HomeMy WebLinkAboutPermit Mechanical 1995-01-27SPRINGFIELO
RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Office: 726-3759 2fr,
JOB NUMBER
225 Fifth Street
Springfleld, Oregon 97 477
LOCATION OF PROPOSED WOFIK:
ASSESSOBS MAP:
LOT:
-
BLOCK:
TAX LOT:/7-e6
SUBDIVISION
PHONE:
STATE ZIP:afr-)=?
OWNEB:
ADDRESS:
CITY:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
GENERAL:
ADDRESS EXPIRES PHONECONTRACTOR'S NAME
ELECTBICAL:
PLUMBING:
MECHANI
CONST.
CONTRACTOR '
RANGE:
* OF BDRMS:
- OFFICE USE -
WATER HEATEFI
ZONING CODE:
FLOOD PLAINOUAD AREA:
, OF BLDGS
SECONDABY HEAT:
SOUARE FOOTAGE:
CONSTR. TYPE
HEAT SOURCE:
LAND USE:
# OF UNITS
OCCY GROUP:
* OF STORIES:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspections requested after 7:00 a.m. will be made the following work day.
REOUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prlor to
cover.
Flnal Plumbing - When all
plumblng work ls complete.
E Slte lnspectlon - To lre made
after excavatlon, but prior to
settlng forms.
Rough Electrlcal - Prlor to Flnal Electrical - When all
electrical work is complete.cover.
tl Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be
approved to obtaln permanent
olectrlcal power.
W Final Mechanical - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framlng lnsp.
Flnal Buildlng - When all
requlred lnspections have been
approved and building ls
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prlor to cover.
E Foundatlon - After forms are
erected but prlor to concrete
placemont.
|-7 ott'u'
Wall/Celling lnsulation - Prlor to
cover.
Underground Plumbing - Prior
to fllllng trench.Drywall - Prlor to taplng.
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanical
- Prlor to lnsulatlon or decklng.Wood Stovo - After lnstallatlon.
Post and Boam - Prlor to floor
lnsulatlon or decklng.lnserl - After flreplace approval
and lnstallatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
E Floor lnsulatlon - Prlor to
decklng.Curbcut & Approach - After
forms are erected but prior to
placomont of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanltary Sewer - Prior to f llllng
trench.Electrlcal Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home ls connected to
the service panel.
Storm Sew€r - Prior to fllllng
trench.
Sidewalk & Drlveway - After
excavation ls complete, forms
and sub-base material in place.
Water Llne - Prlor to filling
trench.
Fence - When completed
Rough Plumblng - Prlor to
cover.
Street Trees - When all requlred
trees are planted.
Final - After all required
inspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been installed.E
7jzz,--
/22v*>r- 7=
fl
E
E
r
fl
E
E
tlil
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Typ
-
lnterior
-
Corner
-
Panhandle
-
Cul'de-sac
IS THE PROPOSED WORK TN THE .HtsroRtcAL DtSTRtCr, oR oN
THE HISTORICAL FIEGISTER?
-
lf yes, this appllcailon must be slgnedand approved by the Hlstorlcal
Coordinator prlor to permit issuance,
APPFIOVED:
PL.HSE GAR ACC
N
s
E
VALUE
(A)
X $/SO. FT.
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT,
Main
Garage
Carport
Plr.t_LD_tNG VALUE, PLAN CHECKAND BUILDING PCNUIT
Thls permit is granled on the express condiilon that the sardconstruction shall, in all respects, conform to the Ordlnanceadopted by the City . of Springfleld, lnctudlng theDevetopment code, regurating ine Jonstruciion and use ofbulldings, and may be suspended or revoked at any flmeupon violation of any provisions of sald ordlnances.
Plan Check Fee: _
Beceipt Number:--_
DatePlans Revi ewed By
Date Paid
Received By:
EMS DEVELOPMENT CHARGE (SDC)
(B)
SYST Systems Development Charge is due on all undevelopedproperties within the City limits which are being improved.
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N0
FT.
FT.
FT.
Plumbing Permlt
State Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fix t u res
ADDITIONAL COMMENTS
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
MECHANICAL PERMIT
(D)26^z
a>
No
Mechanical permlt
lssuance
State Surcharge
Total Permit
,Zrr-
R ./a^E__B
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have carefully examlnedthe completed application and do hereby cerilfy that alllnformailon hereon ls true and correct, and I lurther cerilfythat any and all work performed shall be done in accordancewlth the Ordinances of the Clty of Sprlngfielct, and the Lawsof the state of oregon pertarning to the work descrlbedherein, and that NO OCCUPANCy wlll be made of anystructure wlthout permission of the Bulldlng Safety Divlslon,I further certify that only contractors and employees whoare ln compliance wtth ORS ZO1.O5S wlll be used on thlsproiect.
I further agree to ensure that all requlred lnspecilons arerequested at the proper ilme, that each address Ifrom the street, that the permlt card ls locatedof the property, and the approved set of
Date /-ZZ.V5
s readable
at the front
plans wlll remalnon the slte at all ti s during
Slgnature
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk _-_- ft
Curbcut _-- ft
Demolitlon
State Surcharge
Total Miscellaneous permits (E)
VALIDATION:
RECEIPT NUMBER
DATE PAID >-2 ,
AMOUNT RECEIVEDTOTAL AMOUNT DUE (exctuding clecrrical)(A, B, C, D, and'E Combtned)RECEIVED BY
/-=
?a
fr*
INSPECTION REOTIEST
OFPICE: 726-3759
1. LOCATI
Authorized
OF INSTALI.ATION
rrrttroru, r)f..
SPFITNGFIELD
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit L
lH?:#,J'.ffi f r,?&#*x*,ff ttr
225 FI,rT'E STREET
SPRTNGPTELD, oREGoN 97477 L tT,rcrtrcal PERHTT A?PIJcATToN
City Job tt*b", ?faa7>
COHPI,SIE TEE SCEEDTI.B BBLOS
: 726f,1Q9
LEGAL' DESCRTPTION
JOB
Permits are non-t ferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COT{I3ACTOR INSTALI,ATION ONLI
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:ftems Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular. DvelIing
Sertice or Feeder
$ 8s.00
s 1s.00
$ 40.00
l+A
:
Sum
B. Services or Feeders
Installation, Alterations
or Relocation:Electrical Contractor
Address 0
ci Phone 1+l-lAb
Supervisor Li cense Number S
Exp iration Date t0 -l-95
Constr Contr. Number 0 32 +q
!Expiration Date q -, -4s
Signa of Supervising Electrician
0vners Name
Address
Ci ty Phone
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:
200 amps or less I
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/vo1ts
Reconnect Oniy
o
ee rB, aSoIE
$ s0.00
$ 60.00
$100.00
s130.00
s300.00
$ 40.00
$ 3s.00
$ 2.00
,l DO
5CI,0D
:
200 amps or less
201 amps to 400 anps _Over 401 to 600 amps
Over 600 amps or 1000Erts
D. Branch Ci rcui ts ; .-
Nev, Alteration or Extension Per Panel
C
5. SUBTOTAL OF ABOVE
52 State Surcharge
3"/ Administrative Fee
TOTAL
Temporary Services or Feeders
Installation, Alteration or Relocation
40.00
55.00
80.00
$
$
$
s
,b
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation S
sign/outline Lighting- $
t :.ili ted Energy/Res $
Limited Energy/Comm $
40.00
40.00
20. 00
36.00
4.1o
| .b)'
RECETVED 59 1-L-
/^ e?-?9-37 ?a-aa -
CITY