HomeMy WebLinkAboutBuilding Mechanical 1991-09-27^lGFIELDRESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PRO ED WO
ASSESSORS MAP:
LOT:
h,
JOB NUMBEB
225 Fifth Street
Spri ngfield, Oregon 97 477
TAX LOI
BLOCK:SUBDIVISION
PHONE
ZIP:STATE:
OWNER:
ADDRESS:
CITY:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ADDRESS EXPI RES PHONECONTRACTOR'S NAME
G EN ERAL:
PLUMBING:
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
\R.\\o
WATER HEATER:RANGE:
# OF BDRMS
* OF UNITS:ZONING CODE:
FLOOD PLAIN:
SECONDARY HEAT
SQUARE FOOTAGE:
OCCY GROUP:
# OF STORIES
OUAD AREA:
r OF BLDGS:
LAND USE:
""'\\\T
CONSTFI. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. This is a24 hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspectionS requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
cover-
Final Plumbing - When all
plumbing work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.Eleclrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When all
mechanical work is complete.
Footing - After trenches are
excavated.Fireplace - Prior to facing
materials and framing lnsp.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.Framing - Prior to cover.
Foundation - After forms are
erected but prior to concrete
placement.
Other
Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to filling trench.l---l Drywall - Prior to taping
MOBILE HOME INSPECTIONS
Underlloor Plumbing / Mechanical
- Prior to insulation or decking.Wood Stove - After installation.
Post and Beam - Prior to floor
insulation or decking.lnsert - After fireplace approval
and installation of unit.
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prior to filling
tren c h.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Line - Prior to filling
trench.
Fence - When completed.
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Rough Plumbing - Prior to
cover.
ro\.\1{\
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r
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Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L.HSE GAR ACC
N
S
E
BUILDING PERMIT
ITEM SQ. FT.
Main
X $/SQ. FT.VALUE
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee (A)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express cond jtion that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid
Receipt Numbe
Received By:
Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMB!NG PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
N0
FT.
FT.
FT.
Plumbing Permit
State Surcharge
Total Charge (c)
ADDITIONAL COMMENTS
t-
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan N0
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
Mechanical Permit
lssuance
State Surcharge
Total Permit (D)
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther 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 f urther certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each 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 con
Sig natu re
Date
4
ction
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
VALIDATION:
RECEIPT NUMBER 4w4s
DATE PAID
AMOUNT RECEIV
RECEIVED BY
-]S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OFI ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the H istorical
Coordinator prior to permit issuance.
APPROVED:
C'TY OF
225 FIFTB STRBET
sPRrNcFrELD, oREGoN 97477
INSPBCTION REQIESTT 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALI"ATION
),t'15 lJ,tnrrvr lrC[u'er.
IJGAL DESCRTPTION
o
" JOB
Permits are non-transferable and expireif vork is not started within 180 daysof issuance or if vork is suspended for
180 days.
2. CO}TIRACf,OR INSTALI.ATION ONLY
J
ELECTRICAL PERHIT APPLICATION
City Job Number
3. COUPI,ETB FBE SCEEDUI-E BELOS
A. Nev Residential-Sing1e or
MuIti-Family per dvelling unit.
Service Included:Items Cost,
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portionthereof $ 15.00
Each Hanuf'd Home or
-Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations or
Relocat ion:
200 amps or }ess
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect 0n1y
C. Temporary Services or Feeders
Installation, Alteration or Relocation
Sum
Electrical Contracto
Address P.O,
ci Phone 'l+l -AAZ6
Supervisor License Ndmber l68bS
Expiration Date lo-i-qL
Constr Contr. Number M8+1
Expiration Oate g - l*91-
Signature of Supervislng Blectrlcian
f\
Owners Name P
'Cf S €-trlatuo ',CIrrs.
ilex $ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
a
200 amps or less $ 40.00
Over 401 to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see rrB[ above
Address 1l'15
cit Phone 't4b'l'(33
OIINER INSTALI.ATION
The installation is being made on
property I ovn vhlch is not intendedfor sale, lease or rent.
0vners Signature:
DATE:
RECEIPT *:
RECEIVBD BY:
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit I $ 35.00 trircAEach Additional
Circuit or vith Service
or Feeder Permit I S 2.00 A,Aa
E. Hiscellaneous (Service/feeder not included)
-Each installation
Ptrmp or irrigation
Sign/0utIine Lighting-
Limited Energy/Res
Limited Energy/Comm
SIETOTAL OF ABOVB
5Z State Surcharge
TOTAL
&x-.
$ 40.00
$ 40.00
$ 20.00
$ 36.00
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38.85