HomeMy WebLinkAboutPermit Building 1991-07-31SPRINGFIELI)
IDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726-3759
JOB NUMBER ?1ffi
225 Fifth Street
Spri ngfield, Oregon 97 477
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP:TAX LOT:
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LOT:BLOCK:SUBDIVISION
To request an inspection, you must call 726-3769. This is a24hour recording. AII 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
I femporary Electric Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
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Site lnspection - To be made
after excavation, but prior to
setting forms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
Underlloor Plumbing / Mechanical
- Prior to insulation or decking.
Post and Beam - Prior to floor
insulation or decking.
Floor lnsulation - Prior to
decking.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
tren c h.
Rough Plumbing - Prior to
cover.
Rough Electrical - Prior to
cover.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Fireplace - Prior to facing
materials and framing lnsp.
[X I Framing - Prior to cover.
Wall/Ceiling lnsulation - Prior to
cover.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.
lXl Drvwall - Prior to tapins.
Final Building - When all
required inspections have been
approved and building is
completed.
Other
MOBILE HOME !NSPECTIONS
Blocking and Set.Up - When alt
blocking is complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspections are approved and
porches, skirting, decks, and
ventirIgllave been installed.
M
Wood Slove - After installatlon
lnsert - After fireplace approval
and installation of unit.
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Fence - When completed.
Street Trees - When all required
trees are planted.
NEW
-
REMODEL ADDITION DEMOLISH OTHER
PHON E:
7> z>>ZIP:STATE:
1,
CITY:
DESCRIBE WORK:
ADDRESS
OWNER:
PHONEEXPIRESADDRESSCONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
RANGE:
* OF BDRMS:
_ OFF]CE USE _
LAND USE:
ZONING CODE:
FLOOD PLAIN
WATER HEATER:
* OF UNITS:
SECONDARY HEAT:
SQUARE FOOTAGE:
QUAD AREA:
C OF BLDGS:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
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Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
PL.HSE GAR ACC
N
S
E
J 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
VALUE
u.'y>
,?5
zc,
(A)/.(, 75
fr'r' 7oo
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condrtion that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, inctuding 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.
Recei pt Number:_
Plans Reviewed By Date
Plan Check Fee
Date Paid:
Received By
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
FEE
(c)
FT.
FT,
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
(D)
N0Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By signature, I state and agree, that I have caref ully 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 70'1.055 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
%z.7 ,z? z
Signature
Date
on the site at during construction.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)/5.''f
2*7.:2I
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DATE PAID
AMOUNT BECEIVED
RECEIVED BY
VALI DATION:
RECEIPT NUMBER
N0
TY OF
225 FIFTE STRBEf,
sPRtNGFrEl,D, oREGON 97477
INSPBGTION RBQIEST. 726-3769
0FFICE: 726-3759
1. LOCATION OT INSTALI,ATION
,af?
I,EGAL DESCRTPTION
JOB DESCRIPTION
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 INSTALI,ATION ONLY
Electrical Contractor
Address
cit Phone
Supervisor License Ndmber
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervlsing Blectrician
Owners Name
BTECTRICAL PERHTT APPLICATION
city Job Nunber ?/Oi7ff
COUPLSTB FEB SCEEDUI.E BELOS
S}"IINGFIELO
Nev Residential-Single or
Hulti-Family per dvelling unit.
Serviee Included:Itens Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular Dvelling
Service or Feeder
s 8s.00
s 1s.00
s 40.00
3
A
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less /
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect Only
Sum
47.""
s 35.00 7€->' =
$ 2_.oo 7-*
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Insta1lation, Alteration or Relocation
200 amps or less S 40.00
201 amps to 400 amps _ $ 55.00
Over 401 to 600 amps _ $ 80.00
0ver 600 amps or 1000 volts see rrBrr above
Branch Circuits
Nev, Alteration or Extension Per Panel
D
'/^city ar?az-?. Yhone 3?7/ffi
OSNER INSTALI,ATION
The instaLlation is being made on
property I ovn which is not intended
for sale, lease or rent.
E. Miscellaneous (Service/feeder not included)
One Circuit I
Each Additional
Circuit or vith Service
or Feeder Permi I 2---
STIBTOTAL OT ABOVE
5f State Surcharge
TOTAL
-Each installation
Ptrmp or irrigation $
Sign/OutIine Lighting_ $
Limited Energy/Res S
40.00
40.00
20.00
36.00v
5
DATE:
RECET\IBD BY:
2a
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Permit No:?,r'c87"7
Address I 6 tlL ir) Pz
lssued Date
OR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 28;
I own, reside in, or will reside in the completed structure
2. A.My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
1
B I will be my own general contractor.
!f I hire subcontractors. I will hire only subcontractors reoistered with the
Construction Contractors Board. lf I chanoe mv mind and Eo hire a oeneralcontractor, I will contract with a contrattor'who is reoistered with theConstructibn Contractors Board and I will immediately-notify the office
issuing this building permit of the name of the contraitor.
I hereby certify that the above information is correct and that I have read and understand
the lnformation Notice to P roperty Owners about Construction Responsibilities on the
reverse side form.
-:
t rm pp cant
CONSTRUCTION CONTRACTORS BOARD
0244J 1t90
te
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
@s
,4 'i&,j*<-/f
L
TO: CITY OT SPRINGF.IELD
225 NORTH sTH ST
SPRINGFIELD OREGON 97477
TO; LISA ,/BUILDING PERM]TS
THIS LETTER IS A REOUEST TO EXTEND OUR PERMIT ON ELECT. AND ROUGH-
IN " I,,|ITHIN THE PAST 5 MONTHS CHRIS CHRISEPHENSON ELECT - INSPECTOR
HAS INSPECTED THE PROPERTY AT 409 SO 42PL SPRFLD,#
SENSE THAT TIME, CHRIS HAs LEFT HIS EMPLOYMENT I^JITH THE CITY AND
TOM MARX HAS CALLED AND SAID THAT THE FINAL I,JAS NEVER DONE, T'VE
TALK TO THE ENGINEERING DEPT. OT SUB AND MR " ALONSO SAYS THAT ON
O8-O9*91 AT 4:45P.M. DORLORIS HAS CALLED IN AND REOUESTED TO HAVE
THE METER INSTALLED AS PER ELECT.,/INSPECTOR CHRIS CHRISTEPHENSON
IT FOR ANY REASON THAT THIS I5 NOT RESOLVED BETORE I RETURN ON
04*17*92. PLEASE EXTEND THE PERHIT FOR 18O DAYS AND THEN t^JE I,JILL
ALLOI^I THE CITY TO RE*INSPECT THE PROPERTY.
I I/JOULD EXPECT THAT THIS SHOULD BE THE END OF THIS PROBLEM, MR.
CHRIS HAD INSPECTED THE HOUSE FOUR TIMES AND NANTED ALL I^JIRES
INSTALLED AND IN I^IORKING ORDER BEFORE HE HOULD ALLOI,J THE METER TO
BE INSTALLED , THIS ALSO INCL UDED THE I^,IRES IN THE BATHROOM ALSO .
THANK YOU,
RI EN 03*03 .92
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