HomeMy WebLinkAboutPermit Demolition 1993-12-07RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
SP]lI
JOB NUMBER e./822
225 Fifth Street
Spri ngfield, Oregon 97 477
a
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT:
7 TAX LOT:n,/%o
BLOCK:SUBDIVISION
zlP..STATE:e/4 .CITY:
ADDRESS:
OWNER:
NEW
-
FIEMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
El Er'\TOl/^A l .
ADDR EXPIRES PHONECONTRACTOR'S NAME
MECHANICAL:
PLUMBING
GENERA
CONST.
CONTRACTOR #
RANGE:
g OF BDFIMS:
- OFFICE USE -
LAND USE:
WATER HEATER:
FLOOD PLAIN
* OF UNITS:
OUAD AREA:
* OF BLDGS:
SECONDARY HEAT
SQUARE FOOTAGE:
OCCY GROUP:
* OF STORIEST
ZONING CODE:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. Thls ls 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
f ru1 Temporary Electricw 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.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Final Mechanical - When all
mechanical work is complete.
Footing - After trenches are
excavated.Flreplace - Prlor to faclng
materials and framing lnsp.
Final Buildlng - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.Framing - Prior to cover.
Foundation - After forms are
erected but prlor to concrete
placement.
B Other
Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to filling trench.Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.Wood Stove - After lnstallation.
Post and Beam - Prior to floor
insulation or decking.lnsert - After flreplace approval
and lnstallation 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.
Plumblng Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prlor to filling
trench.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
Slreet 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.
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PHoNE: ?#*n 7=
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Electrical Service - Must be
approved to obtain permanent
electrical power.
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E
Setbacks
PL.HSE GAB ACC
N
S
E
rS THE PROPOSED WORK lN THE
HISTORICAL DISTRICT, OR ON
THE HISTOFICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
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'
Receipt Number:-
Plans Reviewed By Date
Plan Check Fee:
Date Paid
Received By:
VALUE
(A)
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
FEE
AD|E>
(c)
N0
FT.
FT.
-ltr-ls/fiT
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ITEM
Fixtu res
Residential Bath(s)
Sanltary Sewer
Water
Storm Sewer
Mobile Home
Wood Stove/ lnsert/ Fireplace Unlt
Dryer Vent
(D)
N0Vent Fan
Mechanical Permit
lssu ance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rn ace
Exhaust Hood By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
of the property, and the approved set of plans will remain
sig
Date
on the site at all t es during construction.
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
/g--
-2e
/g-?
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
/2^2'?7
OREGO'UCITY OF
SPRINGFIELD
The following prolect as submitted has the lollowing
zoning, and does not require specilic iailc u$oBLEglr,rcAL pBRI{rr AppLrcATroN225 TITTE STREEf,approval.
477SPRINGFIEII)OREGON 97
INSPBCTION REQUBST: 726-3
d.-1,OPEICE: '726-3759
1. LOCATION OF
Electrical Contractor
Address
ci Phone
Supervisor License Nurnber
Expiration Date
Cons tr Contr. Number
Exp iration Date
Slgnature of Supervising Electrician
Ovners Name,TV { F: t
Address
Ovners Signature:
DATE:
city Job Nvnber ?7/1ft=-
3.COHPI.ETB FEB SCEEDT'I,B BELOS
A Nev Residential-Single or
HuIti-Family Per dvelling unit.
Service Ineluded:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular Dvelling
Servlce or Feeder
$ 8s.00
$ 1s.00
s 40.00
B Services or Feeders
Insta1lation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amPs
-
601 amps to 1000 amPs-
Over 1000 amps/voIts
Reconnect Oniy
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
c
_a
Temporary Services or Peeders
Installation, Alteration or Relocation
Sum
permits are non-transferable and expire
if vork is not started vithin 180 days
of i""u"nce or lf vork is suspended for
180 days.
2. COIURACTOR INSTALI,ATION ONLY
200 amps or less E
201 amps to 400 amPs
-
Over 401 to 600 amps
0ver 600 amps or 1000GTls
$
$
$
se
40
55
80
rg
00
00
00,B" a56Til
a
ciq ?FP P6on",^a1-77V28
OSNER INSTALI.ATION
The installatlon is being made on
property I or.rn vhich is not intended
for sale, lease or rent.
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit
-
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
$ 40.00
sigi,zoutrine Lighting- $ 40.00
q?.-
D
E.
SUBTOTAL OP ABOVB
5Z State Surcharge
TOTAL
\BCBIVED
5 _=_____
<r?.2. ----__7-
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