HomeMy WebLinkAboutPermit Mechanical 1992-11-19CO M M ERCIAL/ I N DUSTRIAL
PERMIT APPLICATION
225 Fiftn Street, Springfield, Oregon 97477
SPRINGFIELO
JOB NUMBEFI 7zt
INSPECTION LINE: 726-3769
OFFICE: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:TAX LOT:
PHON E:
ZIP:STATE:qlLJ-?7
OWNER
ADDRESS
CITY:
DESCRIPTION OF WORK
NEW- REMODEL OTHER VALUE: $FA-D MOLIS
n trtr\ lJ lTtrr\-r.
ELECTRICAL:
NAME ADDRESS PHONE
NAME ADD RESS EXPI RES PHON EH77r
/
u-
ICAL:
CONTRACTOR
CONST.
CONTRACTOR #
PLU MBING
NO.FEE CHARGE
Single Fixture
Relocated Bldg.(new fix. addtl)
Water Service
ft.
Sanitary Sewer
ft.
Storm Sewer
ft.
Backf low Device
TOTAL PERMIT
MECHANICAL
Nr)trFF CHA FIGF
Furnace/burner & vent
< 100,000 BTUs ero
Furnace/burner & vent
>100,000 BTUs
FIoor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cool er
Vent Fan/Single
duct
Vent System apart
from AC or htg.
Mechanical exhaust
hood and duct,47n 2.&
Permit lssuance $10.00
TOTAL PERMIT ,8,,,lr.-;
_ OFFICE USE _
LAND USE
HANDICAP ACCESS:
FLOOD PLAIN
LIGHTING POWER BUDGET:
WATER HEATER:
* OF UNITS:
OCCY GROUP:
# OF STORIES
OUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
SO. FT.$/SQ. FT.VALUE
TOTAL VALUE OF PROJECT
X
X
SQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
RCPT#DATEPLAN CHECK FEE BY
2fr7f,
BUILDING PERMIT PLUMBI NG DEMOLITION
5% State
Su rcharqe
5% State
Su rcharqe
MEC wbyll /E{Z FENCE
VALUE $
5% Slate '
Su rch aroe -?f €+DEWALK
FT.
SUBTOIAL
PEBM ITS
PAVI NG CURBCUT
FT.
SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
NQ
ZONING:
REQUIRED INSPECTIONS
It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call
726.3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready
for inspection. Requests received before 7:00 a.m. will be made the same working day, requests made af ter 7:0O a.m. will be made
the following work day.
SITE INSPECTION: To be ROUGH PLUMBING, PAVING: After gravel is in
made after excavation, but ELECTRICAL & place but prior to placing
prior to setup of forms. MECHANICAL: No work is to asphalt or concrete.
be covered until these
UNDERSLAB pLUMBING, inspections have been made SPECIAL INSPECTIONS: ln accordance
ELECTRICAL & and approved. section 306 0f the state Specialty code
MECHANICAL: To be made a special inspector shall be employed
before any work is covered. ATTIC DRAFT STOPS & by the Owner/ Contractor during
CURTAIN WALLS construction of the following work. A
FOOTINGS & FOUNDATIONS: copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prior to placing be furnished to the Building Division.
excavated and forms are facing materials and before
erected, ail steel in place, but framing inspection' srRUcruRAL CoNCRETE: ln
prior to placing concrete. FRAMING: To be made after excess of 2500 PS.l. (306 a.1)
coNcRETE SLAB: To be the roof' all framing' fire
made after au insrab buirding 3l::5::.':fl 3iE:It"f,H;:r" FII:,"J"',.-3"t.Y5tT',rrz oservice equipment, conduit, and vents are'complete and
:i?[,?;".",',:;?{:""i ?i:*""'::i :X? 'fl'":Xi,]i9ffi,1'iJ;[3:?: Bl?lf],ffiIuol,l"EP,.T]t"oin place but before any tighteiing operations. (306concrete is placed. INSULATTON & VApOR a.6)
BARRIER: To be made after all
UNDERGROUND: Plumbing, insulation and required vapor SpRAyED ONelectrical, gas, sanitary sewer, barriers are in place but FIREpROOFING: U.BC.Storm sewer, water and before any lath or gypsum Standards 43-8.drainage lines. To be made board interior wall covering isprior to covering or f illing applied. SPECIAL GRAD|NG,t renc hes.
,NDERFL..R: p,umbins [:::,1',=,'f;XA'J3[Hi"' il;iJt'iiil-:li",5Jb'i],"1
electrical, mechanical. To be according to plans. Chapter 29)
made prior to installation of
floor insulation, decking or LATH AND/OR GYPSUM GLU'LAM BEAMS: lnspection
floor sheathing. BOARD: To be made after all Certificate by an approved
lathing and gypsum board, agency, furnished to the city's
posr & BEAM: To be made interior and exierior, is in Building Division before
prior to installation of floor place but before any beams are placed' (2501 u'Bc'
insulation, decking or floor plastering is applied or before STDS' 25-10J1)'
sheathing. - Sypsum board joints and
fasteners are taped and STRUCTURAL MASONRY: (306
FLooR TNSULATToN & finished' a'7)
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
uBc 2415.
RooF sHEATHTNG AND iHRS^H'^,tJ,tt::#"":,.
NAILING: Prior to installing erected but prior to placing
any roof covering. concrete.
SIDEWALK & DRIVEWAY:
Required for all concrete
paving within street right of
way, to be made after all
excavating complete and form
work and sub-base material in
place.
"ln addition to the inspec-
tions specified, the Building
Official may make or require
other inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
SITE PLAN REVIEW BOARD: Must be requested 2 days in advance
of the date you wish inspection. All project conditions such as
Iandscaping, parking lot stri ping, etc. must be completed before
requesting this inspection.
FINAL BUILDING: Requested after the final plumbing, etectrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
Certificate of Occupancy has been issued by the Building Division
and posted on the premises.
PLANS REVIEWED BY DATE
By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information
herein is true and correct, and I further 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 701.055 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that project 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 on the site at all
times during construction.
Signature Date z
VALIDATION AMOUNT RECEIVED:4f,2,
RECEIPT *:a9a
=
DATE PAID:
RECEIVED BY:
FINAL FIRE DEPARTMENT
ADDITIONAL COMMENTS:
-
C'TY OF OREGO'U
0l/27/02 t Ll:22 00os ??i E080
I
0lEICBr 716-3759
l+T$t
UD F{'Fn SfBEET -iir.r i- :' r'
SPRIIIGEIBLDT ORBCON 97417 :'1 :r:,:; '
insigcflon iuouasrr 726-176r' "'
ELEctnICAL PENfiIT APPTICATIOI
Ct ty Job Nunber q
^t3)
I
-QD 3 COI{PLEf,E PEE SCEEDI'IJ BBT,O9
SPFD DEV. SER [t ooz--.-\r'^!lnlbl'llrLt,
3
t.
Ofi5,1
I a
I IOCffiroN 0r
JOB
C
trrrltc rrt noD-trangfcrablc and explrelf vork lr not staitcd vlthln 180 daysol tssuancG or lf vork ls suspended for
180 dayr.
2, COTTTRACTOR INSIAIIATIOII OM.Y
Elcctrlcal Contrtctor TdE, lda.
Addrcre EPa &*)kt
crty 8ae,ub -Phonc 66t- 6?tt
Supervl cor Llccnsc Ntinber )AO+S
E qpt rltton Drt.to-rS
conrtr contr. Nunbcc e 44do
-Bxplrrtlon D.t.
Slgnrturt ol Supenrlalng Elcctrtclan
0mora Naoc
Addrlrr
ct
Thr lnstellatlon lt belng ntde on
prop.rty f orn vhtch ls not lntendcd
for arhr lcerc or rant. ,
Onrcrr Sl3nature:
DAtEr
tlal-Slnglc or
Hultl-Fently pcr dwdllng untt.
Servlcc Includedt Itaos Cort
1000 sq.ft. or less'
-
Each addlttonal 500
sg, ft or portlon
thereof
Each Hanu!'d Eorne or
-ilodulsr Duelllng
Servlec or Fecder
$ 85.00
s 40.00
\-T'd)Suu
s 15.00
B. Servltes or Feedcrs.
Installatlonr Altcrstlont or
Reloeatlonl
c.
D.
200 amog or lcsg
201 anps to 400 anPs
-
401 amps to 600 anPs
-
601 amps to 1000 tnPs-
Over 1000 anps/volts
-
Bcconnect 0nly .
-Tcmporary Servteec or Fcldcra
Inriallailon; Alterltlon or Rclocatlon
-Each lnstallatlon
Prrmp or lrrlgrtlon
Sign/0utllnc Llghtlng-
Ltmlted EnergY/Res
s300
40
00
00
00
00
00
00
s 50.
$ 60.
$100.
$130.
$
s55F
s 40.00
$ 55.00
s 80.00
gec nBi
200 arups or less
-
201 amps to 400 enps
-
Over 401 to 600 amp3
-
Ovcr 600 amps or 1000 volts
Branch Clrcultr
Nev, Alterstlon or Extenclon Pcr Pancl
Oni Cl.rcult S 35.00
Each Addttlonal
-Clrcult or ulth Servlcc
or Feeder rlirit""'-i1 . s 2.oo' 3e
E, Hlscellaneous (Servlce/fcedcr not lncludad)
s 40.00
s 40.00
$ 20.00
s 36.00
A so, l,ll,tJfd El"Jf' 6tH-
5. SI,BTOTAL OP ABOI,E
5f Stato Surehergr
3
aa
-i^n?lEh Frun JAI*;.),9 fr??Lct
gg
!lrrnrtteO
5r.tllN(;!:IGL1)
has
IT T'BE SCNEDULE DELOS
qfr
APPLICATION
Job Numbe, a^ / </ -
225 I]IFTII I;TRI|I|T
SPTUNGFIIiLI), oltl':GoN 97 477
INSPIICf,ION REQUIIST z 7?-6-3169
OFPICE: 72-6-3751)
1/l
3.
1 OP INSTALLA
LEGAL DESCRIPTION
O -4
JOB DESCRIT"TION
Pcrnrits are non-transferable and expire
1f vork is not started vlthin 180 days
of issuance or it vork ls suspended for
180 days.
2. CO}NRACf,OR INSTALINTION ONLY
Iilcc trical Cont rac tor
Add r:cs s
A. Nev Resident ngle or
HuIti-FamilY Per dvelling unit'
Service Included:Items Cost
B
c
D
1000 sq.ft. or less
Each additlonal 500
sq. ft or Portion
tlrereo f
Each Manuf 'd llome or
Modular Dvelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installatlon, Alteratlons or
Reloca t ion :
200 amps or less
201 anrps to 400 amps
-
401 amps to 600 amps
-
601 amps to 1000 amps-
Over 1000 amps/volts
-
Reconnect 0nIY
TemporarY Services or Feeders
Insiallailon, Alteration or Relocation
200 amps or }ess $ 49'99
ior ,*pr to /ro0 amps
- t l!'99
over 4bt to 600 a*ps
-
$ so'oo
0ver 600 amps or 1000 volTs see trB, above
Branch Circults
Nev, Alteratlon or Extension Per Panel
one circuit s 35'oo
Eaclr Additional
Circuit or vith Service
or Feeder Perrit 1- S 2'oO I
l'liscellaneous (Service/feeder not included)
-Each installation
Sign/0utIine Liglrting-
Limi ted EnergY/Res
-
Liml ted EnergY/Comm
SI,DTOTAL OT ABOVE
5f State Surcharge
TOTAL
4tD
Sum
/s €o50.00
60.00
100.00
130.00
300.00
40.00
Ci ty
Supe
lttone ZZSR^CS)y'/
rv 1s Li ce eNunber ? /€
$
$
$
$
$
E>rpiration Date -.R.)n -/J
Sign ature of pe sl rlclan
/
Ovners Name
Add ress
Ci tv Pltone
OVNEn INSTALLATION
The installation is being made on
property I ovn vhictr is not intended
f or sal.e, Iease or ren t .
Ovncrs Si gna tttrc :
E
00
00
00
00
s40
s40
s20
s36
DATE:
RNCEIPT
I{Ii(:I.IIV[D IIY:
5
o
!
I
Expiration Da r" /f o-{
constr contr . ttu^vu, l*fbV