HomeMy WebLinkAboutPermit Building 1995-05-11RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office; 726.3750
LOCATION OF PHOPOSED WOBK
ASSESSOBS MAP;
LOT
SERIN GF !ELD
Ito
JoB NUMBEa ?SoV<
225 Flf th Streer
Sprlngfletd, aregon g7 477
f\-
,(.
BLOCK:
c
IAX LOT:
I
oQ.STATE:ZIP:
')ooa
\FrEr-bEPfi IN G\
c\PHON E )+r\ -r- l\Qar- Hu
CITY;
o\ADDRESS:
OWNEB:
DESCRIBE WOFIK:ft.e-Sr\E ts ( cq"ce-<--r- c,l<w
NEW>1- REMODEL ADDITION DEMOLISH OTHER
EXPI RES PHON E
I
I_3b'.)4
sQ.t UR LO N)
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\)
CONTRACTOR'S NAME ADDRESS
I r-, h r.l ,1-
Fhu uG-
\iNtr.
G ENEBAL:
EuPLUMBING:
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR ,r
s0-I ltl
v
- OFFICE USE -
LAND USE:
I OF UNITS:
RANGE:
r OF BDRMS:
OCCY GROUP:
WATER HEATER;
r OF STOBIES:
CONSTR, TYPE:
HEAT SOURCE:
FLOOD PLAIN:
ZONING CODE
SECONDARY HEAT:
SOUABE FOOTAGE:
QUAD AHEA:
r OF BLDGS:
To request an lnspectlon, you must call 726.3769. Thmade the same worklng day, lnspections requested
ls ls a 24 hour recordlng, All lnspections requestafter 7;00 a.m, wlll be made the followlng work
E '"-ootary Electrtc
REOUIRED INSPECTIONS
ffi Rough Mechanlcal - prtor to
-
cover.
[Jl nouOt, Etecrrtcat - prtor ro
-
covor.
Slto lnspectlon - To tre madc
af ter excavatlon, but prlor tosettlng forms.
U-nderslab plumblng / Electrlcal /Mechanlcal - prlor to cover.
Footlng - After trenches areexcavated,
Masonry - Steel locatlon, bondbeams, grouilng,
Foundallon - After forms areer€cted but prlor to concreteplacement.
Underground plumbln g - Prlorto fllllng trench
Post and Beam - prlor to floorlnsulatlon or decklng.
Floor lnsulatlon - prlor to
decklng.
Sanltary Sewer - Prlor to f llilng
trench,
Storm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to filllng
trench,'
Rough Plumblng - Prlor to
cover.
w Electrlcal Servlce - Must beapproved to obtaln permanent
olectrlcal power.
fl FlreRlace - prtor to factngH materlals and framlng lnspi
fA Framtng - prtor to cover.
m
ffi flnal plumbing _ When allif" plumblng worl( ls complete.
ffl rinat Etectrtcat -- When alVU electrlcal work ls complete,
ffi flnal Mechanlcal _ When all"--r, mechanical work ls complete.
ffi ftnat Building - When alj':lt requlred lnspecilons have beenapproved and building iscompleted.
ed before 7:OO a,m
day,
Flnal - After atl requiredlnspecllons are approved andporchos, sklrtlng, decks, andventlng have been lnstalted.
wlll be
E
a
g
w
a
m
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng. I I wood slovo - After lnstallatlon
MOBILE HOME INSPE TIONS
lnsert - After flreplaco approvql
anc, lnstallatlon of unlt.
[-l Btocktng and Ser.Up - When all
-
blocklng ls compleie.
Wall/Celllng lnsulatlon - prlor tocover.
[! Drywat] - prtor ro raptng
Curbcut & Approach - Afterforms are erected but prior toplacomont ol concrete.
Sldewalk & Drlvewav - Afterexcavatlon ls completo, formsand sub.base materlal ln place.
Plumbing Connectlons - Whenhome has been connected towater and sewer.
Electrical Connection - Whenblocking, set.up, and plumbinglnspectlons have been approvedand the home ls connected tothe servlce panel,
Fence - When completed
Street Tress - When all requlred
trses are planted.
I
c
)
I
tl
l--l otner
Lot faces
Lot sq. f tg,
Lot coverage
Topography
Total helgh
*9o
"&&M
Lot Tyfr
-
lnterlor
V corner
-
Panhandle
-
Cul-de.sac
IS THE PROPOSED WOBK TN THE .
HtsToRtcAL D|STR|CT, OR ON
THE HISTOBICAL REGISTER?
-
lf yes, thls appllcatlon must be slgnedand approved by the Hlstorlcal
Coordinator prlor to permlt issuance,
P.L, ,HSE GAR ACC
N 4,5
{?"-56
E /2t 7/g
/At '-* fuZz_/e/o_ Dzp
VALUE
4aZYa/o?7
/-7r(fr.p
e
(A)?u?. ?4
BUILDIN
ITEM
Main
G arage
Carport
i
PERMIT
SO. FT,X $/SO. FT.
52.=o
Total Value
Euilding Permit Fee
State Surcharge
Total Fee ewed
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls pefmlt ls granted on the express condlilon that the said
constructlon shall, ln all respects, conform to the Ordlnanceadopted by the City of Sprlngfleld, includlng the
Development Code, regulatlng the construcilon and use ofbulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provislons of sald ordlnances.
Date
a-/(-Z{-
20? =a
Becel
Plan Check Fee:
Date Pald:
Becel pt Number
SYSTEMS DEVELOPMENT CHAR
*(B)
GE (SDC) ,
\+613'#
Systems Development Charge ls due on all undeveloped
propertles wlthln tlro City llmlts which are being lmproved.
Besldentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
?/-e--78-
--2-2y__"a,g(c)
?/za
fr
N0
FT,
FT,
Plumblng Permlt
Stato Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fix t u res
. FT.
ITIONAL COMMENTSA
()
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MECHANICAL PERMIT
-r*
.t-itt3>/),/r///y +B
(D)
N0
?6.?a
/.P
-/ aOt!>-
Mechanlcal Permlt
lssuance
State Surcharge
Total Permlt
Fu rn ace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have caref ully examlnedthe completed appllcatlon and do hereby cerilly that alllnformatlon hereon is true anct correct, and I f urther certlfythat any and ail work performed shalr be done in accordancewlth the Ordlnances of the Clty of Sprlngfield, and the Lawsof the State of Oregon pertalnlng to tho work descrlbed
heroln, and that NO OCCUPANCy wlll be made of anystructure wlthout perrnission of the Bullding Safety Dlvislon.I further certl,y that only contractors and employees who
are ln compllance wlth ORS 701,055 wlll be used on thlsproJect.
I further agree to ensure that all requlred lnspecilons arerequested at the proper tlme, that oach address ls
from the street, that the permlt card ls located atof the property, and the approved set of plans wl
s
readable
the front
ll remalnon the at all tlmes urlng construcUon
Slgnature
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sid ewalk
Curbcut _-.- ft
Demolitlon
State Surcharge
Total Mlscellaneous permits (E)
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVEDTOrAL AMoUNT DUE (excludtng etectricat) AB^ /g(A, B, C, D, and'E Combtned)RECEIVED BY
APPFIOVED:
II
Date
' no.a_2o25_b.
CITY OT SPRTNGFTEIJD SYSTEMS DEVEI'OPMENT CHARGE
WORKSHEET
(cot'IMERcIAL & RESIDENTIAL)
NAME OR COMPANY:t-ln P?tTA{?oz tI UMAN tT
*.4o8 =tr l1o z-z r'4t 6\QooLOCATION:21
DEVELOPMENT TYPE:
BUILDING SIZE:SIZ
1. STORM DRAINAGE
IMPERVI0US SQ. FT.x $o.zoe PER SQ. FT.
2. SAN ITARY SEl,IER-C ITY
NO. OF PFU'S
(See Reverse)
N.A X $43.26 PER PFU
3.TRANSPO RTAT ION
NO OF UNITS X TRIP RATE X COST PER TRIP
N.N. X X$436.1e
X x $436. 19
X x $436.19
4. SANITARY SEWER-MWMC
NO. OF PFU'S N,A,$17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
Mt^lMC CREDIT IF APPLiCABLE (SEE REVERSE)
TOTAL-MWMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
5. ADMiNISTRATIVE FEES
BASE CHARGE (SUBT0TAL ABoVE) X .05
b
a. Ft
$
$
$6
$ lha -?g
Kip Burd ck
-..--
SDC Coordinator
Date +fbfq+
SDC s \+13
1?Z :tql .LD 2,-
INSPECTION REQUEST: 7
OFFICE: 726-3759
225 TIFTS STREET
SPRINGFTELD, OREGON 974D1:t
7 9
Signatu l.J
1.
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 TNSTATLATION ONLY
Address 9.0, W $lU
ci pnonew""rtrl1
Supervisor License Number rl+Lt
Expiration Date D-q5
Constr Contr. Number b-'187U
Exp i0 -1€iration Date
Signat Su Electrician
0vners
Addr
Ci ty Phone
OVNER
The installation is being made on
property f ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
assubmitecl has the tollowing
requlre sp$cr,ic Ie,i,_,j irse
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home. or
Modular Dvelling
Service or Feeder
ELECTRICAT PERHIT APPLICATION
Ci ty Job Number q
SCEEDT'I^E BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
The.following proiect
zonjng, and does-not
approval.
SPRr*-iFlELf,
less
600 amps
1000 amps
?ft,
s 8s.00
I $ 1s.oo
s 40.00
s s0.00
s 60.00
s100.00
s130.00
$300.00s 40.00
L
Sum
%
IS
U.
rl,-Y
--qLi<
'-k a)
A---\)
-IbU
^kY:Ia
3
A
Electrical Contracto
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or
201 amps
401 amps
60L arups
Over 1000 amps/vo1ts
Reconnect OnIy
C
D. Branch Circuits
to
to
to
Temporary Services or Feeders
Installa.tion, Alteration or Relocation
200 amps''or less $
201 amps to 400 amps
-
S
Over 401 to 600 amps S
Over 600 amps or 1000-7oTTs s
40.00
55.00
B0:00
ee nB( a6ove
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Addi tional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not' included)
-Each installation
Pump or irrigation S
Sign/0utIine Lighting- S
Limi ted Energy/Res
-
$
Limi ted Energy/Comm S
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
40.00
40.00
20.00
36.00
5
RPCF,TVET)
U)
3bb
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