HomeMy WebLinkAboutPermit Mechanical 1995-07-27BK:
BLOCK:
7 S/ZS 7
PRINGFIELO
LOT:
JOB NUMBER
LOCATION OF PROPOSED
ASSESSOBS MAP:
RESID ENTIAL
PERMIT APPLICATION
lnspections: 720.3709
Offlce: 726.3759
TAX LOTI
SUBDIVISION,:-
%
225 Filtlr Street
Springfleld, Oregon 97477
OWNER;
ADDN
CITY:
PHONE:
STATE:ZIP:
NEW --*-. IIEMODE,L*----. ADDITION DEMOLISH
DESCRIBE WORI(
OTHER
CONST.
CONTRACTOR #ADDRESS EXPIRES PHONE
CONTRACTOR'S NAME
ELECTRICAL
M EC HAN ICA L:
G EN ERAL:
PLU M B ING
- OFFICE USE -
LAND USE;QUAD AREA:
e OF BLDGST
SECONDABY HEAT:
SQUARE FOOTAGE:
r OF BORMS: _
OCCY GBOUP:
C OF STORIES:
ZONING CODE:
FTOOD PLAIN:
CONSTFI, TYPE:
HEAT SOUBCE:
'{ OF UNITS: _
WATER l-iEATER:_-.*BANGE:
To request an inspectlon, you must call 726.3769. Thlmade the sante werl(ing day, lnspections requested
l*l Ternporary Etecrric
s ls a 24 hour recordrng' A, Inspectrons requestecJ berore 7100 a.maf ter 7:00 a,m, wlll bo macle the tollowlng work day.
REQUIRED INSPECTIONS
wlll be
Slto lnspectlon - 'Io be rnadoafter excavation, but prior toSotting lorilrs.
Underslab plumbing / Electrical /Mechanlcal - prioi to cover.
Rough Mechanlcal - prior tocover,
Rough Electrlcal - prior tocover.
Electrlcal Servlce - Must beapproved to obtaln permanent
olectrlcal power,
Flreplace - prlor to faclngmaterlals and lramlng lnsI
I*l Framlng - prlor to cover,
Wall/Colllng lnsulatlon - prlor tocover,
FInal Plumbing - Whon ailplumblng wgrk ls complete.
l--l flnat Electrlcat - When ail
-
etectrlcal work ls complete,
f(),frnd Mecharrtcat - When ail.* mechanlcal work ls complete.
Foollng - Af ter trenches are
exc avated.
[*l fUasonry - Sreel tocatton, boncJ
-
beams, grouting,
Foundallon - After forrls slserected but prior to concreteplacemen l,
Undergrour.rd pluntbing - prior
to filllng trench,
Underlloor plumblng / Mcchanlcal
- Prlor to lnsulatlon or decklng.
Post and Bearry. - prior to floorinsulatlon or decklng.
Floor lnsulation - prior to
dec ki n g,
Sanitary Sewer - prior to fllllngtrench.
Storm Sewer - prior to filllng
trench.
Water Llne - prlor to fillinglrench,
Rough Plurnbing - prior to
cover.
Flnal Buildl n9 - When allrequlred lns pec tlons have beenapproved and bulldlng iscompleted
Drywall - prlor to taplng.
Wood Stovo - Afler lnstallatloh.
lnsert - After flreplace approvaland lnslallatlon ot unlt. : '
Curbcut & Approaclr - Afterlorms are erected but prlor toplacomont of concret(r.
Sldewalk & Drlveway - Af terexcavatlon ls completo, formsand sub.base materlal ln place.
Fenco - Whgn completed.
Stroot Troes - When all requlredtrees ara plantod,
flo,n,,
MOBILE HOME INSPE TIONS
I elocking and Sot.Up - When ail
-
blocklng ls complete.
Plumbing Connectlons - Whenhome lras been connected towater and sewer,
Electrical Connection - Whenblocking, set.up, and plumblnglnspoctlons have been approvedand the home ls connected tothe servlce panel.
Final - After all requlredlnspectlons are approved andporches, skirilng, decks, andventlng have been lnstalled,
r
r
il
tl
E
Lot faces
Lot sq. fto,
Lot coverage
Topography
Total helght
Lot Typo +
-
lnterlor
-
Corner
-
Panhandle
.- Cul.de.sac
S ,, -S THE PFOPOSEO WOBI( tN THE
HISTORICAL OISTRICT, OR ON
THE HISTORICAL FIEGISTER? --lf yes, thls applicatlon must be signedand approved by the Historlcal
Coordlnator prior to perrnit issuance.
APPROVED:
P.L.HSE GAR ACC
N
S
E
VALUE
(A)
BUILDING PERMIT
Total Valie
Bullding Permit Fee
State Surcharge
Total Fee
SO. FT. X $/SO. FT,ITEM
Main
Garage
Carport
BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT
Thls permit is grantecJ on the cxprcss corlclitiorl that the saidconstruction shall, in all respects, confo'm to the Ordinanceadopted by the City of Sprirrgfielcj , includtng theDevelopment CocJe, regulating the coDstruction and use ofbulldings, and may l)c suspended or rcvol(ccJ at any timeupon violation of arry provisions of said ordinances.
Plan Check Fee: ----_
Recelpt Nurnbcr:-___ _.
Plans Rcviewecl 13y Date
Date Pald:
Received By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmcnt Charge ls cjuo on all undeveloped
properties within the City linrits whiclr are bcing inrproved.
ITEM
Flx t u res
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
N0
FT.
FT.
FT.
( \,)
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
(D)
Mechanlcal Permlt
lssuance
State Surcharge
Total Permlt
By slgnature, I state ancJ agrce, that I have carcf ully examlned
the completed app|cailon and do hereby coril fy that all
lnformatlon hereon is true ancj correct, ancJ I f urther cerilly
that any and allwork performed shall bc done in accordance
wlth the Ordinanccs of thc Clty of Sprlngf ield, and the Laws
of the Stato of Oregon pertalnlng to thc work descrlbed
hereln, and that NO OCCUPANCy wiil be mado of any
structure wlthout perrnission of the BullrJirrg Safety Dlvislon.
I further certlfy that only contractors and employees who
are ln compllance with ORS 701.05S wlil be used on this
Prolect.
I {urther agree to ensurc that all requlrecl lnspections are
requested at the proper Ume, that each adcjress ls readable
from tho street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
slle at all tlmes durlng constructlon
Date
o
7-2e
atu re
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut ' ft
Demolltlon
State Surcharge
Total Mlscellaneous Permlts (E)
TOTAL AMOUNT DUE (excluding clectrlcal)
(A, B, C, D, and E Comblned)
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
2
Zo
u
zoniii-.. ..'.,.: rr)es not roquire spe._dic la, td useapl)rovx,.
sPlltwGFtELO
EI,ECTB.ICAL PERHTT APPLICATTON225 FIFTH STREET
SPRINGFIELD OREGON 97
INSPECTION REQIIEST: 7
OFFICE: 726-3759
?
Authori;ed Si
rob Nunbe.q5 i2ZlCity
SCEEDTIIJ BELOV
New Residential-Single or
Multi-Family per dvelling unit.
Service Included:
ftems
isFl'tiXJIJt';-\i"*A
Ost.a6b
r JOB DESCRIPTION
q&s
Yermits are non-trArtsferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspen?ed for
180 days.
2. COMRACTOR INSTALI,ATION ONLY B
Electrical Contrac,orNL!": L.-,O.rr LLt&
Address\lCf 1;, LIL:L
d
Ci ty [11(1-L rLe ptrone Le E,Lc--d.itoS
Cos t
$ 8s.00
Sum
200 amps or less
201 amps to 400 amps
-40L amps to 600 amps
-60L amps to 1000 amps-
0ver 1000 amps./voIts
-Reconnect 0n1y
Supervisor License Number *}JPJ S
Expiration Dat e/O ?c
Constr Contr. Number & ^ I 9SC
Expiration Date
sing Electrician
r11
0vners Name
Phone
o*L[r*rrALLArroN
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
DATE:
-__T__
1000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Manuf 'd llome or
-Modular Dvelling
Service or Feeder
Services or FeedersInstallation, Alterationsor Relocation:
$ 1s.00
$ 40.00
$ 40.00
s ss.00
$ 80.00
see trBil aEve
$ s0.00
s 60.00
$ 100. 00
$130.00
$300.00
$ 40.00
c Temporary Services or Feeders
InstalIation, Alteration or Relocation
D
200 amps or less
201 amps to 400 amps
-Over 401 to 600 amps
0ver 600 amps or 1000Eris
Branch Circuits
aa6'"""&8 L{CoDLfWE
city]1n lJ-&
Nev, Alteration or Extension Per Panel
One Circuit \ $ 35.00 ryEach Additional
Circuit or vith Serviceor Feeder Permit ,$ 2.00
E Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $Sign/Outline Lighting- $Limited Energy/Res
-
$Limited Energy/Comm S
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
0 f-
40.00
40.00
20.00
36.00
EO5
S
RECEIVED