HomeMy WebLinkAboutPermit Mechanical 1997-07-15RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726.3759
SPRINGFI ELO q7 tobTJOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
LOCATION OF PROPOSED WOFIK:?*t A/, L+h
ASSESSOBS MAP:t7 0345t2 TAX LOT DL/)
LOT BLOCK:
7 vb- vs1 IPHONE:
OR&€^)?"2 vz7STATE:ZIP:,CITY:
?at
P:N F,'E /d
L*nt
6+hADDRESS:
OWNER;
NEW
-
REMODEL ADDITION DEMOLISH OTHER
CPcl(ir'IO Clulfa4-F a-/z*t(4JDESCRIBE WORK:
b@1/D V b'lr,S 1
ADDRESS
0
EXPIBES ,S PHONE
?7 (o^9 l-q-?
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
occy cRou", .iuTHORl.ED UNDEpmHEiptmffI ls_reI_-.-
wArER HEATER: ,. . rf nAY PEBI$S{GE;---.-
ffi
,, oF sroRrES:
--oeMilENCED
0R |BdEAUDOAE0 FOR
QUAO AREA:LAND USE:
'# oF BLDGS'6ITSHALT pXBmffif;TI{F WOBK
r OF BDFIMS:
- oFFtcE usE -
SECONDARY HEAT:
SOUARF. FOOTAGE:
ZONING CODE: _,
FLOOD PLAIN:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll bemade the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
[--l Temporary Electric Rough Mechanlcal - prlor to
cover.
Flnal Plumblng - When ailplumblng wgrk ls complete.
Slte lnspection - To be made
after excavatlon, but prior to
settlng forms.
Rough Electrlcal - Prlor to Flnal Electrical - When allelectrical work is complete.covor.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Electrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flnal Mechanlcal - When all
mechanlcal work ls complete.
Footlng - After trenches are
excavated.Flreptace - Prlor to faclng
materlals and framlng lnsp.
Flnal Buildlng - When all
required lnspectlons have been
approved and building ls
completed.Masonry - Steel locatlon, bond
beams, groutlng.
l--l Framlng - Prlor to cover.
f-l WattrCeltlng tnsulatlon - prtor to|J cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
n other
Underground Plumblng - Prior
to fllllng trench.Drywall - Prlor to taplng.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulatlon or decklng.
MOBILE HOME INSPE TIONSnWood Stovo - After lnstallallon.
Post and Beam - Prlor to floor
lnsulatlon or decking.lnsert - After flreplace approvql
and lnstallatlon of unlt.
Blocking and Set.Up - When alt
blocklng ls complete.
Floor lnsulalion - Prior to
decklng.Curbcut & A3rproaclr - After
forms are erected but prior to
placemont of concrete.
Plumblng Connectlons - When
home has been connected to
water and sewer,
Sanitary Sewer - Prior to fllling
trench.Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home ls connected to
the servlce panel.
Storm Sewer - Prlor to lilling
trench.
Water Llne - Prlor to lilling
trench.
Rough Plumblng - Prlor to
cover.
Street Trees - When all required
trees are planted.
Flnal - After all required
inspectlons are approved andporches, sklrtlng, decks, and
ventlng have been lnstalleci.
SUBDIVISION:
--
E
E
n
tl
tl
tl
E
l--l Sidewalk & Drlveway - After
'J excavation ls complete, forms
and sub-base materlal in place.
[-l Fence - When coiilpleted.tt
E
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
PL.HSE GAR ACC
N
S
E
_- Panhandle !
-
Cul-de-sac
Lot Type
-
tnterlor
__ Corner
ICT,
S T H PE Fro POSED KWOR TTN H Ets'H ICALTOR DISTR o R ONTHEHISTORICALREGSTER,,
rhyes,is appl oicatl n rnu sbe edgnndpdprovehebyHSrioacCoordnatorprloopermrssuance.
APPROVED:
VALUE
(A)
-
iiT
SQ. FT. X
BUILDING PERM lT'
$/SQ. FT,
ITEM
Main
Garage
Carport
Total Value
Building permit Fee
State Surcharge
Total Fee
uate
Plans Flevi ewed By
E,
PE
UB L D GN LU
,I
P NLA c H EC KANBDULDGNRMTThispermisranstedonthecxpressticondino hat the s aidtruconsonctihalsallnt,conformrespects,to the rdload nanceedopthebycivoSnriptiesdcnUdnoDevel,heenpmsCode,natregu hes con S rU ct ton anduib udtn ofanss,d bemay SU dspen ored revoked atu a imnvtny epoolatinonyionprovisofsidsaordinances.
Plan Check Fee:
Date Pald:
Receipt Number:
Fleceived By:
SYSTEMS DEVELO ENT CHARGE (sDC)
(B)
PM
emsSyst Deve lop men C isharge d UC on al dun eve lopedpropertiwleshtncihetyrnitshichbareetng
Flxtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
No
(c)
PLU
ITEM
MBING PERMIT
FEE
--
Plumblng permlt
State Surcharge
Total Charge
IF THtrAUTHOR,ZED UNOER
JH'S PERMTT
ADDITIO NAL COMMENTS
Y PEH,OD
0R ls
Wood Stove/ lnsert / Fl replace Unlt
MECHANICAL PERMIT
State Surcharr.tSZC //y*,1^ {2,-
Total Permlt
-
(D)? h ,-&(-\.
Ven
r7,tly
N0
Mechanical permlt
lssuance
Furnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have caref ully examlnedthe completed appllcaUon and do hereby cerilty that alllnformaflon hereon ls true and 6oriect, "ni f'f urtn", cerilfyth.at any and all work porformed ehall Ue Oone ln aocordanoswlth the Ordinanccs of the City of SprlngflelO, anO tne Lawsof the state of oregon pertarnrng to tho work descrlbedhere'tn, and thar NO OCCUPATCY wttt Oe maOe of anystructure wtthout permloslon of Ihe Bulldlng gafety Olvlolon,I further cerflfy that only contractors anAimptoyees whoare ln compliance with ORS 7O1,O5S wlll be used on thlsproiect.
I further agroe to onsuro that all requlred lnBp€cllon. erer€quested at th€ propor ilme, thet ssch address r8 r€sdebrefrom the strest, that the pormrt card re roaatod at tho frontof the property, and the approved set of plans wlll remaln
I times
7-tr*7
structlon.
Date
on the slte at
Slgnature
MISCELLANEOUS PERMTTS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-.
ft
Curbcut _-- ft
Demolitlon
State Surcharge
Total Mlscellaneous Perrnits (E)
TOTAL AMOUNT DUE (excludtng electrlcal)
(A, B, C, Q'and E Comblned)
eli ae
VALIDATION:
FIECEIPT NUMBER 6
DATE PAID 7-/5 - q7
AMOUNT RECEIVED
RECEIVED BY W-
2 6,J D
I
improved.
--_
sPFtft -€LD
'g*1*roN oFfl:sffirroH
225 FtFtfl sIrxET
SPRINGI'rELD, OREGON
IIJSPECMOil REOUES?:
0FFICE: 726-3759
Ilc foilowrr,q project as submitted lras tho lollowing
z,'^ i:1,U, sn,;i cces not requlro epocific land ues
afi*iotal.
7c,nin- Lfulf'_-
i)awLzh{fi1
136*0/6Eisnutrte Y\A
ELECTRICAL PBRUIT
c;ty Job Number
COHPLETE FEE SCBEDTILE BETOIJ
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home. or
Modular Dvelling
Service or Feeder
$ 8s.00
s 15.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
40L amps to 600 amps
601 amps to i"000 amps
r 1000 amps/voIts
ct 0n1y
lF ices or Feeders
eration or Relocation
3
A
Ii
JOB DES
€
Permits are non-transferable and expire
if vork is not started vithin 1.80 days
of issuance or if vork is suspended for
18O days.
2. CONTRACTOR INSTALLATION ONLY
El-ectrical Contractor C
Address 0.?aao t
Ci ty t^{-Phone 3
Supervisor License Number
Expir,ation Date r0/q4 4{vy
PTLON
Ier200 am
201 am
0ver 4
0ver 6
Sum
aboVe
.00
.00
.00
llBr
$ 3s.00
00
B
tcfrrts
$ s0.00
$ 60.00
s100.00
s130.00
$300.00
s 40.00
40
55
80
e
----r-'-
u4y
Constr Contr. Number /o
Expiration Date
Signature f Supervising Electrician
pst o 400
01 to 600
00 amps o
sS
amps
-
S
amps $r 1000-7ofTs se
0vners Name
Address 9-r*
phone ---
?
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
0vners Signature:
DATE:
D. Branch Circuits
Nev, Alteration or Extension Per Panel'
E. Misceflaneous (Service/feeder not included)
one Circuit J-Each Addi tional
Circuit or vith Servicel
or Feeder Permit ,
-Each installation
Pump or irrigation $
sign/outline Lighting.-. Ili.ili ted Energy/Res - - $
2$
35
A
40.00
40.00
20.00
36.00
5 SUBTOTAL OF ABOVE
5% State Surcharge
3% Administrative Fee
TOTAL
RECEIVED