HomeMy WebLinkAboutPermit Mechanical 1998-07-14RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office:726-3759
SPFrINGFIELD
LOCATION OF PROPOSED WORK:&E5o o
ASSESSORS MAP:i1 6321 q Ll
LOT BLOCK:
&fi,
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
TAX LOT:/23 cl-oo
e
SUBDIVISION:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
--
PHONE:
77 Y17ZlPi
U/T(-f-l-C (L
8rz,t
Gtrfe
o
e--t
6l
oR.
ENNOWNER:
ADDRESS:
DESCBIBE WORK:
CITY:STATE:
ADDRESS
opL€
EXPIRES ,S PHONE
to 1t -7{ 7L(6 *t6"1
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOB #
GENERAL:
PLUMBING
1
FLOOD I)LAIN:
# oF uNrrs, NOTICE:
PERMI SHATI
THIS PEBhlIil
- OFFICE USE -
HEAT:
SOUARE- FOOTAGE:WATER HEATER:RANGE:
OUAD AREA:
r OF BLDGS:
LAND USE:
OCCY GROUP:
E OF STORIES:
CONSTR. TYPE
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ts a 24 hour recordlng. All lnspections requested before 7:oo a.m. wlll bemade the same worklng day, lnspections requested after 7:00 a.m. wlll be macle the followlng work day.
REOU ED INSPECTIONS
[---l Temporary Etectric h Mechanical - Prior to I--l Flnal Plumbing - When ail
'J plumblng work ls complete.
Slte lnspectlon - To be made
alter excavation, but prior to
settlng forms.
Rough Electrical - Prior to Flnal Electrlcal - When allcover.rlcal work is com plete.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Eleolrical Servlce - Must echanlcal - When all
approved to obtaln
electrlcal power.
work ls complete.
Footlng - After trenches are
excavated.Flreplaco - Prlor to faclng
materlals and framing lnsp.
Flnal Buildlng - When ail
requlred lnspectlons have been
approved and building is
completecl.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prior to cover.
Foundatlon - After forms are
erected but prlor to concrete
placemont.
Other
Wall/Celling lnsulatlon - Prlor to
cover.
[l Underground Plumblng - prior
'J to filling trench.Drywall - Prior to taplng
Underlloor Plumblng/ Mechanlcat
- Prior to lnsulatlon or decklng.
MOBILE HOME INSPECTIONS
Wood Stovo - After lnstallailon.
Post and Beam - Prlor to floor
lnsulatlon or decking.J-_] lnsert - After flreplace approvalH and lnstallatlon of unlt.
Tl Blocking and Ser.Up - When ail
-
blocklng ls complete.
Floor lnsulation - Prior to
decking.Curbcut & Agrproaclr - After
forms are erected but prior toplacemont of concrete.
Plumblng Connectlons - Whenhome has been connected towater and sewer.
Sanitary Sewer - Prior to fllllng
trench.
Slorm Sewer - Prior to fllling
trench.
Sidewalk & Drivewav - After
excavation is complete, forms
and sub-base material in place.
Eleclrlcal Connection - Whenblocking, set-up, and plumbing
lnspections have been approved
and the home is connected tothe service panel.
l--l Water Llne - Prtor ro fiiling
'J trench.l--l fence - When coiitpteted.
Slr€el Tr€es - When all requlred
trees are planted.
Final - After all required
inspectlons are approved andporches, sklrtlng, decks, andventlng have been lnstalled.
Rough Plumbing - Prior to
cover.
?rotrt t
E E
E
fl
E tl
l:'j . :\
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Typr
Y
-
lnterior
-
Corner
-
Panhandle I
-
Cul-de-sac
.S THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPBOVED:
P,L,HSE GAR ACC
N
S
BUILDING PERNIIT {
VALUE
(A)
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
ITEM
Main
Garage
Carport
SO. FT. X $/SQ. FT.
BUTLDING IALUE, PTRITI CHECK
AND BUILDING PERMIT
This permit is granted on the express condition 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.
Plans Reviewed By Date
Receipt Numbe
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties within the City limits which are being improved.
ITEM
Flxtures
Besidentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
l€, oo
D
(D)
No
S
Vent Fan
Mechanical Permlt
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
2LTD
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true ancl correct, and I f urther certlfy
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 perlainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Building Safety Division.
I further certily that only contractors and employees who
are in compliance with ORS 701.055 will be used on thls
proiect.
I {urther agree to ensure that all required lnspections are
requested at the proper tlme, that each address ls readable
lrom the street, that the permlt card ls located at the front
h
(-7 t
i)
(rv'on.
Slgnature
Date
of the pro and the app set of plans will remaln
on the site I times {9tl
Oo
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
/1t'
-Ld
VALIDATION
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
ET
'7b{
FT.
FT.
L
*ffitr'iE(d
726-37 69
1 ON OF TION
LEGAL S sitl
J DE PTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
Expiraiion Date
.,-rrojoct r:s Gubmaod he.,i,l.ru r-lot roquho opooffio h,
SPFIIqGFIELO
EItr PERMIT APPLICATION
\dsuN unber 0
CEEDULE BELOV
Residential-Single or
ti-Family per dvelling unit.
vice Included:
Items Cos t
$ 8s.00
$ 1s.00
$ 40.00
1000 sq.ft. or less
Each additional 5OO
sq. ft or portion
thereo f
Each Manuf'd Home. or
-Modular Dvelling
Service or Feeder
s s0.00
s 50.00
s100.00
s130.00
s300.00s 40.00
C
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
(
225 FIFTE STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE:. 726-3159
Constr Contr. Number 2o-tLl
Exp irarion our" lO 'I'9 8
Signa ture of Supervising Electrician
Ovners Name fi'l wi n c P-nn e'',t'
tn nNY
Pf:B\OtU't5er
Sum
2. CONTRACTOR INSTALI,.ATTON ONLY B. SCTViCCS OT FECdCTS
Installation, Alterations
Erectrical contrac,"' RU i defS Etfttff'C lfp6. ReLocation:
Address 95 tsD.l 200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601, amps to L0O0 amps_
0ver 1000 amps/vo1ts
Reconnect 0n1y
Ci ty Phone 4 z3*
Supervisor License Number glp -S
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps"or less S 40.00
over 40L to 600 amps
-
$ 80.00
Over 600 amps or lb0O-volts see rrgrr uffi!-
Address Z<@ tuq-SAFI
Ci ty
*tt*-
OIINER TNSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
onecircuit ) $35.00
Each Additional
Circuit or vith Service
or Feeder Permit I $ 2.00
-\Phone
boc
2u)
E. MisceLlaneous (Service/feeder not included)
-Each installation
Pump or irrigation S
Sign/0utline t ighting- S
Limited Energy/Res $
Limited Energy/Comm S
40.00
40.00
20.00
36.00
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTALRECETVED B
5
7<
68\S