HomeMy WebLinkAboutPermit Mechanical 1995-09-11RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Qffice; 726.3159
\
LOCATION OF PHOPOSED WOBK:
SPRING IELt)
JoBNUMBE"%
225 Fllth Streer
Sprlngfteld, Oregon g7477
n lloh
ASSESSORS MAP:/?-a 3-a </*L//
TAX LOT:O3
LOT:BLOCK:SUBDIVIStON: _
CONTRACTOR'S NAME ADDRESS CONST,
CONTRACTOR ,{EXPIRES PHONE
PHONE:
STATE:ZIP:
I
r)
OWNER:
ADDRESS:
CITY:
DEMOLISH OTHERITION
DESCRIBE WOR}(:
NEW-_- REMODEL A
G EN ERA L:
PLUMBING
MECHANICAL:
ELECTBICAL:
QUAD ABEA:
I OF BLDGS:
OCCY GROUP:
E OF STORIES:
WATEB HEATER: _-
l--l tornporary Etectrlc
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
Rough Electrlcal - prlor tocover.
, OF BDRMS:
-
- OFFICE USE -
LAND USE;FLOOD PLAIN
'{ OF UNITS:ZONING CODE:_
To request an inspcction, you must call 726.3769. Thls lsmade thc sanre worklng <.tay, lnspections rcquested afle
a 24 hour recordlng. Alr lnspectlons requestccl before 7:00 a.m. wlll ber 7100 a.m. wlll bo macJe the tollowlng work day.
REOUIRED TNSPECTIONS
ffi Rough Mochanlcat - prtor to'- cover.
SIlo lnspoction - To lre madoafler excavailon, but prlor tosettlng lorrrrs.
U.nderslab plumblng/ Electrical /Mochanlcal - prloi to cover.
Footlng - After trenches areexcavated.
Masonry - Steel locauon, bondbeams, grouting,
Foundatlon - After lorms areerecled but prlor to concretopracoment.
Underground plumblng _ prlorto (llllnq trench.
Underlloor plumblng/ Mochanlcal
- r,ilor to Insulatlon or decklng.
Post. and Boany. _ prlor to f loorrnsutailon or docklng,
Floor lnsulallon - prlor todecklng.
Sanltary Scwer - prior to fllllng
t rcnch.
Storm Sewer - prlor fo lllllngtrench.
Water Llno - prlor to llllingtrench.
Rough Plurnbing - prlor tocover.
Eleclrlcal Servlce - Must beapproved to obtaln flermanentcleclrlcal power.
Flroplace - prlor to faclngmaterlals and lramlng lnspi
Framlng - prlor to cover,
[l Wail/Celilng tnsutarton _ prlor to
-
cover.
[-_l Drywal] - prtor to raptng.
Wood Slovo - Aftcr lnstallatlon,
lnserl - After flreplace approvqland lnslallatlon of unlt.
Curbcut & Approaclr _ Alterforms are erectcd but prlor toptacomont ol concrctc.
Sidswalk & Drlveway - Afterexc.availon ls completo, formsand sub.base malerlal ln place.
Fence - When compleled.
Slroel Troes - When all requlredtroes aro planted.
f-l Ftnat ptumbtng - Whon alt
-
plumblng work ls complete.
l--l Ftnat Etoctrtcat - Whon ail'- electrlcal work ls complete.
ffi rntt Mechantcat _ When ail
-
mochanlcal work ls complete.
Flnal Buildlng - When attrequlred.lnspecilons have beenapproved and bulldlng lscomplotcd,
Electrlcal Connoclion _ Whenp]9:Krlg, set.up, and ptumbinsrnspecilons have been approveda.no ilte home ls connected tothe servlce panel.
[Z ottror
MOBILE HOME INSPECTIONS
[-l Blocktng and Ser.Up _ When ail
-
blocklng ls compleie.
Plumblng Connoctlons _ Whennome has been connecled towaler and sewer,
Final - Af ter all requiredInspecilons are approved andporc.hes, sklrilng, decks, andvenun0 have been lnstailod,
,i
SECONDABY HEAT:
SOUARE FOOTAGE:
Lot facos
Lot sq, ftg,
Lot coverage
Topography
Total helght
Lot Type _
-
lnterlor
-
Corner
-
Panhandle
-
Cul-de.sac
ks --; THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
and approved by the Historical
Coordinator prior to permit issuance.
APPBOVED
P.L,HSE GAR ACC
N
S
E
BUILDING PERMIT
ITEM SQ. FT.
Maln
Garago
Carport
(A)
X $/SO. FT, = VALUE
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls grantect on the exprcss cor.lcjition that the said
construction shall, ln all respects, conform to il.]e Ordinance
adopted by the City of Springflclct, including the
Development Code, regulating the co0struction and use of
bulldlngs, and may [:e suspended or revokcd at any tlme
upon violation of any provisions of saicJ ordinances,
Recelpt Nurnbcr:__-... _
Plans RcvlewecJ t3y Da te
Plan Check Fee:
Received By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmcnt Charge ls cJue on all undeveloped
propertles wllhln tlro City linrlts which are being lmproved.
ADDTTIONAL COMMENTS
ITEM
Flxtu res
Rosldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
((, )
FT,
0
PLUMBING PERMIT
Plumblng Permlt
Stato Surcharge
Total Charge
Wood Stove/ lnsert/ Flroplace Unlt
Dryer Vent
74aa(D)
-/s=
drz>
NoVent Fan
Mechanlcal Permlt
lssu ance
State Surcharge
Total Permlt
zL?q
f->-r>
MECHANICAL PERMIT
Fu rnaco
Exhaust Hood
I further agree to ensure that all requlred lnspections are
requested at the proper tlme, that oach address ls readable
from the street, that the permlt card ls located at the f ront
h-e_approved set of plans will remain
n
req
of the property, and t
tidu
Slgnatu
Date
on the slte at
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldowalk
-
(t
Curbcut ' f t
Demolltlon
Slate Surcharge
Total Mlscellaneous Permlts (E)
4Zt---t
TOTAL AMOUNT DUE (excluding clectrlcal)
(A, I, C, O, and E Comblned)
VALIDATION:
BECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
Date Pald:
FT,
FT.
By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true and correct, and I Iurther certlfy
that any and all work performed shall bc done in accordance
wlth the Ordinanccs of the Clty of Sprlngf icld, and the Laws
of the Stato of Oregon pertalnlng to thc worl< described
hereln, and that NO OCCUPANCY will be made of any
structure wlthout pertnission of the Bulldirtg Safety Dlvislon.
I further certlly that only contractors and employees who
are ln compllance wlth OFIS 701.055 wlll be used on thls
prolect,
a
/B? >,/
SPCIIN(- FIELO
afr,
lii,l"J',1Tlno::?X"i'?ilXH'$:t'lSiJIEl:;*-'nn
aPProval'
225 PIFTE STREET Zonin
SPRTNGFTELJ, OR-EGON
INSPECTTON REQIIEST:
OFFICE: 726-3159
97 47
AUthorizsd
1. LOCATION OF INSTAILATION
o
LEGAL DESCRIPTION
., JOB DESCRTPTION
ELECTRICAL PERHTT APPLICATION
City Job tor Au, ?27 2O
L
Permits are non-trans ferable and exPire
if vork is not started vithin 1B0 days
of issuance or if vork is suspended for
180 days.
2. COI\TTRACTOR INSTAII^ATTON ONIY
3. COHPI.ETE FEE SCMDULE BELOS
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:
I tems Cos t
s 8s.001000 sq.ft. or less
additional 500
sq. ft or portion
thereof
Each Manuf'd Home. or
Hodular DveIIing
Service or Feeder
s 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amPS
-
601 amps to 1000 amPs-
0ver L000 amps/vo1ts
Reconnect 0n1y
C Temporary Services or Feeders
Installajtion, Alteration or Relocation
A
B
Sum
t
a
Ci ty
Supervisor cense Number ILg s
Expiration Date lo -
Constr Contr- Number 0 s+q
Expiration Date q
Signa re of Supervising Electrician
Yn"". ltll - {^3to
Electri
Address
Ovners Name
Address
cal Contractor
P,0 .E s s0.00
s 60.00
$100.00
s130.00
$300.00s 40.00
Ci ty
OVNER I-ATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:
200 amps"or Iess
201 amps to 400 amps
-Over 401 to 600 amPs
0ver 600 amps or 1000-?oTTs
D. Branch Circuits
Nev, Alteration or Extension Per Panel .
one circuit I S 3s.00 J$PO
Each Additional
Circuit or vith Service
or Feeder Permit I S 2.00 A,aA
E. Miscellaneous (Service/feeder not'included.)
-Each installation
Pump or irrigation _Sign/Outline Light i.g_
Limited Energy/Res
Limited EnergY/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAI
-t-qb 40.00
s5. oo
80. o0
ee "Brt aEove
s
s
s
s
o
pnone 141 - ^444
s 40.0q
s 40.00
$ 20.00
s 36.00
r,E AE!TITFN
5
3q, q
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