HomeMy WebLinkAboutPermit Mechanical 1999-04-13RESIDENTI,qL
PERMIT APPLICATION
lnspections: 726-37G9
Otfice:726.3759
spRlNcFtELp
??oq ktJOB I.JLJMEEN
225 Filtlr Strcc(
S1:rlngflclcl, Orugorr g2477
LOCATION OF PROPOSED WORI(:a'/
^l
+lqtln
OWNER:PI.IONE,:
CITY:OKSTAI'E:7-tP
1+7+b -
r-!-
N DDITION DEMOLISI.I OTF'E'1
OESCRIBE WORI(:
NEW- REMODEL T '
N DDRESS
T:.X P Ii:] E,S PI.IONE
D
CONTHACTOR'S NAME
GEN EBAL:
ELECTRICAL
PLUMBING:
MECHANI
CONST.
CONTI1ACTOR ,
_ OFFICE USE -
// Of UNI
QUAD AREA:
, OF BLOGS
FLOOD I)LAIN:,
ZONING CODI]:
OCCY GBOUP:
A OF STORIES:
LAND USE:
ASSESSOBS MAP:t7oiL33/TAX LOT:I l</oct
LOT;
-
BLOCI(SUBDIVISION: -
To rcquest an lnspccilon, you rnust carll 726.3769. Tlrmadc thc sante worl(lng cjay, lnl;pcctions rcqucstcd
rljil$FpIfsu{fi
af rcr 7:@O16ri8
RE QUIRTD lNSpECt-tONS
(f uc$tccJ bclorc T:OO atn, wlll bcworl( clay.
Temporary Eloctric
Silo lnspoction - To bc madcatt.cr cxcavation, bul [)rior toscttlng lorrns,
U-ndcrslab plunrbing / El ec trical /Mcchanlcal - prioi to covcr.
Footlng - n (tcr trenchcs arccxcavalcd.
Masonry - Stccl location, bondbearns, groutlng.
I Founcjallon - A(tcr lorrns arc
-
crccted bu( prior to concrctcptacerncn t.
Rouglr Mccltanical - prlor tocovcr.
nougll Elcclrical - prior tocovct'.
Elcclricai Scrvlcc - Must beal)provccl to obtaitl pcl.rrrancntclectrlcal I)OWCr.
Flrcplacc - prlor to faclngmaterlals ancl (raming lnsp.
Franring - prlor to covcr.
Wall/CcllinO lnsulntiorr _ prlor tocovcr.
I DrVvrall - prlor ro rapirlO.
Wood Stovc - Allcr lnstallalion
li.:1, - Atrcr ftrcg.llacc apt)rovalano instaJlaUon oI unit.
Ctrrbcrrt & AJ:l.rroaclr _ n ltcrrormS arc crcctccj but ,)rior loplaccrncr) I o( corlcrr:lt:.
Siclcwalk & Drivcway _ nfrcrcxcaviltiolt is complctc. [orntsan(t sul).basc tnalcriitl in 1.ll;tcc.
Fencc - Wl)cn cornpletcd.
{itroot Trccs - Whcn all rcqulrccltrccs arc planlccJ.
ll Final [rlrrrrrbirrg - Whcn all.- ptuntl)ing worl< is contplcl.c.
Elcctlic;rl - rr'Vlrcn altical wc.rrl< is corrrplclc.
Firritl
cc tr
lilo
Ot.lrcr
ial Mcclranical - Whcn allcllanical worl( ls cornplctc,
Final tJuilclinU _ Whcrl allrcquirccl .inspcctlons have bccn;rpprovcd and builcling is
c orn ptc tccl.
Underlloor plurnbln g/ Mcchanical
- Pnor to Insulatlon or dccl(ino.
Post and Bcam - prior to ,loorlnsulation or clccl<ing.
Floor lnsulation - prior todccl(lno.
Sarritary Scwcr - prior to tilling
t rcn c lr.
Stornr Scwcr - l)r.ior fo Illlinglrcncl'r.
Watcr Linc - prlor ro tillingtrcnch.
Undcrgrounci plu
to fllllng trcnch.
nrbing - prior
Rouglr Plurnlling - prior to
cover.
MOBILE I.IOME INSPESTIONS
[l Btoctrirrg an<t Scr.Up _ Wtrcn all.a blt:cl<in1l is cornplcic.
Pltrrlbirrll Corrrrccliorrs _ Whcnltotnr.l lr;rs bccn Cot.rllcCted tOw;tlcr iln(l :;cv/()r.
Elc'clli<:;rl Corrncctiorr _ Wltcn
I]::|1,:::,, scr.up. on<J ptrrnrbinslrrspc.clions ltnvc l;cort approvcd;lnd tllc.lrornc is connccted lotlrr: scrvicc;tancl,
Final - Af lcr all rcquircdillspcctions arc approvcd andporc.llqs, $l(irting, deCks, andvcntln0 havc bccn installecl.
4t
law requtres
DI]MS:
of the
OAH
I.IEAT
RANG
FOOTNGE:
WATER t-IEATEFI; __
Lot laccs
Lot sq. lto.
Lot covcrago
Topography
Total l'lcl0lrt
Lol 'l-y1l
-
lntr:-rJoi
--- Corncr
-
Panlrarrdlc
-- Cul-de-sac
Sctbacl<s
P.L.HSE GAR NCC
N
J
E
ts TIJE P110,)OSEO WORI( iN TllE .
I-IISTORICAL DISTRICT, OR ON
TI{E I{ISTORICAL REGISTER?
-
ll yes, this application must be slgncd
arrd approved by the Hlstorlcal
Coordinator prior to permit issuancc,
APPROVED
BUILDING VALUE, PLAI\I CHECK
AND BUILDING PERMIT
Tl-ris pcrnritis grarrtecl on thc cxprcss conditiotl tlrat tl'lc said
construction shall, in all respccts, conlorm to the Ordinancc
adoptcd by thc City of Springlicld, including the
Dcvelopment Coclc, rcAulating thc construction and use o[
builclings, and may bc suspcndcd or rcvol<ecj at any tlrne
upon violation oI arry provisions oI said ordinanccs.
[]larr C]rccl< Fec
Da lc l)aicj
Rcccil:t Nrrtrtbc
Rcccivccl By:
Plans Flovicwcd l3y Datc
Systcms D<lvclopmcnt Chargc is duc on all undevelopcd
propcrtics witl.rin tlrc Cily lirrrits whiclr arc bclng lmprovcd'
ADDITIONAL COMMENTS
/
By slgnature, I statc ancJ agrce, tlrat I have carcf ully cxamlned
tl'rc complctcd application ancl do hereby certlly that all
lrr(ormatlorr lrcrcott is truc a11(t corrcct, and I Iurthcr certify
that any ancl all worl< pcrformccl slrall bc done in accordance
with tlrc Ordinartccs ol tlrr: City o( Sprirrg(lcld, artd tlrc Laws
of tlrc Statc of Oregon Jrerlairring to thc worl< describcd
hcrcin, and tirat NO OCCUPAI'JCY will [:c trracjc o( any
struclurc willrou t ;tcrtnissiorl of tlrc BuiltJlrrg Satety Division.
I [urthor certity tltat orrly contractors and enrployecs who
arc in cornpliancc'witlr ORS 701.055 wlll bc used on thls
pro jec t.
I Iurther agree t<.r cnsuic that all rcquircd inspcctions arc
req ucstcd ilt thc Prol)c c, tllat each addrcss ls rcadable
rnrlt card Is locatcd at thc frontfrorn thc strcct, tll
of tl)c ,)ropcrtY,.aiicJ tlr rovcd sct oI plans will rcmalna,)l)
on thc sitc at unn cot-\st
(
I ti
C
Slgnaturc
Datc
VALIDATION
RE,CEII)T N
DATE PN ID
UMT]EF'I
q
AtvIOUNT RECEIVf'.D
{')
BUILDING PERMIT
ITEM SO. FT.
Main
Garagc
Cart)ort
VALUE
(^)
x $/so. t:T.
Total Valuc
Building Pcrnrit Foc
Statc Surcltargc
Total Fcc
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Rcsldcntial Bath(s)
Sanltary Scv.rer
Walcr
Slortn Scwor
Moblle Homc
PERMIT
FEE
NN
l:'1.
[:T.
(c)
Plurnblng Pcrrnit
Statc Surclrarge
Total Cltargc
PLUMBING
ITEM
Fix t u res
Woo<J Stovc/ lnscrt / I:lrcplacr: Urti I
MISCELLANEOUS PERMITS
Mobile Honte
Statc lssuancc
Statc Surclrargc
Sl<Jcwalk
--
ft
Curbcut
-.-
ft
Oemollllon
Statc Surcharge
Total Mlsccllaneous Pcrtnils (E)
MECHANICAL PERMIT
ICO Dc
r{7f
L Lu
No
nt
u4-
(D)
Drycr
k
Fu rnacc
Exhaust Hood
Vcnt Fan
Mcchanical Pcrttril
ls su ancc
Slatc Surcltlttl;t--
Total Pcrtrllt
TOTAL AMOUNT DUE (cxcluclinO clcctri(;al)
(4, B, C, D, and E Corrrt:irtccJ)FiE,CEIVE,D BY
0t
Lt
FT.
225 FIPTS STREET
SPRINGFIELD, OREGON
INSPECTION REQIIEST:
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
T4
DESCRI
The lollowing project as submitted has the tollowing
zoning, and does not require specific land use
approval
Zoning
l-Dft*-
r-{*q
7 t4")
S$nature
ELBCTRICAL PERHIT APPLICATION
Ci ty Job Number ?7o 7r r
3. COMPI.,ETE FEE SCEEDI.ILE BELOV
A. Nev Residential-Sing1e or
MuIti-Family per dvelling unit.
Service Included:
I tems Cos t Sum
Lr\1\L)l\:,urt
IINGFIELO
Iess
500
PTION
/ /10,t0
JOB DESCRTPTION
*a t)rJ-rL
lling
Feeder
Services or Feeder
s 8s.00
$ 1s.00
s 40.00
ee mBr a6OV-e
Permits are non-transferable
if vork is not started vithi
of issuance oL- if vork is s
180 days.
2. COI'ITRACTOR INSTALL,ATION
Ci ty Phone L8f -/A /r'
Supervisor License Number TyrzS
Exp iration Dare /O-t - O
Constr Contr. Number 2A' a t fC
Exp iration Date /O-- I ^ OO
Signature of Supervising Electrician
0wners Name ln,l /,o /1, <
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps'"or less
201 amps to 400 amps
-over 401 to 600 amps
-Over 600 amps or 1000T5[s
or
,s
Installation, Alterations
Electrical Con tracrcr k S Hprilil. \Gn<,,(lw.or Relocation:
Address 0.o brf 2-9? i z 200 amp
20L amp
401 amp
601 amp
Over 10
Reconne
00 ampsct 0n1y
ss
0 amps
-_
0 amps
00 amps_
/vo1 ts
s
s
s
s
or
to
to
to
s s0.00
s 60.00
s100. 00
s130.00
s300.00s 40.00
1e
40
60
10
40.00
55.00
80.00
$
s
$
s
c
Address >/1 1t pbfx
D. Branch Circuits
E
Nev, Alteration or Extension Per Panel
One Circuit I $ 35.00 tt
Each Additional
Circuit or vith Serviceor Feeder Permit _ $ 2.00
Miscellaneous (Service/feeder not included
-Each installation
Pump or irrigation _Sign/OutIine Lighting_
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
t^,,
Ci ty Phone "7Ub .lL{)rl
OVNER INSTALLATION
The installation is being made on
property I ovn uhich is not intended
for sale, Iease or rent.
0vners Signature:
DATE:
$ 40.00
s 40.00
$ 20.00
$ 36.00
j r'5
RECEIVED B
9oQ-r-., dr e,zv-