HomeMy WebLinkAboutPermit Mechanical 1998-11-23RESIDENTIAL
PERMIT APP ON
lnspections:
Office: 726-3759
SPRII\rGF!ELE,qfrt"lfl
%ty,
JOB NUMBER
225 Fifth Street
Spring(leld, Oregon 97477
LOCATION OF PROPOSED WOFIK:/26 z fizr 7//
ASSESSORS MAP:t703zc7 7
LOr BLOCK:SUEDIVISION
/lt'Co PHONE:
7vz7STATE:ZIP:
7
5
6
2
c
7 z(-
CITY:
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
'Ly.l (/C*f /0DESCRIBE WORK:
ADDFIESS
sal r7z-C
EXPIRES ,t PHONE
/-4
CONTRACTOR'S NAME
GENERAL:
ELECTRICAL:
MECHANICAL:
PLUMBING:
CONST.
CONTRACTOR #
To req
made
uest an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requested before 7:00 a.m. w,t bethe same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
UI RED INSPECTIONS
Mechanlcal - Prior tol--l remporary Etectrtc l--l finat ptumbing - When alt|J plumbing worl( ls complete.
l--l Masonry - Steel locatlon, bond
-
beams, groutlng,
Slte lnspectlon - To be made
alter excavatlon, but prior tosetting lorms.
Underslab Plumblng/ Electrical /Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Foundatlon - After forms are
erected but prlor to concreteplacemont.
Post and Beam - prlor to floorlnsulatlon or decklng.
cover.
Electrical Servlce - Must beapproved to obtain permanent
electrlcal power.
Final Eleclrical - When allelectrical work is complete.
F Mechanical - When allical work is complete.
Flnal Buildlng - When ailrequired lnspectlons have beenapproved and building is
completed.
er /rrug
MOBILE HOME INSPECTTONS
Plumbing Connections - Whenhome has been connected towater and sewer.
E Wall/Celling tnsulatlon - prlor
cover.
Wood Slovo - After lnstallation.
Sidewalk & Driveway - Afterexcavation is complete, forms
and sub-base material in place.
Electrical Connection - Whenblocking, set-up, and plumbingInspections have been approvedand the home is connected tothe servlce panel.
E ,'r'ffiifl;"1[:J#-tlns - Prror [l Drywau - prior to tapins.
l--l Unaerltoor plumblng/Mechanlcat
Prior to lnsulailon or decklng.
lnserl - After flreplace approval
and installation ol unlt.
[-_l Blocking and Ser.Up - When ail.J blocklng ls compleie.
Floor lnsulation - prlor to
decking.Curbcut & Approach - Afterforms are erected but prior toplacement of concrete.Sanitary Sewer - Prior to fllling
trench.
l-_| Storrn Sewer - prtor to fililng|J trench.
E llj**lne - Prlor to filllns n Fence - when cornpteted
l-l Rough Plumbtng - prlor to,J cover.Streel Trees - When all requlred
trees are planted.
Final - After all requiredinspections are approved andporches, skirting, decks, andventlng have been lnstalled.
'i,
rAx Lor ?OS )
[-l Rough Etectricat - prior tor--J cover. L_l
tl
[l Flreplace - prtor to factng
-
materlals and framing lrrsp.
I-l Framlng - prlor to cover.
II
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Typt _
-
lnterior
-- Corner
.- Panhandle
-
Cul-de-sac
IS THE PROPOSED WORK TN THE
HISTORICAL DISTRICtr, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
APPBOVED:
PL.HSE GAR ACC
N
S
E
BUILDING VhIUE, iiUTt 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
ouildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Receipt Number:-
Plans Fleviewed By Date
Plan Check Fee:
Date Paid
Received By:
VALUE
(A)
fMrr
Total Value
Building Permit Fee
State Surcharge
Total Fee
FT. X $/SQ. FT.
BUILDING PER
ITEM SO.
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
C Atc o
ITEM
Fixtures
Residentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N.
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
. FT.
Wood Stove/ lnsert/Flreplace Unit
tT-oo
(D)
No
6.oo
Vent Fan
Dryer Vent
Mechanical Permit
lssuance
State Surcharge
Total Permlt
Jo,0?qrl tfw
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certlfy that all
lnformation hereon is true and correct, and I lurther certlfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Buildlng Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 wlll be used on thls
proiect.
I further agree to ensure that all requlred lnspections are
requested at the proper tlme, that each address ls readable
f rom the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
on the sile at all times during constructlon.
€Slgnature
Date \r-t:-gI
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
oemolitlon
Slate Surcharge
Total Miscellaneous Permits (E)
I 7
Lo
VAt-IDATION:
BECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
1L/ L
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
OFCITY
: ,r',.{ l0eg nqt {equlltE
0<e L
INSPECTION REOUEST:
OFPICE: 726-3759 4NP
tRa1. LOCATION INSTALI,A n4l"
el
I,EGAL
/? olz-[DESCRTPTTON) 3 oosi/
Permits are non-transferable and expireif vork is not started vithin 1B0 daysof issuance or if work is suspende for
180 days.
2. COMRACTOR INSTALTATION
siPrl =IELO
BLEqTRTCAL PERHTT APPLTCATTON
,/ 5/
Sum
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
-
Modular Dvelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or
201 amps to
401 amps to
601 amps to
Over 1000
Reconnec t
amps/voI ts
Only
c Temporary Services or Feeders
Installation, Alteration or Relocation
aSove
D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit t $ 35.00 3f-
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not included)
-Each instal-lation
Pump or irrigation
Sign/Outline Lighting-
Limited Energy/Res
-Lirnited Energy/Comm
-
I
{t &,{
726-3
Y
BELOg
or
ing uni t.
tems CostI
.00
.00
.00
.00
.00
.00
200 amps"or less $ 40.00
201 amps to 400 amps
-
$ 55.00
over 401 to 600 amps
-
$ 8o.oo
Over 600 amps or 1000 voTts see I'8"
.00
.oo
)
Elec tri
follow rules the Oregon Utitity
AddresAlotification
in 952-001
Ci ty
Supervi
cal the the telephone
U*ititfn+eti+eatior
Expi ra t ion is 1-800-332-2344).
Constr Cont . Number
Expi ra t i Da te
Signature of Supervising Electrician
ovners Nane Day't o ttN/ t p/+ 4CL9J
Address lz Lz 1t/ ?/r,u
Speat C,ty' Phone 1>/-faL 0
less
400 amps
1000 amps
$
$
$r
$r
50
60
00
30r.
$300
s40
Ci ty -/
OVNER INSTALI,,ATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Signature:
DNE:(1.
SUBTOTAL OE ABO\IE
57. State Surcharge
i? ea*i"istrative Fee
TOTAL
$40
$40
$20s36
.00
.00
5
RBCEIVED
js-d
c)
oAR 952-001-
O4
City Job Number q 7t
Service
()3.'lo.'98 r)g: 1' FAL Sr).1{7!I1.33
BI-|.(t HEiTING & t
2777 NE ST TOSEPfr T-
MATINN., OR 97T28
(roil fi?1133 i
LLOI} SMITS
PBOPOSAL
WorI To Ec Pcr{pnmcd At:
ua^u fl--#,1r;).* 4* (*-y*..-..
'/
screes . I Ik 3--.-tl!- ..9-!+-s .*. . .
Phone SYt - ll--!":--Y-Q.k-Q
ScageSp^!,iif"adCicy...oYl-_
--fr.:... .S.{*1'*o* l-\{dnc L-s-. ......
Date of Ptans .S :./Q.--E- e,unicecc
StaceCicy
SEreer
We heraby prop.!r6 ro furnish rhe rnaterials and perforrn che tabor necessary for che complctim of
/O ilo.,* o.t-.-.)***____
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fruosoc /4a_/.?__-.C.Tr+n<__ z 2*b*_r/C_ )
-fu qo-../---o/*lc<
le6/n-4_ for
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f:r^,'rb * .-L--l-rco/
All marerial is guaranreed ro be as specified. and cha above work co bc p.rformed in accnrdanca with Ehe drawings and
specifications submigted for above work and compleEed ln a subscancial workmanlike mlnncr for the sum ot
. Dollar=tS 4/,dZg l.
wiEh paymencs to bE made as follows:
Any rlLrrolton r,r dad:cion frsm *gw tpec'ficarions involyirq orlra
cogEo, wll be errcwsd orly upuil wrrEen orders. end rill bucoina gn
ercrt ch*ga omr lnd obwr: che esrirnace. AII egr€carl<:nrs conriagenr
uDon 6trik!s, aDddElt.J or delays beyond our contrul. Owr.r Eo cirrry
fire, Eo,Trado end olhcr ncoilr3Bry lnsurEner uFjll Blroee rarnrlL WrL-
mm's Cunpensucron t,td Publlc Ljabtriry lnuurtnce on abm wc*, cs bc
talun qut bv
Respecctully submicced
per
#4/aa
Noc*-This prolosal may ba rzichdrawn by us if not accepced
wichin(aQ . days.
//-
aboveThe conditionsandions are to thedo asworkspecifiracpr'iues sacisfacEory specifled.
bewill a5 abovs.ouclinedmadePayment
Oace 3 4 (J
ATtEPTANCE OF PROPOSAL
,b, FoRM 38so oRtGtr{At MADE IN U,S.A
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