HomeMy WebLinkAboutPermit Building 1999-5-14
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
ASSESSORS MAP'
LOT:
OWNER' ~Jt.wk4llM ~~~~
ADDRESS: . ~S [.,;> 3. (. -
~~...
~(. vu.,,~
CITY'
DESCRIBE WORK:
NEW
REMODEL
~ ZIP: ~~r-
\'1.~t."~ -~..,\- oJ UcA Ma.C"~
OTHER
.
BLOCK'
tU~~ ~
STAT'"
1afIl.o.tL
ADDITION
DEMOLISH
.
990 ).63
JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
TAX LOT: 0/ ~J1
SUBDIVISION:
PHONE:
G: e\'\- 05.2.j
CONST.
CONTRACTOR .
CONTRACTOR'S NAME \ ,(lDDRESS
GENERA" "C:s~ (D.....~~,
PLUMBINC" b.o~ ~c.l.
MECHANICAl' c,lMHt.4("~ Art:..
C~\.u tJ~ ~(\.
LAND USE:
AJ6~l)!jj:JI1-Sl:0reaonl"wro...,,",~u') ZONING CODE:_
follow rules ado~ted by th 0 J. <-
Not~I1l~RCT."" . - e regon Uhlil)1 . OF BDRMS'
. . ,I, .<OTIl r. '''ose rUles are set forth
Ino~~~'h~10throl'gh()IlR9a2'OOl_ SECONOARY HEAT:
,: oo9d:-?ou may obtain Copies f h
WATER HEATER: C811il'4~m&eeft.. (lOt e rules by SQUARE FOOTAGE:
,..".................._ , ~~j. "'Ult:i: metelepnone
',' .. .-. 'C,_ -'''l,jU'' Ull"Iy'I~OllTlcatin
To request an Inspectlqn, you must call 726-3769. "(hls)!!!I'!211'~J_!f.??-:YJaa'IAllTn.r'~ctlons requestad before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 8.m. will be made the followlr9 work day.
ELECTRICAl'
QUAD AREA-
. OF BLDGS'
.'
OCCY GROUP:
. OF STORIES:
-
.
~ Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel locatlon, bond
beams, grouting.
\
o Foundation - After forms are
erected but priori to concrete
placement. '
D Underground Plurblng - Prior
to filling trench.
O Underlloor Pluml!lng/Mechanlcal
- Prior to Insur,!IOn or decking.
,
o Post and Beam - Prior to floor
Insulation or. decking.
i
O Floor Insulation - Prior to
deckl ng. . .
,
D Sanitary Sewer - Prior to filling'
trench. .
o Storm Sewor - ~rlor to filling
trench.
O Water Line - Prior to filling
trench.
o Rough Plumblng:- Prior to
cover. \
"
....
- OFFICE USE -
REQUIRED INSPECTIONS
[Kl Rough Mechanical - Prior to
cover.
[k] Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtai n permanent
electrleal power.
o Fireplace - Prior to facing
materials and framing Insp.
IEJ Framing - Prior to cover.
~ Wall/Celllng Insulation - Prior to
cover.
[k] Drywall - Prior to taping.
o Wood Stovo - After Installation.
O Insert - After fireplace approvel
and Installation of unit.
o Curbcut & Approach - Alter
, forms are erected but prior to
placement of concrete.
o Sidewalk & Drlvewav - Alter
. excavatlon Is complete. forms
and'sub.base material In place.
o Fence - When completed.
D_St~eet Trees - When all required
trees are planted.
EXPIRES ..... PHONE
.. 6~~\~1.
.,
FLOOD PLAIN:
IKJ Final Plumbing - When all
plumbing wc;>rl< Is complet,e.
~ Final Electrical - When all
electrical work Is complete.
~ Final Mechanical - When all
mechanical work Is complete.
I.XJ Final Building - When all
required Inspectlons have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connectlons - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
I
Lot faces
,
L~t Ty.
Interior
Lot sq. ftg.
Lot coverage
Corner
Topography
Total height
Panhandle "
Cul-de-sac. \
. ~ . . \
BUILDING PERMIT."
"
't
ITEM
SQ, FT.
X $/SQ. FT. =
Main
I' - l
Garage
Carport
I:
Fit.,.
~4,';""',
.-
"
Total Value
Building Permit Fee
State Surcharge
. ~ . ,
Totai Fee
(B)
PLUMBING PERMIT
ITEM
Fixtures
~
Residential Bath(s) N'
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
"
Total Charge
(C)
MECHANICAL PERMIT
- Furnaco
Exhaust Hood
,.
~ Vent Fan
N'
2-
Wood Stove/lnsert/Flreplace Unlt~
Dryer Vent
Mechanical Perml t
Issuance
State Surcharge
Total Permll
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
,I
TOTAL AMOUNT OUE (excluding electrical)
(A, B, C. 0, and E Combined)
. . . ,: ., ;', ,~~
J- . ~.., ,,,,,,,\,'.;~~.;';'~li'.';l
~..~\...". . :.:,rJtl:.,~
"
lip.L,
IN
Is
I,w
'Ii~ '
VALUE
"
'. .
.".~.
"
,
I~
- ,
FE6
~.J
c?/J c;.>
'f.oo, 2,~
f(t t(l>
l60
fr. s-o
c. _ ()f)
It.. <,f)
1(1. {),)
/. ~ ~
2-Z<(-?-
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,?:Q. ,.;
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2, ").
.IS THE PROPOSED WORK IN THE.
'''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
Setbacks '
HSE GAR Acc'l
I
I
I
'1' ,
BUILDING "ALOE, PLAN CHECK
AND BUILDING PERMIT
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED'
Thls<pe~mlt is granted on the express condl,tlon that the said
constructlon'shall; In "" respect's,-conform to the Ordinance
adopted by the City -01 Sprlnglleld: Including the
Dovelopment Code,; regulating the construction and use of
oulldings, and may be suspende~d or ..revo~ed at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
,.,
'," . 1
..., ,.
(~OdO
f fO.57J
5'0 &'5
(to.urA)
SYSTEMS DEVELOPMENT CHARGE (SDC)
Date Paid:
Receipt Number'
Received By:
.. .. .... '. '\
~ L'\ ' - ~
Plans Reviewed By
"
. I
Date
.
Systems Development Chinge Is due on all undeveloped
<,' ." - ',,' '..
properties within tho City limits W.hich are beIng Improved.
, ,~,' ".,
ADDITIONAL COMMENTS
-Note:
-Building Inspector may require
-1dditional pl<l:1s inf0'"m2,t!0n,
_and/or fees for the completion of
this project.
By signature, I state and agree, that I have carofully examined
the completed application and del hereby certify that all
Information hereon Is true and corr~ct. and I further certify
that any and all work performed shafr be done in accordance
with the Ordinances 01 the City of Sprlnglleld. and the Laws
of the State of Oregon perlalnlngtto tho work described
herein, and that NO OCCUPANCY will be made of any
structure wIthout permission of lhe Building Safety DIvision.
I further certify that only contractOrs and employees who
are In cO"1pllance with ORS 701.055 will be used on this
project.
I further agreo (0 ensure thai all rdQulred Inspections are
requested at the proper time, that ohCh address Is readable
from the street. that the permit card Is located at the front
,
of the property. and the approved t of plans will remain
on the site a d ring tructlon.
Signature
Date_
VALIDATION:
() S 'fjJ 2.-'7
DATE PAID 5/1'1/'1"
AMOUNT RECEIVED 'i1 ~ /1 2-1 s. I 'f
RECEIVED BY _M 0,.//
RECEIPT NUMBER
Thelollowing project as submitted has the following
zoning, and does not require specific land use
approval.
225 FIFTH STREET
SPRINGFIELD, OREGON 97477Zonlng
INSPECTION REQUEST:Da~76-,76Q
OFFICE: 726-3759
Authorized Signature
1. LOCATION O~J!NSTALLATION
77'5 tvOll-rld.df,# hIE
LEGAL DESCRIPTION
/7/11, U.l2 olI/?
JJ JO~ DESCRIPTION I
fTV{ (ff ('l C (II. C",. 5
LDA-
'5-14-"1'\
KW ~
. A.
ELECTRICAL PERMIT APPLICATION
Ci ty Job Number 1f'1l Sf. ?
bOMVLETE FEE SCHEDULE BELOV
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
It ems
1000 sq,ft. or less
Each additional 500
sq. ft or portion
Permits are non-transferable and expire - ~~~f
if vork is no t started 'j,l\hj."lIfl@'WCda!llilnlaw reQu'jfi\\1 ~ftyuf' d Home or
of issuance or if work Ib~ ~~t\P"l!,~tliOzbytheOre~g~~l'Pwelling
180 days. to.t~ tion Center. Those rules A~W6/}l.or Feeder
Notllca 5.?-U01 0010thrOUghO by
2. CONTRACTOR INSTALiJA'TtatrY~SNaY 'obtain copBl$ otst1NX~ or Feeders
0090"OU c _.~r.L\'.Iote:theNl~,q~lf1:Mion, Alterations
Elec trical Con trac torC e~w.\I~~~t.5f:JgOft.Utility ~lfJtii!~~\\'ea t ion:
numo'" . . 1 800.332-2344).
Address p.o. (3cx d.?~<!>( ~Cenlef\S - 200 amps or less
201'amps to 400 amps
401 amps to. 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
Ci ty F'i)c.,^~, d'111{OJ-Phone SSt.;.('3"?/
Supervisor License Number 3~ ;)'1-$
Expiration Date ,1L?,I~
I
Constr Contr. Number ~S7/0
Expiration Date ~ ~~~
Signature of Supervising Electrician
//1 2.1~ A (fi-oW1 ~
Owners Name (; .e.A~ /' It-:,. <: 7.:]
Address 775" ;1!M7"I/tL4.rP
Ci ty Sf) eJ Phone /
,.
OVNER INSTALLATION
The installation is being made on
property lawn which is not intended
for sale. lease or rent.
Owners Signature:
,
, ,
DATE~---~7i\(7~?---------------t!-------
RECEtPTlI': ., Q "?~o7-7/1 _ i
RECEIVED -. BY: .(J/ (..-) t?k.Y
Cost
Sum
$ 85.00
$ 15.00
$ 40,00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps' 'aT less
201 amps to 400 amps -----
Over 401 to 600 amps -----
Over 600 amps or 1000 volts
D.
Branch Circuits
$ 40.00
$ 55.00
$ 80.00
see liB" above
.'
Nev, Alteration or Extension Per Panel
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited EnergylRes
Limited EnergylComm
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit II
E.
5.
SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
I
S'\
$ 35.00
$
22-
2.00
not included)
$ 40.00
$ 40.00 .
$ 20.00
$ 36.00
5'70
7_ 8'.s
I. ., /
1/1.,(,
.
\-gC{O_5(Q3 . . . ____u~D-16
~D3),(J/~ -{)1313
Sf 1'1 . I L'3 ()
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE:
4/2( (qe,
. r
TO : Bu il ding Depa rtmen t
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Bui 1 di ng
Address or location of building ~ 7t; ~
Name of O\'mer c:.YI1.~ \J.....\~';"\
Type of building <'.v;t\e, Q",,:I,,\ Xf1J"'U:\.~ /...___
~ (Dwelling, Store, Narehouse,
Estimated value of building $ ['(.1.( .1'10
roo 0 (X)
,
etc.)
Estimated loss
to building $
4/2-( / q,/
Date of fire
LOC~{:~ damage in'build'ing '"R..~\'ao"" - G~\;>t.~ - A41'c.,f: wJ(J....
(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire ~c)2- - CQ.A~"'1 . (dJJ.s.
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information ~.,,"~d. ~~ +-n-A1f,'r.
Electrical Hazard ~~ ...-ft,.~~ ~~M,~
cc : t.j. Z3 {f 1
/)J
'H d--
(Wirinq, Outlets, etc.)
Si~~~ -
~~B-S