HomeMy WebLinkAboutPermit Building 1995-07-25N6*fpv-g31*'
4to 3
SPFl tr.rGr=telo
JOB NUMBER
BLOCK:
TAX LOT:
LOCATION oF pRopoSED WoFK: _ __lsD
ASSESSOBS MAP 1-oz-
RESID ENTIAL
PERMIT APPLICATION
lnspections; 126.3t69
Office: 726.3759 225 Flf th Street
Springfleld, Oregon 97477
LOT:
-
SUBDIVISION:
-4-
PH ON E:-4so t
ztP:
4aut)
STATE:p.
ADDRESS o<e3
Q74 t "7
/Ao?z Sttt -{4.
OWNER:
CITY:
DEMOLISH OTHER
DESCR'BE WORI(
NEW ___- nEMoDEl.-_\_ ADDrrroN
coco N
N TRACTOR ,EXPIRES PHONE
ST.
ge4
,SB
CONTBACTOR'S NAME ADDRESS
CfS
MECHANICAL:
ELECTRICAL
G EN EBA L:
PLUMBING
- OFFICE USE -
LAND USE:
/ OF UNITS: _
HEAT SOUBCET .--_-
RANGE:
, OF BDRMS
QUAD AREA:
, OF BLDGS
SECONDABY HEAT:
SQUARE FOOTAGE:
WAIEB t-tEATER:_-.--
OCCY GBOUP
, OF STORIES
FLOOD PLAIN:
ZONING CODE;--
To request an lnspection, you must call 726.3made the Sanle workjng clay, lnspections rcq
Tornporary Electric
769. Thls ls a 24 hour
uested af ter 7:00 a.rn.
REQUIRED tNS
Rough Electrlcal - prior tocover,
ry
ry
ry
Flreplace r prlor to faclngmaterlals and framlng Inspi
Framlng - prlor to cover.
[--l Wood Stovo - After lnstaltailo.n
recordlng. All lnspectlons requested before 7:OO a.m, wlll bo made tho followlng wort( day.
PECTIONS
will be
Slto lnspcction - -l-o be macjoafter excavation, but prior tosetting forrrrs.
U-nderslab plumbing/ Electrical /Mechanlcal - prior to cover.
Footlng - Af ter trenches areoxcavated.
Masonry - Steel locatlon, boncjbeams, grouting.
Foundallon - After forms areerecled but prior to concreteplacemen t,
Underground plunrbing _ prior
to flllinq trench.
E 3 ff i'l',: lJ,?:f,j,',?,,"' y,";X;,?,';;l
m frl',',i,?i^u#lt;,l,iror ro ,oor
E 5g?i,];suratron - Prior to
ffi Sanitary Sewer - prior to fliltngF trench.
[-l Srorm Sewor - prior ro fiiltn9
-
trench.
Water Lino - prlor to Iillinglrench.
m
ffi nough Mochanlcat - prlor lo_--1 COVer.fVl rtnaf ptumbing - When att*f ptumbtng work ts comptete.
M Flnal Etectrlcat - When ail-7y etectrical work ls complete.
m
lt'] Elecrrtcat Servtco - Must bel: approyed to obtaln permanentr otectrlcal powor,
Flnal Mecharrlcal - When allmechanlcal worl< ls complete.
Flnal Buildlng - When allrequtred.lnspectlons have beenapproved and bulldlng iscomptetgd,
E O thor
Wall/Colllng lnsulatlon - prlor tocover.
Rough Plurnbing - prlor to
cover.
Eleclrical Connoction _ WhenD-rocl(tng, set.up, and plumbtnglnspoctlons have been approvedand the home ls connected tothe servlce panel,
Flnal - After all requiredlnspections are approved andporc.hes, sklrtlng, decks, andventlng havo been lnstalled.
Lns:lt - After ftreptace approvqlano lnstallatlon of unlt. .
Curbcut & Approaclr - Af terIorms ars erected bUt prior loplacemont of concretn.
Sldewalk & Drlveway - A,terexcavatlon l9 completo, formsand sub.base materlal in place,
Fence - Whon completed.
Slreet Troes - When all requlredtrees are planled.
MOBILE HOME INSPE TIONS
[-l eJocking and Set.Up _ When ail
-
blocktng ls compteie.
Plumbing Connections _ Whenhomo lras been connected towater and sewer.
-.5 -
i\n
A)
h a(i
t?
r
Drywall - prlor to taplng.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
-
Corner
-
Panhandle
-
Cul-de-sac
IS THE PBOPOSED WORI( IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
--
llyes, thls applicatlon must be slgned
and approvcd by the Historical
Coordlnator prior to pcflnit issuance.
TOTAL AMOUNT DUE (excludlng electrlcal)
(A, B, C, D, and E Comblned)
APPROVED
VALIDATION:
BECEIPT NUMBEF
DATE PAID
AMOUNT RECEIVED
---_
P.L,HSE GAR ACC
N
S
E
BUILDING PERMIT
ITEM SO. FT.
Main
Garage
Total Value
Bullding Permit Fee
state surcharse \93 + U.q6
Total Fee (A)
VALUE
\ 06.31
x $/so. FT.
t. Pf-
Carport
-\{,ssD-
1g.se
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt is grantcd on the cxprcss co|.rcliliori tlrat the said
construction shall, in all respects, conform to ttre Ordinance
adopted by thc City of Springfield, includlng the
Development Code, regulating the coDstruction and use of
bulldlngs, and may be suspended or revol(cd at any time
upon violation of arry provisions of said ordinances.
Plan Check Fee: .-----
rDat[:?.'\K
Plans Rbv}ewc<J 13y
r/aq,tqq
Datc Pald
Recel pt N urnt:cr:--.....
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)6
Systems Developmcnt Charge ls cJue on all undcveloped
properties within thr: City linrlts whiclr are bcing inlproved,
ITEM
Flxtu res
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
!t2-
FT.
FT. g5
.9"Fr. so
3.ls,{8.e
55.P
PLUMBING PERMIT
FEE
-Ao,-
Plumblng Permlt
State Surcharge
Total Charge
P..LB + t.3g
(c)
ADDITIONAL COMMENTS
,
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
Mechanlcal Permlt
lssu ance
State Surcharge .?B +,1E
Total Permlt (D)
rs- ga
& 5. [o'
I3-
../\)
LO
B-
\',s-9_
1 9lrVent Fan
MECHANICAL PERMIT
Furnaco
Exhaust Hood
N0 I
By slgnature, I statc and agree, that I have carctully examlned
the completed appticatlon and do hereby cerilly that all
lnformatlon hereorr ls true and correct, ancJ I lurther cerilfy
that any and all work performed shall bc done in accordance
wlth the Ordinanccs of thc Clty of Sprlngf ield, and the Laws
of the Stato of Oregon pertalnlng to thc work descrlbed
hereln, and that NO OCCUPANCy wiil tte maclo of any
struclure wlthout perrnission of the Bulldirrg Safety Dlvlslon.
I [urther certl,y that only contractors and employees who
are In compllance wtth ORS 701.05S wilt be used on thls
prolect,
I further agree to ensurc that all requlrecl lnspections are
requested at the proper tlme, that each address ls readable
from tho slreet, that the permlt card Is I
of the property, and the approved set of pla wiil remal n
ll tlm du
0
Date
d at the f ront
on the slte nstructlo
MISCELLANEOUS PERMITS
Moblle Home
Stale lssuance
State Surcharge
Sidewalk
-
ft
Curbcut ' f t
Demolltlon
Total Mlscellaneous Permlts (E)
ruu,ct-- (tr*L,6
€f,etf3ur*lirr€?,
6q.o3
4oo
-
Jz-
G{.ca
*s.1
_u5-4a$
RECEIVED BY
-
-
z.
-b
N0
\
C'TY OF OFEGO'V
The lollowing project as submifleiJ h;s: the
zoning, and does not roquire speci.fic lond
approval.
SPRt tELf,
f.)llow:ng
use
BLECTRTCAI PERHIT APPLICATION225 FTPTS STREET
SPRTNGFTELD, OREGON 97477
INSPEC;TION REQTJEST: 7 7
oFFICE: 726-3759
Authorized
1. LOCATION OF INSTALLATTON
rgo 3'1th r
IJGAL DESCRTPTION
JOB DESCRIPTION
Permits are non-transfer and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONIRAC:TOR INSTALI,ATION ONLY
EIec trical con t'".tot C{ S thnhffu, (,lU
Address
signarure- NM 3. coMptETE FEE SCEXD{II,E BELOV
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular Dvelling
Service or Feeder
s 8s.00
s 1s.00
s 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
2
Sum
5c.oo
Signa ture of Supervising Electrician
Ovners Name
Address
Ci Phone 05lo
OVNER INSTALTATION
The installation is being made on
property I ovn vhich is not intended
for sal-e, lease or rent.
Onners Signature:
DATE:
200 amps or less i
201 arnps to 400 amps _401 arnps to 600 amps _
60L amps to 1000 amps_
0ver 1000 amps/volts
Reconnect 0n1Y
200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amps
0ver 600 amps or 1000 voT[
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
Miscel-Ianeous ( Service/feeder
-Each installation
Pump or irrigation $
sign/Out1ine Lighting- S
Limi.ted Energy/Res $
Limited Energy/Comm S
s see uBu aEiE-
not included)
40.00
40. 00
20. 00
I'h. oo
3,-{d)q2
$ s0.00
s 60.00
$100.00
s130.00
s300.00s 40.00
cit Phone 4iil 1?tD
Supervisor cense Number I b 8b S
Expiration Date
Constr Contr. Number 038+
Temporary Services or Feeders
Installation, Alteration or Relocation
C
Expiration Date q - r-q
I
$ 40.00
s 5s.00
$ 80.00
I D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit I S 2.00 th.OO
E
l,
RECEIVED
5
qt 19
City Job tt*U", 2*/6O
la-t -05