITY:STATE:aB-ZIP:
DESCRIBE WORK:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME ADDRESS
CONST.
CONTFIACTOR #EXPIRES PHONE
GENERAL:
PLU M BI NG:
MECHANICAL:
ELECTRICAL:
_ OFFICE USE -
QUAD AREA
# OF BLDGS
LAND USE:FLOOD PLAIN
* OF UNITS:ZONING CODE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
# OF BDRMS
WATER HEATER:RANGE:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
l-l Temporary Electrictt A Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
w Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.Electrical Service - Must be
approved to obtain permanent
electrical power.
E Final Mechanical - When all
mechanical work is complete.
w Footing - After trenches are
excavated.Fireplace - Prior to facing
materials and framing lnsp.
w Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.Framing - Prior to cover,
E OtherFoundation - After forms are
erected but prior to concrete
placement.Wall/Ceiling lnsulation - Prior to
cover.
Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After installation
Post and Beam - Prior to floor
insulation or decking.lnsert - After fireplace approval
and installation of unit.
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to f illing
tren c h.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Line - Prior to filling
trench.
Fence - When completed
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Rough Plumbing - Prior to
cover.
)q1r'2 y=
fr1 1-A/
I
tl
E
w
E
wr
E
E
E
Underground Plumbing - Prior
to filling trench.
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks , THE 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:
P.L.HSE GAR ACC
N
S 2/
E /1'
VALUE
| lzaea
(A)ft/.zz
c/4 {
X $/SQ. FT.
3?. _>
Total Value
Building Permit Fee
State Surcharge
Total Fee
/v/.s2
6-77
BUILDING PERM!T
ITEM SQ. FT.
t',t^in h?D
Garage
Carport
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.
DatePaid: @
Receipt Number: 27 fa
-Received
Zl2-zV-2,
DatedCVi
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
4ana
N0
t/2-e
2-e
o/= ae
4
FT.
FT.
FT.
(c)
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
(D)1<-
.7 5
-? --,-Vent Fan
/V/,Y /1e
/D' oe
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
N"/
By signature, I state and agree, that I have carefully 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 further certify that only contractors and employees who
are in compliance with ORS 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
on the site at all times during construction.
Date
Signature
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricatl 24,?3
(A, B, C, D, and E Combined)
iz??
2 a2-2 6AMOUNT RECEIVED
BECEIVED BY
DATE PAID 2-2
VALIDATION:
RECEIPT NUMBER
OF OREGO'U
st,tilN(;FtELt
atu
225 FIFTE STREEf,
SPRTNGFTELD, oREGON 97477
INSPECTION FJQUEST:. 726-3769
oFFICE: 726-3759
1. LOCATION OP INSTALI.,ATION
LLli? il. Y1l4-
I.,EGAL DESCRIPTION
JOB DESCRIPTION
E'€C AOotVa*/
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI.ATION ONLY
Electrical Contrac tor '[7 L ?Hn tTf
Address i fo P.Ty l,/te ut Da
Ci ty Evt Phone 3'f "'t-UIZJ
Supervisor License Ntimber /zt 5
Exp iration Date /fS -1 t - at L
Constr Contr. Number Lo, z9t- C
ExpirationDate lo' I -q1*
Signature of Supervising Blectrician
ne tD M1 |
ELECTRICAL PBR}IIT APPLICATION
Ci ty JobNumber ?ttq'lo
3. COHPIJTB PEB SCtrEDULB BELOV
A Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
Items Cost
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
s 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
Sum
B
200 amps or I
201 amps to 4
401 amps to 6
601 amps to 1
One Ci rcui t
Each Additional
00 amps
00 amps
000 amps_
s s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
ses
Over 1000 amps/voIts
Reconnect 0nIy
D. Branch Circuits
Nev, Alteration or Extension Per Pane1
I $ 3s.oo li
200 amps or less $ 40.00
0ver 401 to 600 amps _ $ 80.00
0ver 600 amps or 1000 volts see rrBrr above
Owners
Address
Ci ty
Dob
>lt ? N, \qL
(2 LD Phone 1"ll-tt''|3
OVNER INSTALLATION
The installation is being made on
property I ovn which is not intendedfor sale, Iease or rent.
Ovners Signature:
DATE:
RECEIPT #:
Circuit or vith Service
or Feeder Permit L- S 2.00 t/
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $
Sign/0ut1ine Lighting- S
Limi ted Energy/Res
-
$Limited Energy/Comm $
STJBTOTAL OP ABOVB
5Z State Surcharge
TOTAL
\Q ',*--
00
00
00
00
40
40
20
36
/.25
RECEIVED BY:
*D-€5
7a ?-
t
C. Temporary Services or Feeders
Installation, Alteration or Relocation
C'TY OF
DEVELOPMENT SENVICES
PUBLIC WOBKS
M ETROPOL'TAN WASTEWAT E R M AN AG E M E NT
hy,,. I j, .:
l;l'liif'it )l ll t I ' . )/i ') l
(!;(): t ),'.'ti .ii':,.'i
Hay 27, L992
Ron Kephart
2656 North 33rd Street
Springfield, Oregon 97478
Dear Ron:
Your request for an extension of your permits to construct an addition a1.2467
North 34th Street, City Job Number gL747O, has been revieved and approved'
This extension may only be granted one time and vill expire 180 days from the
date of this letter (November 27, 1992)'
If you have any questions, or if I may be of any assistance, please feel free to
phone me at 7?-6-3790.
Sincgrely,
Lisa Hopper
Building Services Representative
cc:Dave Puent, Building 0fficial
Ih
Tfrffi3I,,.,,o,
5- lr- qJ-
BB# 5721 3
2656 N. 33'd Street
Springfield, OR 97477
746-2129
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