HomeMy WebLinkAboutPermit Building 1999-10-13
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LOCATION OF PROPOSED WORI<: StolpO DAISY i:t 10
17 0 ?-3~u'-f (') 1409
OWNER: 'Le.es t Pd PR.AV
ADDRESS: 5"4,b :D4JSY #- 10
CITY: ~rLJJ.qfLd.d
DESCRIBE WORI<: TNSTALL HEAt 'PLLmP
REMODEL V" ADDITION
./, ~,\i
RESIDENTIAL
PERMIT APPLICATION
Inspections: 72603769
Office: 726.3759
ASSESSORS MAP:
LOT:
NEW
CONTRACTOR'S NAME
GENERAL:
'.
.'
SPRINCFIELP ~'VlIl"...;,.~
JOB NLJMOE/l
<11' 139 C;
I
225 Filth Streel
Springfield, Orugon 97477
OLOCI(:
TAX LOT:
SUBDIVISION:
-,
PHONE:
'721o-b 74-J
---.-
STATE:
DR
ZIP: __,!141e
DEMOLISH __. OHIEI1
ADDRESS
CONST.
CONTRACTOR II
EXPII1ES ~ PHONE
PLUMBING:
MECHANICAL: CDmfor-t F~W jqSI DON srJ SuITE D
ELECTRICAL:
LJ.bD
6.. 27 "Dl' '1Zb--D/W
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- OFFICE USE -
NOTICE: LAND USE:
TtflS PERMIT SHALL EXPI~EbIF.lliftr~ORK
AUTHORIZED UNDER THIS PERMIT IS NOT
lJUIVIIVlcl'JlJcU UH IS ABAN'O~QlFOFt~E:
At~'1'-48&B1W-PERIOD. HEAT SOURCE: ______
QUAD AREA:
If OF SLOGS:
OCCY GROUP:
II OF STORIES:
WATER HEATER:_
-.----
FLOOD PLAIN:
ZONING CODE:
" OF BDrtMS:
SECONDMIY HEAT: ___.....
RANGE: ___
SQUARE FOOTAGE: "._,_.._.
To request an Inspection, you must call 726.3769. Tills Is a 24 hour recording. All Inspections requcsled before 7;00 .un. wll/ be
made tho same worl<lng day, In:;pcctlons requested afler 7:00 a,m. will be made lhe Iollowln~J worl< day.
D Temporary Eleclric
o Site Inspection - To be made
after excavallon, bul prior 10
selling Iorm::>,
o Unders(nb Plumbing I Electricnll
Mechanical - Prior to Cover.
o Footing - After trenches arc
excnvated. .
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms Me
erected but prior to concrete
. placement.
o
Underground Plumbing -- Prior
to 1I111ng trcnch.
o Underlloor Plumbing I Mechan/cn!
- Prior to Insulation or declcing.
o Post and Deam -Prior 10'lIoor
In:;ulntlon or decl<lng,. .', '
o Floo':,lnsulation 0,- Prior to '.,
decl<lng. \
o Sanilnry Sewer - Prior 10 filling
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior 10 tilling
Irench.
D Rough PlumbillO ~ Prior to
cover,
REQUIRED INSPECTIONS
D Rough Mecllanic.11 - Prior to
covcr. '
o
Final PllImbing - When all
plllmblng w9rlc Is cornplel,e.
o Rou!J,l1 Electric,,1 - Prior 10
COVCI.
D r-ilHlI Elecltical - VVl1en all
ulectrical worl< is complete.
,--./ (
@~!~~~,I Mechanical - When nil
meclwnlcal wOrl< 'Is complele.
o Electrical ServIce - MlIst be
approvecl to obt::iin perrrwnenl
electrlCul power.
o Final Ouildin(J - When all
required In::>pectlons have been
approved and building 13 . Tl
completed. , ~\Il' i'li'. ,'IC'l', 'U. I
. .. '. " """\' 'J'" ; ',' l \i ,\
. """ ""\\1' .,r.... ". ','q-~. "oJ
1 f"'. 'tf' t... f ,. .
t, ,ll(i"" Z',! e~ .' , ,I '.' ,.. ....... ~:.. ,1~)
. G;]' Other" "~'" '.. .
,'.. ',' .'~ll. 'r";-' . . .
.. . ....... " '\: '.4~'it:....\-.U u-
. .. . . I I,..'
o WalllC'ellinG Insulation - Prior lo~ ..,d-.- -'. ',~~-;;,.." ,;.c'r, hll
cover. . 'y;~r, "f" ";-'1' r ,. ~ "',. .' ~l"e
\., '.~ I . .~" " 1 t... 1 .' >oJ. ,,. ~ _ l
. ".,. ~..." ...' . . " . "
cadII" .' , " )'~' atioi1
. b' ;~ to'- ...~. Iv.' ...,',::f. i " ::tL', ,~'u..lIIC
~ll'l"",~ .. "" ..
w .'.11 .J.' . ~.' ,.,~.~:t.... ..t"~4,
MOBILE"~i6ME "rN'S'PECToIONS
o Flrepl':1ee - Prior to facing
materials and lraming Insp,
o Framing - Prior to cover..
o Drywall - Pdor 10 t.lping.
. 0 Wood Stove - Afler In:3Ialla:lon.
o Inzert - Afler fireplace approval
and Installation or unit.
o 010c1\illg and Set.Up - Wilen all
blocl<ln~1 Is complete. .
o
o Plul11bin!J Connections - Wilen
11Oml) I)OJ:; been connecled 10
Wi.lter ;IIKI SeVl(:r. '
Cllrbeut & Appro:Jch - Afler
torms arc ,,'rce led bul prior to
placement Qf c:oncrcl(l, .
D Sidewalk & Drivew:I\' - Afler
excavation Is complele, forms
ancl sul).bnse.ma!crlnl in place.
o ElectriClI1 COllllectioll - WI1Cn
1)loc)IIII!J, SUI.up, and plumbing
In:;peC:ll()ns l1;wc been approved
ilnd llle 110ll1e ir. connected to
lhl} :.>crvice panel.
.. 0 Fence - Wilen completed.
. 0 ~Hroot Trees - When all required
trees arc planted.
I I Final - Arler aI/ required
Inspections arc approved and
porches, sl~lrllng, dccl<s, and
venting 11<Ive been Instnl/ed.
_.~---- .-~._- ~
Lot laces Lol TY,,- Setbncl15,
Accl
. P.L. HSE GAR
Lot sQ. Itg. Inlerior' ,\
Lot coverage Corner N
~--_.
Topogrnphy Panhandle S
---
Total height Cul.eJe.~ac W
,.----.- --- ----
. . IS THE PI~OPOSED WO~< iN THE,
" "'HISTORICAL DISTRICT,.OR O~ '
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
E' ^
.' ./
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X :t/SO.FT. ,. VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
.
.
TIlls permit is gronted on tile express condition that the said
con:.;truction shall, in all respects, conlorm to 1l1e Ordinance
adopted by the' Ciry 01 Sprin'grield,' including the
Dcvelopment qode, regulalingthe'construclion and usc 01
buildings, and may be suspended or revollcd at any lime
upon violation 01 any provisions o( soid .ordlnances.
Main
Cnrport
Plan Checll Fcc:
'Dale P:lid: ; . ,
Total Value
-......--..-.-.- ---.-
Receipl Number:
Building Permit Fcc
Received By:
Stale Surcharge
Tolal Fcc
(A)
-. --...--.... .---.--------
Plans Reviewed 8y
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
l .
(0)
\ '
Systems Development Cl1arge is due on oil undeveloped
. , .
, ,properti9s w,illlln the Cily limits Wlllcll ore being Improved.
,
.:
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Oall1(s) " NO
Snnltary S!'lwer
WaleI'
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Pormil
Slale SurclHHoe
Total Charge
(C)
MECHANICAL PERMIT
\
Furnace
Tolal Permit
(0)
.j[r b. ---
~1.Q-,--==_
-
LO:~T ~_lf.~
~~.~
(
Oy signature,. I slale and agree, lhall haye carelully examined
the compleled application and do hereby certl(y Ihat all
In(ormallon hereon is true anel correct, and Ilurttler cerlJry
thai any and all worl< perlormed shall be done in accordance
with tile Ordinnncu:.; or llle Cily 01 Sprlnglleld, nnd the Laws
or llle Stale o( Oregon perlninlng 10 the worl< described
heroin, and that NO OCCUPAJ-.JCY will be made o( any
structure willlout permission of the Building Snrety Division.
I further certily lI'wl only contractors and employees who
arc in compliance'will) ORS 701.055 will be used on this
project.
Exhausl Hood
Vbn'l Fan
NO
Wood Slove/lnserl/ FI ref"llace 'Unit
Dryer Vent
Mechanical Permit
Issuance
Slale Surcllar!)e
Sldewall<
II.
I further agree to cn~;ure Ihal all required inspections arc
requested althe proper time, thai each address Is roadable
(rom tile 511' crmlt card Is located al the Ironl
nn tile orJproved sel 01 plnns will remain
all imes d ring cor "II' ctlon.
Ct
/0 ,,/,3. --99
MISCELLANEOUS PERMITS
Mobile Home
Stale Issuance
Stnle Surcl1nrge
Slonnt
Date
~
Curbcul
It
Demall tlon
~1111C Surch;Hge
VALIDATION:
RECEIPT NUM8Ef-1
n '3 S<Xt ,_
,
TOTAL AMOUNT DUE (excludina electrical)
(A, 0, C, D, and E Combined)
10 -\?-~ 'i
AMOUNT RECEIVED c:JI O-~. <S"'2)
~ u...-:>
FlECEIVED OY
TOI:!1 Mlscellnneous Permits (El
DATE PAID
"
NOTICE: , has the following
T#!~~iQMfM~fl~~~~ic.land use
A~~ID~~~~ I HE WORK
ahlQrov8.l, UNDERW
225 FIFTH STREET CUlVlMEN~ C ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON tfi7..;7l, qq I ? a.~,'
INSPECTION REQUEST: r"~(g! ~ Gi ty Job Number S> I ',(
OFFICE: 726-3759 ,\'lO Signature -
ALllflOll . 3. COMPLETE FEE SCHEDULE BELOY
1. LOCATION OF INSTALLATION
5' ~ ~ (.... (\ (.:}- <I :< '-' -;tt:b
I
. "
'.
t:'.:,"...'.. ,,::,': 1,', -~:.
.' ~:t,
"
SPR.FIE~D
I '," ,
"', ;"1
.
New Residential-Single or
Multi-Family per dwelling
Service Included: '
. A.
~GAL DESCRIPTION
17~'J- ~ 34'1 f)/t(o 9
Items
JOB DESCRIPTIOND ATTEr'fnON:C)~eCic.:l ;aw rec1.9.P;.Q; 1;S_q!..tfilt. or less
J.:J,p~' p()~ fnlln,^, rlll~~ ~Hin~t~d by the (~s<F,t1riaj~q~~t ional .500
I ~, \ Notification Cer"'Rr.l~r~.;;:. ~u!s~g~~; !:.+~,!'8}-1hPortIon
Permi ts are non- transfeh~\~~~ER ~!l2_r1t~.p.J'~'r~'itr"rOIJ('I;1 C~~E7~~2PJ01-
if ~ork is not :tarted Y.>b~~~~'~18(lqa~~~@in c~pi0Sf)f8h~ r-HW.bl~jyd H~me. or
of Issuance or If work IS susp,e.naea""nfRr (1\Ic.....\.h()~'Olduf.areDwell1ng
180 d call1r,g .m~c,", t'"'~' ,\, ...... n~S\' "..lJ..UII F d
ays. numberlorthe Oregon Utility l\lt1~iCafiOl~r ee er
2. CONTRACTOR INSTALJ..A.TION oNfymteris 1a800:J192-%~llfJices or Feeders
}"Jc- Installation, Alterations
Elec trical Con trac tor. J(.Sf-if-l.>T12(Lfb,LJCO,vSu.:f~r Relocation:
. A. ddress P D G O~ .}-t-( q ~ 3 200 amps or less
201 amps to 400 amps
Ci ty~.. ' Phone b8 [3 -('ot t( 401 amps to 600 amps
601 amps to 1000 amps
Supervisor License Number -r:s L{ q) 5 Over 1000 amps/volts
Reconnect Only
Expiration Date JIJ- I,'-D I
,. .
,
uni t.
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
Constr Contr. Number <:)0 gf?q
Expiration Date j'#- ~ 0-00
200 amps"oT less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
$ 40.00
$ 55.00
$ 80.00
volts see "B" above
Signature of Supervising Electrician
r~ v.-AJ/-
Owners Name /1/:1 c::L~,a r
D.
Branch Circuits
Address S~(t') 0 Dw--I5.~
,
\
Ci ty ~(JftA"1 ft-i,(J
OVNER INSTALLATION
Pf2t8::::j
-:/::I:-cP
7i-~'-b?<'{f
, ,.
New, Alteration or Extension Per Panel
. One Circuit t
Each Additional
Circuit or with Service
or Feeder Permit
Phone
$ 35.00 3S.Qu
$ 2.00
not included)
The {nstallation is being mide on
property I own whi~h is not intended
for sale, lease or rent.
. Owners Signature:
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
E.
---------~1--7-------------------------
DATE: /0/ (11~ .
RECEIPT tt: 0\ 5"~h'~ '
RECEIVED BY: AI v.>~
5.
SUBTOTAL OF ABOVE
7% State Surcharge
3% Administrative Fee
TOTAL
40.00
40.00
20.00
36.00
$
$
$
$
~QE
. /. 0"-...,
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