HomeMy WebLinkAboutPermit Mechanical 1992-07-30sP FIELT)
RESIDENTIAL
PERMIT APPLICATION
lnspections: 7:'(l-3769
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LOCAI ION OI I JROPQS TD WOR
ASSESSOTlS I,IAP:
JoB NUMBE "
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225 Fif th Strect
Springlield, Oregon 97477
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TAX LOT
BLOCK:SUBDIVISIONLOT _ ___
OWNER: - -
ADDRESS: -
CITY: --- -,
PHONE
?ot
ZIP: --
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ADDITION DEMOLISI1 OTHER
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W itr^ Ai ( Co r..
NEW
DESCRIBE woRK: - I" d
CENEFIAL:
I'l.tJMl:llNG.
MECIIANI(.:A I..:
ELEC'I'RlC/iL-:
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N DDNEI]S EXPIRFS PilONtlCONINACIOII'S NAMT
CONST.
CONTRACTOR /
OUAD AREA:
* OF BLDCS:
OCCY GNOUI'
_ OFFICE USE _
LAND USE:
# OF UNITS
FLOOD PLAIN:
ZONING CODE:
* OF BDRMS:
SECONDARY HEAT:-
Final Plunrbing - When all
plumbing work is cornplete.
# OF STORIES:
--WATER HEAIER RANGE:SOUABE FOOTAGE:
Torequr:stanirtspectirrn,you!-nustcal!726-3769.Thlslsa?4 l'rovr recorcling Alljnspectionsrequestecl hefore7'00a.m.will be
macle the sanre working day, inspections requested after 7:OO a.m. will be made the following work day.
REOUIRED INSPECTIONS
Temporary Eleclric Rough Mechanical - Prior to
over.
l-l Watcr Line - Prlor to lillirrg l-l Fence - Wlren completed.U trench.
Site lnspection - To be rnade
af ter ext;avatiorr, l>ut prior to
setting Iornrs.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - Afler trenches are
excaval()d.
Masonry - Steel location, bond
bealils, grouling.
Foundation - A{ter fornrs are
erecle(l but prior to concrete
placentL.n t.
Underground Plumbing - Prior
to fillirrg trench.
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.
Post arrd Beam - Prlor to floor
insulatrt-rn or decking.
Floor lnsulation - Prior to
deck i ng.
Sanilary Sewer - Prior to f illing
trench.
Storrn Sewer - Prior to filling
trenr;tr.
Rouglh l)lumbirrg - Prior to
cover
ft;
l-_l DrVwall - Prior to taping
Wood Slove - Af ter installation
lnserl - After fireplace approval
and lnstallation of unit.
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Sidewalk & Driveway - After
excavation is cornplete, forms
and sub-base nratt-rial in place.
Street Trees - When all required
trees are planted.
ugh Electrical - Prior to
ver
Eleclrical Service - Must be
approved to obtain perfi]anent
electrical power.
Flreplace - Prior to facing
rnaterlals and framing lnsp.
Framing - Prior to cover
Wall/Ceiling lnsulation - Prior to
cover,
-d Finat Etectrical - when all
,J erqrtrical work is coml)lete.
,X Final Mechanical - When all
mechanical work is complete.
Final Building - When all
required inspections have becn
approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When alt
blocking is complete.
Plumbing Connections - Wherr
home has been connected to
water and sewer.
Eleclrical Connection - When
blocking, set-up, and pltrmbing
inspections lrave been approvc.d
and the honre is connectcd to
the service panel.
Flnal - After all rerluireri
inspections are approved and
porches, skirting, decks, and
venting have been installed.
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CONSTR. TYPE:
HEAT SOURCE:
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Lot laces
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
J I'HE PROPOSED WOFIT( IN THE
._i]ISTORICAL DISTRICT, OR ON
THE HISTORICAL FIEGISTER? --lf yes, this application must be signed
and aPProved bY the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Tl'ris permit is grantecl on the express condition that the said
consiruction 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 revokecl at any tirne
upon violation of any provisions of said ordinances'
DatePlans Heviewed BY
Plan Check Fee: ---
Date Paid
FleceiPt Number:-
Received BY:
VALUE
(A)
BUILDING PERMIT
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
Systems Development Charge is clue on all trntleveloped
properties within the City limits which are being improved'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
SanitarY Sewer
Water
Storm Sewer
Mobrle Home
PLUMBING PERMIT
FEE
N0
FT.
FT.
FT.
(c)
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
MECHANICAL PERMIT ./21//t/ /{,*
oo
Mechanical Permit
.7r
? f 7r
(D)
orc
N0
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct' and I f urthcr certify
that any and all work performed shall be done in accordance
withtheordinancesoftheCityofSpringfield,andtheLaws
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 further certi{y thar only contractors and ernployees who
are ln compliance with ORS 701'055 will be trsed on this
proiect.
e to ensure that all reguired inspections are
he proper time' that each address is readable
that the permit card ls located at the f ront
ancl the approved set of plans will retnain
ignat
Date
site at a tinres during construction
ro
o
I further agre
requested at t
from the street,
of the perty,MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut ._-.---- (t
Demolition
State Surcharge
Total Mlscellaneous Permits (E)
S7 7<
DATE PAID
AMOUNT R
RECEIVED
VALIDATION:
FIECEIPT NUMBER
TOTAL AMOUNT DUE (exclud
(A, B, C, D, and E Comblned)
ing electrical)
=,\\.u\i}- .
/ollowing orot.rnt/]g, anci doesapproval.
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALLATION ONLY
rr;t ns submlted has thenct require specific
PERI{IT APPLICATION
Ci ty Job Nunber
Authorized Signature faorrrr* PEE
'.EEDULE
BELos
A. Nev Residential-Single or
MuIti-FamiIy per dwelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Hanuf'd Home or
Modular Dr.,elling
Service or Feeder
$ 8s.00
$ 1s.00
s 40.00
Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps I401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect Only
Temporary Services or Feeders
Installation, Alteration or Relocation
225 FIFTB STREET
SPRINGFIEIJ, OREGON 97477
INSPECTION REQT BST: 726-3ffip.u
0FPICE: 726-3759
1. LOCATION OF
IJGAL DESCRIPTION
JOB DESSRIPTION
ab
200 amps or less
201 amps to 400 amps
-0ver 401 to 600 amps _0ver 600 amps or 1000 volt
st"uNGFtt:LO
SUBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
Sum
s see rrgrr
"f,ffi
Electrical Contractor
Address
e{ S eo,otirn ,..fto
B
c
s s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
s ss.00
$ 80.00
cit Phonel(! 4A36
Supervisor License Number tht6 3
Expiration Date lO - l- g )-,
constr Contr. Number Ojglq
Expiration Date Q -l-92-.
Signature of Supervising Blectrician
Ovners
Address
Name
cit Phone
OVNER ALLATION
The installation is being made onproperty f ovn vhich is not intendedfor sa1e, Iease or rent.
Ovners Signature:
D. Branch Circuits
Nev, Alteratlon or Extension Per Pane1
one circuit I s 35.00 35',OOEach Addi tional
Circuit or vith Service
or Feeder Permit _ $ 2.00 _
Miscellaneous (Service/feeder not iniluded)
-Each installation
Pump or irrigation $Sign/Outline Ligtrting- $Limited Energy/Res
-
$
Limi ted Energy/Comm S
E
5
00
00
00
00
40.
40.
20.
36.
DATE:
RECEIPT
OF OREGOTU
RECEIVED BY:
3 o
5