HomeMy WebLinkAboutPermit Building 1990-10-15
00 RESIDE~AlALoo.
" APPLICATIONYffRMIT
225 North 5th Street
Spri ng f'i e ld J Oregon 97177
Building Division
7,~G-37 5'3
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SPRINGFIELD
rob Loo:lti::)71: b335" .,0A-/s: '1 # / z ""2-
16::c8301':: Map H /70 2- 3"3 00 Tc;:r Lot II
Yi.bdivision:
0/ 300
::unCI': WAa(b4-) WM V LJ ~k:-A
I 7~/- O~9:2-
4ddress: 5/Irr16 Phone:
City: c:::.,;::;A?/ d R ,?/e( () I'J#< Zip: ~?479./
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Date of AppZicaticn___
:on t rae tors
.:eneral
Receipt .'1
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Describe r\'orl~:
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Address. Lise. n Bidrs
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(.01 .ct-m SLf.)
tJ:;",fl{i&A.-')
) J.ulIlb:i.ng
~leclHln:i.ca.l
~J.t;:c t ci.!;u 1
511peL',..-:tt;;r.l.f; Elec t r:ie iLln
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, Value
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Signed:
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Date:
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It is the responsibiZity of the permit hoUder to Bee that all inspections are made at the proper time, that each ~dross is readab!e '
from the street, and that the permit cal'd is located at the front of the property.
'!Jui!di,'1g tr:vi::io~ approl:ed plan s1u;U remain on tha Building s.it$ at aU times.
[!.70C'<:DU!?E FOR [NSPECTION RE'QUEST,:CAll 726-3769 (recorder) state your City desi!Jrrated job nwr.bor, job address, type of ill3pea~ic/l
l'cque:Jced ar.d wherl you will be ready for inspcction, Contractors 01' OIJners name and plwne number. Requests received cefcl'e 7:00 cr:r
~'il1 be made the same dcy, requests mcde after 7:00 = Llill be made the nezt :.JOrking dny.
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&2aHZ:llcd TnSr1(YJt1:cntl
I sn.~' INSN.Y..":'j"ON: To be made after
--1 e;ccav.:zci,:m, !mC priOI' to set up of
fOI'TTIs. '
-J ~"'.~F.R~LA,B PLU~\IBING, ELECTR~C,1L &
,,!r.I.II..!.IlI..AL: To be made before any
--_. wo/'k is ~ov(J1'ed.
_.I
NJI!'l'TNG ~ FOUND,1TICN: To be made
aj't...,/, tl'i::>luhC8 (lI'e excavated and
i'm'",:; QJ'C cl'ectad, but pl'ior to
pOZil.'>tltj ccnCI'et.s.
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U!ID~!I(;!IOI/;;,D P::UM.'3 JNC, SErlE!?, W,1TF.,'1)
li,'!~U.!!!.l(;!~: 1'0 be ",a::1e priolo to Ii 1-
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1III/lE.'!."'f.OO!! I'J.IJ!,!!l[,VG I~ MECHANICAL:
1',/ .'hi mll<le pr'iol' to 'irwtaUation' of
{I ~,..".i mmlc t'ion 01' decking.
1'0:':'1' :1I1!) BF.M.r: To be made prior to
7~-;,Jt;;l/.~tiCII of flool' insl<lation 01'
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.'IO!'{;.'I ,"{,II,'!lif:'.'C. ErRCT.f1!CA:: ,~ MF.ClI-
..111' {.;..i-f-::'- ,'ia - :';01'1: 'i:J to be co~'el"ed
;;;~!.Tl'i;JJ{)se 'in8pect1:ons have been
mnde ,ulll apPl'ove.:!.
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tf!.; C:t)~': (f t::
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1'['1:01' to plccir.g facing
i.lIld befor'e fJ'(Uning inspec-
-J ,".'I..i.':I:';,;: ;'!l/:It be reqllOsted afteI'
;;;..j;-;~;,'~~/, Dr l'OI/[Ih plwr.bin'], eZectri-
"..zi ..; :::,:.:hllli~al. Ill! I'ooring
/u'w'i"..1 ,~ chi/fmcys, et~. nr.wt be
G(,ll!lf11.:!.':I, Nil IJ:Jl'k 'i:J to be COYI-
e.1<":!,"/ '''It,,' /. UII::: 1:nspcation has
. lh'l''i -:l.il' ,nl.! appt'ot.'cd.
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Your City Desigrnted Job Number Is:
D INSfJLATION/VAl'OFl BARRIER INSPECTION:
To be made after all insulation a~~
, required vapor carriers are in place
" "but l;"efore any lath, gypsum board or
wn covering is applied, and before
any insulation is concealed.
D
DRYWALL INSPECT!ON: Tc be made
aftel' an dl'ywaU is in pl.ace,
but prior to cny taping.
MASONRY: Steel location, bond
beams, gl'outi7lg 01' verticals in
accordance with U.B.C. Section
2415.
WOODSTOVF.: After installation is
ccmpZeted.
DEMOLITION OR gOVED BUILDIi/OS
~ Sanitary SB'.Jer ::apped :It property line
..-J . ", ',I ItI"~ 1",'tl'h"'t~"1f.h~\,.'f":" 1.,1; iki... I~'
:=J Septi~ tank p:imped and fi nad wi th g7'a:Jc l
I Final - mIen above items are ccmpleted
--1 and lJhen demolition, is complete or stn.,,-
ture moved and premises ::leaned up.
Mobile Hcmes
~'BlOCking and Set-up
/ , 1.' . and
:~p~umv.ng connect.ons -- SelJel' lJa~el'
"~lectrical Connection - Blocking, set-lip
, and plunwing connections nr~st ce approved
efore requestin!J elec~rical inspec~io~
=:J Ac::esGory Building
~ Final - After porches,' skirting,
~eta. are completed.
I
decks,
D
D
D
CURB .~ APPROACH AP.'WN,: After> forms
aI'e ere:Jted bllt pI'iol' to pouring
"on~re te.
~
-
-
D
SID.<:r/ALK .~ DRIt'Er/!.Y: For all con-
crete pavil1{J lJithin street right-
of-way, to be made after all exca-
vating complete & fo~ lJOrk & sub-
bane material in pl.a::e.
AU pl'o.fect conditions, :mc.': au tllB ~',nlltallation of stl'eet tl'eca, "co,~pleti.~m of tne
l'eql/il'ed 1mld::r:r.p1:r.o, et(!., rrowt be satisfied befol'e the BUILDINC FINAL oat! !Ie raqueutsd.
FJNAf. BUnDING: Tile Final Building Inllpection nnlDt be I'equested after tlte .~'i'l(!l PlwnbiniJ
EZectrical, and Mccllllr:iclll Inspections /zqVC been made cj.ul approvad.
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'M.I, f./,lNIIGU:S ..1N/) rU:ANOIJT:: If/l."r m: ,1CO:s:;mLP., AD,TUST!!.':N'!' TO BE MAnE .~T NO r~ST TO CTTY I'r:l~~'~ ' of :!
D
fENeF.: J.'her. compl.>te -- Provide
gates or movable sections throug~
P.U.E.
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Lot Sq. Ftg.
S af lot Caverag~
.~ of Stories
Total Height
Topography
Interior
Setbacks
1I0uGe ' r.arane
I AcceSll.
,
L-COC;"
/ledl'oomo: ~""'),.
Ener17/f So,wees ~ '/';I/'(!
!feat
Water !featcI'
Ran(1e
. Fil'iJnZacc
woodstove
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JOB NO. q()/{)5.1
SOLAR ICES S :EQ,-
OccupanclI G : R.~ ~
WT ' TYPE -1 wt Faces -
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I P.L.
North
East
South
fvest
Tyve/Coy:st: .
Zone:
Corner
Panhandle
Cul-de-sac
Fees
TTEM
SQ.FTG
/ X
Va Zue
Building Value & Permit
This pemit is granted on the exprells condi tion that the H.,ll:,i .~(lI1" I "IIL'/.,:on
shaH, in aZZ respcctG, confom to the Ordinance adopted })y d,.) ,'" I I, ',l[
Springfield, incLuding the Zoning Crdinance, reguZatill(J the ':<::111;/)';,,'(1:':11
and UGe of buildings, and m:;.y be Gucperlded or revoked at r.;I:Y t;:,,/., lIi,,-'11 /)1:';-',
Zation of any provisions of said OrdinarlCes.
, ,
Main
I GaraGe
Caroort
AccessorII
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Is.D.c.
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State Surcharge
Total Charges
~
, Nan Check Fee:
Datc Paid:
Recdpt II:
Sig~ed:
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Building Permit
lITEM
I Fix,ture8
IResidentiaL (1 bath)
'sanitary SeLJer .
I Water
1Lf0 ~ '"
NO.
FEE
CHARGE
--
Plumbing, Permit
No percon GhaH construct, instaZ?, az.ter or challge any rleLJ CI' c:::il; t; ",IIU
plumbing or drainage syste:n in whole or in part,' udess Glwh pCI'GOII I:'; (:11...
Legal possessor of a valid plumber's license, except that a pC:'G071 mail Ii,;,
pLumbing LJork to property LJhich is OlJ7led, leased or operated by tho apl'l.I:-
cant. '
Total Charnes
\ % .00
( 6,bO
l'l~
J~ .rt<:; ..
FEE CHARGE
Electrical Permit
'Plumbing Permi t
State surcr.arge
, 1 n'M
I Res. So. rta.
I NalJ/Ertend Circuits
I Temporary Service
I
NO.
Where State LarJ requires tr.at the electrical LJork be done by all E,'lectl'ic,zI.
Contractor, the eZectrical portion of this pemit shaH not be vaLid wltiL
the Label has been signed by the Electrical Corltractol'.
Ele~trical Permit
State Sur~har!1e
Total Charges
i A
1TSM
NO.
FSE
CIIARGE
Mechanical Permit
f'urnace ETU' S
I E;;haua t llood.
Vent Fan
WoodstolJe
Pernrit Issuanc2
Me~hanical Permit
State Surcharae
Total CharQeo
-- ENCROACHMENT --
..
SCC".lr1.tu D2lJ03it
-'
Pl.an Exam1.ner
uate
Stora(Je
Total Charges
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,I HAVE CAREFULLY EXAMINED the completed application for permit, and do
hereby certify that aH i~fo;omation hereon is true and corr~ct, alld 1
further certify that any ar.d aH work perfor:1led shaH be dO:"le in accol'-
dance with the Ordinances of the city of Springfield, and th:; La:.;a of tho
State of Oregan pertaining to the lJOrk described herein, c:nd that NO eccl)
PANey wi LZ be I7flde of any structure wi thout permis3ion of ti,e Bu i ldinfl Di
vision. I further certify that o:1ly contractors' a,:d e:npl"yees wl:o are irl
c~~pliance LJith eRS 701.05S LJill be used on this project
foIai71tenanl,e
Pcmit
Curbcut
I SiderJ.:J. lk
I Ff!rl~e
El.ectrieal Label.
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B'1.:.JS
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I S,A.S
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tJ\e\io, . ~_ ,
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I TnTAr. AMOUNT DUE: ~ -
,
SP.FiEL:J
. 'i 'IIi ~_'1!ll.!1.i 1..=:'"6' l
E.Hiscellan~ous (Service/feed~r
-Each installation ,
Pump or irrigation
Sign/Outline Lighting
Signal Circuit or
limited energy panel
,,~ . I ",,-
225 FIFTH STREET
SPRINGFIELD" OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1;. LOCATIOJ!, OF ~ALLATION J...L. \ n h '
, , S6u~' \..)(\~-'M' ~ A.
LE~ DESCRIPTION' , ~~/'\ '
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'('\" JOB DESCRIPT, ~t<?N _ -1\
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Permits arenon~transferable and expire
if vorkis not statted within 180 days
of issuance or if vork is. suspen~ed for
180 days.
2. CONTRACTOR INSTALLATION ONLY
, "
Electrical Contractor
Address
City
Phone
. '
Supervisor License Number
Expiration Date
Constr Contr.Number
Expiration Date '
Signature of SuperviSing Electrician
Ovners Nam~(L--\-\tffi ~Uctn )0.
~ddr.ss Q')?>"C; tu ~ ~ lzi:
Ci 'y 0\}~\&' Phon. 'l41-{)2Cl Z,
OWER INSTALLATION'
the installation is being made on
' property ,1 ovn vhich is not intended
,for, sale, lease or rent.
Ovners Signature:
~.21fl /Y74~ '/ t! ~f'~
~~~~~----T!)-~T- ,~----------~----
RECEIPT .: ' )\-,l', . / \A i ~-=-o
RECEIVED nY:~/\ )
5'. '
ELECTRICAL PERMIT APPLICATION
City Job Number' qO 1c9b-
3. COMPLETE PEE SCHEDULE BELOV
Nev Residential-Single or .
Hulti-Family per dvelling unit.
Service Included:
Items Cos t
Sum
1500 sq. ft. or less
Each additional 500
sq. ft or portion
thereof '
Each Hanuf'd Home or
Modular Dvelling
Service or Feeder
$,85.00
$ 15.00
\ $ 35.00 ~~
B. Services or Feeders Cio Branch Circuits
included). Installation, Alterations
or Relocation:
100 amps or less
101 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
, f
Reconnec t Only ,
$ 35.00
$ 60.00
$ 90.00
$130.00,
$300.00
$ 35.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 35.00
201 amps to 400 amps $ 40.00
Over 401 to'600 amps $ 80.00
Over 600 amps or'lOOO volts see "B" above
Branch Circuits
Nev; ~lteration or Extension Per Panel
One Circuit
Tvo to ten Circuits
Each Addt'l ten or
portion thereof
$ 35.00
$,50.00
$ 15.00
not included)
$ 36.00
$36.00'
SUBTOTAL OF' ABOVE
5% State Surcharge
TOTAL
S 36.00
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Permit" No:C'..D \~ CS \ ~".,
'Addr~ss: ' h?;?~S ~~' LDAA ~r2Z
Issued bc::1~ Ol) , Date:, }O/''6f1o
/ .
ST A TEM ENT:
,.'INFORMATIONNOTICETOPROPERTY OWNERS
, ABOUT CONSTRUCTION ,RESPONSIBILITIES
Note: Oregon Law; ORS701~055(4), requires residential.buildfngpermit 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 submi,t t~isstateri1ent. This statement,will be filed 'with the permit.
, Fill in the applicable blanks; and initial. box 1 and either box 2A or 2B:,
/
1. I \I I I own, reside in, or will reside in the completed structure.
2. A.I \//, My general contractor is' ~S;,\\.S'~[',--~ _
Contractor registration n~mber ~ \ q\a4- 4 \ 4ql
~&1s
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
/
B. , ~/ I I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. If I change my mind and (jo hire a general
contractor, I will contract with a contractor- who is registered With the
Construction Contractors Board and I will immediately notify the office
issuing this building permit of the name of the contractor.
.,
,I hereby certify that the above information is correct and that I have read and understand
, the Information Notice to Property Owners about Construction Responsibilities on the
, reverse side of this form. '
Signature of Permit Applicant
Date
CONSTRUCTION CONTRACTORS'SOARD
0244J 10/24/89 ' ' ,,' ,"
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E COpy TO ISSUING AGENCY PERMIT FILE
K COPY TO APPLICANT '
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