HomeMy WebLinkAboutPermit Mechanical 1993-07-21SPrrINGFIELD
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
O(f ice: 726-3759
LOCATION OF PRO
ASSESSORS MAP:
LOT:BLOCK:
To request an inspection, you mLlst call 126-3159 This is a 24 hour recording. All ins pections requested before 7:00 a.m. will be
JOB NUMBER
225 Fifth Street
Springtield, Oregon 97 477
TAX LOT:
SUBDIVISION
made the same working day, inspections reques ted after 7:00 a.m. will be made th e following work day.
EQUIRED INSPECTIONS
Temporary Electric I'Rough Mechanicat - prror tocover.plu
al Plumbing - When allmbing work is complete.
Site lnspection - To be made
af ter excavation, but prior tosetting forms.
I Unaerstab ptumbing/Electricat/
-
Mechanical - prioi to cover.
Rough Electrical - prior tocover.
cover.
Wood Stove - After installation.
,rl Final Electrical _ When ail
-
electrical work is complete.
Final Mechanical - When allmechanical work is complete.
Final Building - When ailrequired inspections have beenapproved and building iscompleted.
Electrical Service - Must beapproved to obtain permanentelectrical power.
Fireplace - prior to facingmaterials and framing lnsp.
Framing - prior to cover.
Wall/Ceiling lnsulation _ prior to
Footing - After trenches areexcavated.
Masonry - Steel location, bondbearns, grouting.
Foundation - After forms areerected but prior to concreteplacement.
[-l Underground plumbino
- prinru to filling trench [-_l orvwall - prior to taping.
Underlloor plumbing / Mechanical
- prior to insulation or decking.
Post and Beam - prior to floorinsulation or decking.
Floor lnsulalion - prior todecking.
Sanitary Sewer - prior to fillingtrench.
Storm Sewer - prior to fillingtrench.
MOBILE HOME TNSPECTIONS
[-l Btocking and Set.Up _ When ail.J blocking is cohplete.
Plumbing Conneclions _ Whennome has been connected towater ahd sewer.
l-nsg1t - After fireptace approvatand tnstallation of unit.
Curbcut & Approach _ Afterlornts are erected but prior toplacement of concrete.
Sidewalk & Driveway _ Afterexcavation is complete, formSand sub-base matenal in place.
Fence - When co!"npleted.
Eleclrical Connection _ When
:-,9:ki19, set_up, and plumbingrnspections have been approvedand the .home is connected torne service panel.
PHONE:
ie (4
STATE:ZIP:
(to
o
9 797o
OWNER:
ADDRESS:
CITY:
NEW
-
REMODEL ADDITION DEMOLISH
a*4 q
OTHER
&', sta-(/ ^'/'4 4 d4 *a7trr1ec1krDESCRIBE WORK:
k^9 Z4&
ADDRESS EXPIRES PHONE
S"'y_6
/o {dr tl-M.q
CONTRACTOR'S NAME
ELECTRICAL
CONST.
CONTRACTOR ,
GENERAL:
PLUMBING
.{PII-Yt _ OFFICE USE _
# OF BDBMS
LAND USE:
# OF UNITS
FLOOD PLAIN:
ZONING CODE:
SECONDARY HEAT
SQUABE FOOTAGE:
OUAD AREA:
C OF BLDGS:
CONSTR. TypE: -_-
HEAT SOURCE:
RANGE:
OCCY GROUp: =-=_
WATER HEATER:-
# OF STORTES: .--
$i*r,.l Ptumbins - Prio!.to Street Trees - V/hen all requiredtrees are planted.
Final - After all requiredrnspections are approved andporches, skirting, decks, andventtng have been installed.
tV) r(
y'r', /a^z{,o
/7qb -?. C, 1,1rrh r( #
MECHANICAL:
f-l Water Line - prtor to filtino'.---J trench. -' -- """'v I I
N
C
Lot faces
Lot sq. ftg.
Lot coverage
TopograPhY
Total height
Lot Type'-
-
lnterior
--
Corner
-
Panhandle
-
Cul'de-sac
Setbacks
HSE GAR ACCP.
-IS THE PFIOPOSED WOAK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-=-lf yes, this application must be signed
ancl aPProved bY the Hislorical
Coordinator prior to permit issuance'
APPROVED:E t_
BUILDING VALUE, PLAN CHECK
Anp BUILDING PERMIT
This perrnit is gr;rnted on the express condition that the said
construction shall' in all respects' conform to the Ordinance
;;;;i;J tv tire Citv of Sprinsfield' includins the
Developnrent Co<Je, regulating ine construction and use of
[r,lo,"!t, and may be"suspended or revoked at anv time
Ipon ,iorntion of any provisions of said ordinances'
DatePlans Flcvi ewed BY
Received BY:
Plan Check Fee:
--
--
Datc Pai.l:
FleceiPt Number: - -
BUILDING PERMIT
VALUE
(A)
SQ. FT. X $/SO. FT.ITEM
Main
Garage
Carport
Total Value
Buil<Jing Permit Fee
State Surcharge
Total Fee oevei pedUndnaUdeCnhargVCMCDeopenlsSysmnbeiprovedhhcaresmlncIrtylrESpeproSYSTEMS DEVELOPMENT
(B)
CHARGE (SDC)
ADDITIONAL COMMENTS
PLUMBING PERMIT FEE
-?t
N
FT.
FT.
FT.
(c)
Plumbing Permit
State Surcharge
Total Charge
ITEM
Fixtures
Residential Bath(s)
SanitarY Sewer
Water
Storm Sewer
Mobile Home,
Wood Stove/ lnsert/ Fi replace Unit
MECHANICAL PERMIT
N0
DrYer Vent
(D)
Fu rnace
Exhaust Hood
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
By signature, I state and agree' that I have carefully examined
the completed applicatiJn unO do hereby certify that all
information hereon is true and correct' and I f urther certify
that any and all work pertormed shall be done in accordance
with the Orclinances of the City of Springf ield' and the Laws
oftheStateoforegonpertainingtotheworkdescribed
herein, and that NO OCCUPANCY will be made of any
StruCtUrewithoutpermissionoftheBuildingsafetyDivision.
I furtl'rer certify that only contractors an<J -employees
who
are in compliance with ORS 701'055 will be used on this
proiect.
re that all requirecl inspections are
Signatu
Date
I further agree to ensu
time, that each address is readable
requested at the ProPer
mit card is located at the f ront
from the street, that the Per
roved set of Plans will remain
of the ProPerty, and the aPP
ng constructionuIion the site at all timesMISCELLANEOUS PERMI
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
tl
Curbcut
-
fl
Demolition
State Surcharge
(E)
TS
Total Miscel laneous Permits VE
RECEI PT NUMBER --
VALIDATION
RECEIVED
DATE PAiD,--
AMOUNT REC
TOTAL AMOUN
(A, B, C, D' and
T DUE (excluding electrical)
E Combined)
tS
C'TY OF SPR"VGFIELD,OREGO'U
:iPR!,{GFIELD
225 PTYTB STRBEf,
SPRTNGPTBLD, ORBGoN 97477
INSPBCTI0N REOIIBST: 726-3
OPFICE: 726-3759
ELECTRICAL PERT{IT
f\Art
City Job Nunber
natu$ft *ggUtgri_tpE,ScBBDIILE BELoII
(
1
Permits are non-transf and expire
lf uork is not started vlthin 180 days
of lssuance or lf vork ls suspended for
180 days.,
2. CO}TITACTOR INSTALI.ATION ONLY
Electrical Cont ractor /oltf:tt3,ti. /O
Address 4 2 oz ''J 5 Zl
ci Eu 0 rl/Phone 3'/'/ - 2L/ , /
Supervisor License Number a.//'2rtr/
Explratlon Date lo't - 1z
Constr Cont r. Number 7.7€" L.lul, s
Explration Date lo-/-qs
of Supervising Electrician2\ --) o.tZttttt-'
0vners Name 6u / f urtl/sy'
Address 3oz{ /oll"724
s/tf4tfrerl phone 7/6-t707
Nev Residential-Single or
HuIti-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each addltional 500
sq. ft or portlon
thereof
Each Hanuf'd Home or
-Hodular Dwelling
Servlce or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
A 7
Sum
B
Slgnature
1-r-
c.
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
B. HisceLlaneous (Service/feeder not included)
STIBTOTAL OF ABOVE
5Z State Surcharge
TOTAL
Temporary Services or Feeders
Installation, Alteratlon or Relocation
200 amps or less $ 40.00
Over 401 to 600 amps S 80.00
Over 600 amps or 1b00 voTts see uB" a56ff
Ci ty.
OSNER INSTALI,ATTON
The installation is beirig made on
property I ovn vhich is not intended
for sale, lease or rent.
Ocners Slgtature:
DATE:
$ 40.00
$ 40.00
$ 20.00
$ 36.00 m
5
RBCEIVBD
rc
I
200 amps or less $ 50.00
201 amps to 400 amps
-
$ 60.00
401 amps to 600 amps
-
S1oo.o0
601 amps to 1000 amps- 5130.00
over 1b00 amps/volti $300.00
Reconnect 0n1y $ 40.00
-Each installation
Pump or irrigation
Sign/outline Light ing-- z Limited Energy/Res
Limited Energy/Comm _-
I