HomeMy WebLinkAboutPermit Mechanical 1994-06-21:;t,IilN(it:lELt,
NESIDENl IAL
I'EIIMIT AI'PL'CAI ION
IrtsIrut:llotrr;: /:'(r'370U
OJlice: 7?b'lll'.tl
Locn 11611.1 r)l' l'llo['()iil:l)
ASSE$SO11S ti|AP:
\\1 3 (C
JO8 N('MtJEn
22li l:llllr tiltcol
Slrr lrrg lleld, ()r e11<ttr'J / 47 7
TAX LOT:
SUBDIVISlON:LOT: . ----.. .RLOCI(:
NEW.._--..- NEMODEI. ADDII'ION DEMOLIS}I OTHER
PIIONE:fb
r(L <-
+o
f-bs-e
DESCRIBE WORI(;
S'IATE:
OWNER: --.--.irr
ADDIIESS: -
CllY:....--- -.
InsJ(
col.trflAcloll's NAME At)D'lE[is
GENEfIAL:
PI IONEEXPIRES
\,l\->1Y't - ? YYJ_
Er-ECrnrc/rL , .---y-! )-J-- e*_ -q *f
'--v-
(e
L,Ltt
CONST.
CONTRACTOR /
FLOOD PLAII'l:
ZONING CODE:
, OF BDRMS:----r--...
SECONDARY HEAX
QUAD AIIEA
, OF BLDGS
occY G,l(rul' ....-.- .
tIANGE:---.
- OFFICE USE -
}IEAT SOURCE:
r OF UNITS:
, OF STORIEf;: .-----
iW fEn llEAll:t]:
:
SOUARE FOOTAGE:-. .
CONSIR. TYl'E:
LAND USE:
lo rurlur::ri ar irl$Jruull()n, you ilr,r!il cail r26 li16$. Tlrls !a a 24 lrcrir Iocor(!lJl{J. All lns;recllolrs loqueslctl holole 7:('o 'l ln' wlll b(:
,ratlu llr, r;irrrr' wotltllg rlay, llrsJrcr:llons rc.tlttesletl aller 7:OO a,tlr. wlll bo tttatlo llro followlrrg work day'
I1EOUINED INSPECTIONS
[-- | tcrrr 1,o r iu y E !ec lr lc
I--l Slle tnsrrecllott - To bo lnadeU aller exi;avall<rn, llul ptl.r lo
solllrlg lrrlllls.
tl Undclslitb Plurrrbhlgl Eleclrlcal I
Mochartlcnl - Ptlor lo covcr.
Foolltrg - Allot lrencltos ttlo
oxcavulrttl.
Maeonry - Sleol locallol't, boltd
bealrts, groullng.
n Foundllton - Aller lornts oro
erecled ltul Pllor lo cotrcrels
placotrtcnl.
l:l Undorgrottnd Plumblrrg - Prlor
lo ,llllrtU ltencll'
Undat ltoor Pturrrbllrgl Mochattlcal
- l'rlol lo lnsulallolt ol tlocklng'
l,osl otttl [lonltt - Prlor ltl llool
Irrsulallon or tlr-'cklttq.
Eleclrlcal Settrlcs - Musl be
approvod lo oblaln Portnanenl
eleclrlcal powoL
lI Flroplaco - Ptlor lo laclrtglJ ntalorlals antl lralltlttg lttsp'
Frarnlng - l'rlor lo cover.
WalllCelllnO lneulallon - Prlor lo
tlough Mccltanlcal - Ptlor lo
cover.
llouoh Eloclrlcnl - Pllor lo
covor,
cover.
t:]
l-l Flrral Bulldlrro - Wltort allL-J rotlulrod lnsJr<lcllolrs ltavo boolt
ajr;xovod and bulldlltU ls
cotnplole<1.
tl
,t
Flrrat Plunrbltrg'- Wlrcrr all
plutnblng work ls ctrltt;rlelo,
Flnal Electrlcal - Wlton all
olectrlcal wotlt ls coltlPlols.
Flnal Mecltattlcal - Wlton all
rnscltanlcal wtllk ls, cotltplolu'
Olhor ---
I:|
t_l
Floor lrtstrlollotr - Ptlor lo
decltlttg.
Sartllnly Sewer - l'rlor lo lllllttg
lrctl.:ll.
!ilornr Sower - Prlor to lllllltt
lronclt.
Wolcr Llrte - l'tlor to lllllttg
Irr:nclt.
Ilouglt l'lulnblrrg - Ptlor lo
covet,
l:]Drywall - Prlol lo laPlng.
l_l Wood Slovs - Allot lnslallallon.
lnserl - Altor llroPlaco aP;rloval
alrrl lnslallatlon ol unlt.
t:l Curbcul & APProaclr - Allor
lortts are orrlclotl bul ;tllor lo
plucemonl ol concrele'
l-l Sklowalk & DtlvowaY - AllttrlJ ox,:avallol ls corrrplolo, lotltts
an<t sub'baso rll&l{rrlal llr placo'
l----l Fonce - Wlren <:olnlrlole<l'
Slteel Tteos - Whon all tstlulterl
lreoB are ltlanlcd.
MOBILE HOME INSPESTpNS
Blocklrtg and Sel'Up - Whan ull
blocklng ls corrtPlolo. '
11.
l-l Plunrblttg Colrttecllotts - WltuttlJ honte ltas ber:tt colrlloclo(l to
walot attd aowor,
Eloclrlcal Cottrtscllolt -- Wltott
blor;klrrg, uol'tt;r, art<l ;rltllltlllttg
llrs;roctlonu ltuvo troolr ulrprovrttl
anci llre ltolrto ls cottnoclod lo
llro sorvlco 3:anel.
t:]l:]
tl Flrral - Altor all retlulttttl
Irrsrrocllons uto aPPtovod and
llotcltos, sklrllng, tlecks, and
ventlno ltavo been lrtstilllad.
t*l
l.r.rl lirccs
Lol st1. llg.
Lol covora0g
Topograplry
Total helghl
t-rrl Ty1
-..--- ltllorlor
_--* Cofitor
-
Panhanc.lle
-.- Cul.do-sao
Lt rs iltt- t,ilot)os[1) woHt( il.t lilt:
I ilr; t()lilcAl- t.ltsl nlct, on ot,
I I lE I llS IORICAl"" llEGlS f l:R?
ll yoo, llrls apgrlk:allolr rnrrsl lro olgnorl
and agrproverl by llrr: l.llslorlcal
Coordlrral<.:r prl<lr lo p€rnrll lssuance.
ACq
APPNOVED:
s
W
E
BUILDING VALUE, PLAN CIlECI(
AND BUILDING PERMIT
l'ltls permlt ls Orarrletl on llto cxpress condlllott lltal llte sald
construcllon sltall, ln all respects, conlortn lo tlte Orrlinitnce
arloplecl by tlto Clly ol Sltrlrtgllclcl, ltrt;lutlitrg llle
f)ovoloprnenl Corle, tagulaling llre conslrucllott ettrtl uso ol
bulldlngs, and nlay bo suspetrclecl or tcvoketl al ;tny lltno
Upon vlolatlon ol any plovlsions ol saicf orrlirrances.
tjiiriri -rtovi
owr:r t ny [);r lc
l)lan Clrock Foo: -_.__._...___..
Dale Pald
Rocelpl Nurnbor:--
Eocolvorl By;
BUILDING PERMIT
II'EM SQ. FT.
Maln
Gatage
--
Carporl
VAI.I.'E
(At
x $/so. FT.
Tolal Valuo
Bulldlng Psrmll Foo
Slllo Sttrcltitr.t;o
Tolal Foo
Syslonts f)cv<.tlt>lltlortl Oltittllc ls tlttt-. on all rrrtrlcv(rl()l)c(l
properlios wltlrlrr llr<,t City llttrils wlrlclt aro beirtg inrptovotl.
SYSTEMS DEVELOPMENT CHANGE (SDC)
(B)
ADDITIONAL COMMENTS
.[,t. ^ --C--,^l^,t
I
3 3
O:f----vvLr.5-7.-v o( l,*,r-*__
ITEM
Flxlutos
tlesldonllal Balh(sl
Sanllary Sower
Waler
.ri*
Storm Sewor ,"
Moirlls lloms
PLUMBITIG PERMIT
Nc
FEE
FT,
FT.
FT.
(c)
Plumblng Permll
Slalo Srrrcltargo
a
Tolal Gharoo
Wood Slove/ lnserllFlroplacs Unll
Dryor Vcnl
MECHANICAL PERMIT
(D)
Nc
.#Meclranlcal P6rmll
lssuance
Slale Sttrcharge
Tolal Parmlt
Furnaco
Exhausl llood
Vanl Fan
Ry slgnaluro, I slale atttl agree, llral I ltavo carelrrlly exatnlnetl
lhe cotttplolcrl a;>llllcalloll and rJo lrereby cr:lllly lltal all
Irrlortnatlon lrorcon ls ltuo an(l colrccl, and I lttrllrt:r cetlily
lhal any and all work pcrlorlncd sltall br: dono ln ar:tlortlaltco
wllh tlre Orcllnances ol lhc Clly ol Sprlnglleld, atttl lltc Laws
of llro Slalo ol C)rr.'1;ort pettalrtlng lo tho wotlt tlosclibod
Iroreln, ancl lltal NO OCCI.IPANCY will tro ttra<lo ol any
slruclure wlllroul pertt.tlssion ol the Bulldlng S:tlely Divlslon.
I lurther cerllly lltal only co,rlraclors and cnt;llgyecs wlto
aro ln cornpllanco wlllt ORS 701.055 wlll bs ttsetl on lltls
prolecl.
I lurlher a0Iee lo ensule llrat all tequlred lnspecllons ate
roqueslc<l al llrc ptoper llrtre, lhal caclt address ls readal)lo
lrom lho slteel, llral the petlllll card ls localcd al llte llonl
ol lhe properly, ancl llro approverl sel ol planll wlll Iolllal,l
llrs slto al all lltrtos durlttg consl
lo --.------. .-..
o
MISCELLANEOUS PERMITS
Moblls llotns
Slalo lssuanco
6lalo Eurclrarge
Sldowalk
-
lt
Curboul -- ll
Dotrtollllott
Slillo SuIcharoo
Tolat Mlscollanoous Perlltlte (E)
TOTAL AMOUNT DUE (oxcludlng oleclrlcal)
(A, B, C, Q and E Comblned)
VALIDATION
IIECEII'T NU ETI
DATE PAII)
AMOUNt nEo
TItsCEIVED E}Y
t)
P.t. .Gnn
N
u9E.
2_D
^l
CITY OF SPRIINGI;IEL4 C,RF..GO,fV
yprrt*tol
INST4LLATTp,N,^.U /(A<:2
SPB!T{GFIELE'
ua(,
EI,ESIRTCAL PERHTT APPLICATION
City Job Nunber
3.FEE SCffiDIILE BELOV
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cos t
$ 8s.00i.000 sq. f t. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 1s.00
B Services or Feeders
Installation, Alterations
or Relocation:
200 amps or l-ess
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amPs_
Over 1000 amps/voIts
-
Reconnect 0n1Y
D
approval.
225 BTrTE STREBT
sPRrNGrrELD, oREGoN
INSPBCTION REQIIBST:
OFFICE: 726-3759
1
20
tl ,4Sv
LEGAL DESCRIPIION
elr JOB
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. CONTRACTOR INSTATI,ATION ONLY
Electrica] Contractor
Address \
Ci tv Phone
Supervisor License Number
Expi.rati.on Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
c
One Circuit L-- $ 35.00 ?E'
Bach Additional
Circuit or vith Service
or Feeder Permit
-
$ 2.00
E. Miscellaneous (Service/feeder not included)
Temporary Services or Feeders
Inslallation, Alteration or Refoeation
200 amps or less $ 40.00
ior uri," to 4oO amps
-
$ 55.00
0ver 600 amps or 1000-vofTs see I'B, above
Branch Circuits
Nev, Alteration or Extension Per Panel
Sum
Signa
l*k^-
ture:.,i K*td
$ 40.00
@
=o llO
s s0.00
s 60.00
$100.00
s130.00
$300.00
$ 40.00
/Name (P',*1Ovners
Address JDdP-Lr//t7 P ilrn,! /l t+<z
Ci ty f e/)Phone
OIJNER INSTALLATION
The instalfation is being made on
property f ovn vhich is not intended
for sale. ]ease or rent.
Owners.
(!r, lI
-Each installation
Pump or irrigation $
sign/outline Lighting- $
Limited Energy/Res
-
S
Limited Energy/Comm $
40.00
40.00
20.00
36.00
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
DATE:
RECEIVED BY:
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