HomeMy WebLinkAboutPermit Mechanical 1999-10-27t
RESI DENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
SPRINGFIELD
?1rqroJOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
KcA/<n./
ASSESSOBS MAP:bZ 0/r'{L TAX LOI 0tt
LOr BLOCK:SUBDIVISION:
rrl I 7rr1-/e zzsPHONE:
3s.zg
ZIP:)---STATE:?7'
'R,'*
CITY:
ADDRESS:
OWNER;
NEW- FIEMODEL ADDITION DEMOLISH OTHER
uDESCRIBE WORK:
GENERAL: _
PLUMBING:
ELECTBICAL:
a( DSr-.-/L
ADDRESS EXPIRES ,f PHONECONTRACTOR'S NAME
MECHANICAL:
CONST.
CONTRACTOB #
,{ oF uN rrs: ffi DER n4BfpEnf\fr?RffiloT_
@NSTR. rvre: COMMENCEnORISABAf\SDHEBIFOB-
..,^^!inn
OCCY GROUP:
,,.LAND usE'- THtsFERMITSFIALLEXFffiPf\A tN:^-^ -WUHK
WATER H
RIES:
EATER:
# OF STO
SQUARE- FOOTAGE:
OUAO AREA:
r OF BLDGS:
- oFFrcENffrTcgt
HEAr souRcEr ANYIS0DAYPERIOD. sEcoNDARy HEAr:,.',
To request an lnspectlon, you must call 726-3769. Thls ls a24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be
made-tho:Sen1g wqrklnO day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REOUIRED INSPECTIONS
Temporary Electrlc
E
E
tr
Slte lnspectlon - To be mado
after excavatlon, but prlor to
setting forms.
Underslab Plumblngl Electrical /
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underlloor Plum$lng I Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulatlon or decklng,
Floor lnsulatlon - Prlor to
decklng.
Sanltary Sewer - Prior to fllllng
trench.
Storm Sewer - Prior to fllllng
trench.
Water Llne - Prlor to filling
trench.
Rough Plumblng - Prlor to
cover.
l-l Rough Electrical - Prior toI-J cover.
l_l Framlng - Prior to cover.
l-l WatttCelllng lnsutatlon - Prlor tou cover.
Rough Mechanlcal - Prlor to
cover.
Electrlcal Servlce - Must be
approved to obtal
olectrlcal power.
n permanent
Flreplaco - Prlor to faclng
materlals and framlng lnsp.
Drywall - Prlor to taplng
Wood Stovo - After lnstallatlon
lnsert - After flreplace approval
and lnstallatlon of unlt.
Curbcut & AJrproaclr - After
forms are erected but prior to
placomont of concrete.
Sidewalk & Drlveway - After
excavation ls complete, forms
and sub-base materlal ln place.
Fence - When coinpleted.
l--l Flnal PlumbinglJ plumblng worl<- When all
ls complete.
Electrlcal - When all
cal work ls complete.
Mechanlcal - When all
nlcal work ls complete.
Buildlng - When all
requlred lnspectlons have been
approved and bullding is
completed.
Other
MOBILE HOME INSPECTIONS
Blocklng and Set.Up - When all
blocklng ls complete.
Plumblng Connectlons - When
home has been connected to
water and sewer.
Eleclrlcal Conneclion - When
blocklng, set-up, and plumbing
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Flnal - After all required
lnspectlons are approved and
porchos, sklrtlng, decks, and
ventlng have been lnstalled.
l--| Underground Plupblng - Prlor|J to fllllng trench.
tl
.$troet Trees - When all roqulred
trees are planted.
F
.,iras
BANGE:
E
fl
E
E
tl
E
E
.t
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type -
-
tnterior
-
Corner
-- Panhandle I:
-
Cul-de-sac
IS THE N THE.
HISTOBICAL D OR ON
THE HISTORICAL REGISTER?
-
It yes, thls appllcatlon must be slgned
and approved by the Historlcal
Coordlnator prlOr to permit issuance.
ED:
P.L.HSE GAR ACC
N
E
lry__
FT.
(A)
rdlrr t
Total Value
Building Permit Fee
State Surcharge
Total Fee
iIm
X $/SQ. FT. = VALUE
BUILDING PER
ITEM SO.
Main
Garage
Carport
BUILDIN:G tAIrf,e, Fmru cHEcK
AND BUILDING PERMIT
Thls permit is granted on the cxpress condition that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Springfleld, including the
Development Code, regulating the construction and use of
bulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Revlewed By Date
Fleceived By:
Plan Check Fee:
Date Paid:
Receipt Nu
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties wlthln the City llmlts which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
Nc
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
- FT.
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
tf .,,
26"{o
t
€n
(D)
N0
't?
Vent Fan
().J0
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed appllcatlon and db hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the Clty of Sprlngfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Bulldlng Safety Divislon.
I further certlfy that only contractors and employees who
are In compllance with ORS 7O1.OS5 wlll be used on thls
prolect.
I further agree to ensure that all requlred lnspections are
requested at the proper tlme, that each address ls readable
from the street, that the permlt card ls located at the tront
of the property, and the approved set of plans will remaln
ru
Slgnature
Date
on the slte at all tlmes
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exctudtng electrtcat)
(4, B, C, Q and E Comblned)
0
(o
c
DATE PAID
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
AMOUNT RECEIVEO
s
rI__
FT.
225 IIFTE STREEI$eidifi r^0,' onseUl[' " g?f, 7Ys
n""'"
INSPECTTON REQTEST: 726-3769
OFPICE: 726-3759
'fhe tollowing Prolect AS
zontng, and does not require sPecific land use
approval Lr)
Zoning
Uate
?A
EI,ECBICAI PERI{IT APPLTCATIO}'
Citl' Job Nunber Q?rcra
3. COH}L'TE FgE SCEEDUIJ BELOV
Neu i:sitie:iial.-S:.ngie c:
Hui:: -Fam: -;; Per oue!-!-lng un: :
Se:'i'::e in:iudeC:
I iens
sPat lELo
100i sc.. f :. or Ies*=
Eaci a<idi t: onal 50[:
sc. :r o; pcrricr
thb:eof
Each lianuf i Home- or
Ho<iu-ar Dvelling
ggsr'rce or Feeder
Serrices or Feeders
Instailation, Alterations
or Reiocation:
1. :..OCATION OF .r: i6i^ll3!1y'a i - L',rr
1-i.utiL DiSCRIPTI642
OI\
I
B
D
Lus.
s 85.00
s 40.00
c,,-
JOB DESCRIPTIOX
Permris are non-t
if vork is not st
ransferabre and exPire
arted viti:in 190 daYs
L),
of ittu"nc€ or if r.'o:il' is suspended for
180 ca1's.
2. COI{TRACTOR INSTALI,AITON ONLY
Electrical Contracto L.[iIftIC SERYICT
Address A.'.
ur Lj/
Supervis License Number s
Expiration Date lO - |-o
Const: Cont::. Number htCO (
Expirarion cate a-tt - 6
Siggature of Supervising Electrician
QEo.
THISPERMIT REIFTHEWORK
A
200 amps or less
201 amis to 400 anPs
-401 amps to 600 aEPs
-
601 anis to 1000 amPs-
over ib00 amps/vo1ts
-Reconnect OniY
Tenpo:arY Services or Feeders
tnsiallaiion. Alteration or Relocarion
200 amos"or less S 40'0C
over 4b1 to 600 anPs
-
S 80'oo
Over 500 amPs or lO0OEis see uBn above
tsranci. Circui ts
iies, iLtera:lon or Extension Per Paael
oneC::cuit I S -?5'C.-ff
iach ;titii tional
Circu: t or ui th Service
or leeder Permit s 2.0c
!'1i.sce-ianeous ( Service/:eeder not :ncludecl )
-9ach lnstall-ation
?unp c: irriSation
-
Sign/0u tline Ligi: ting-
Liuited EnergY/Res
-
Linited EnergY/Comm
s 50.00
s 50.00
s100.00
s130.00
s300.00
s 40.00
C
:)
T9gMMENCEDORTS
ANY 180 DAY PEBIOD.
OINEP. INSIALI.ATION
The installat:on is being maoe on
piop.trl'r oun vhich i-< not intended
io; sale. lease or reni'
ners Signature:
DAIE: lt
SIETOTAL OF ABOVE
)V State Surcharge
3I Adninistrative Fee,ry
s 40.
s 40.
s 20.
s 36.
OC
OC
OC
00
RBCETVED
tt 7?
5
OO