HomeMy WebLinkAboutPermit Mechanical 1998-09-15SPRTNGFIELD
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726-3759
lnrr 7
@lr,
JOB NUMBER
225 Fitth Street
SprlngflelrJ, Oregon 97477
L.{(3 lJ+ ^{Lar e
LOCATION OF PROPOSED WORK:
i'7 6j Lq 7LI TAX LOT:D07tt
ASSESSOBS MAP:
LOT BLOCK:SUBDIVISION:
PHONE:
.f lr.
ZIP:
€^\
S
3 I
STATE:
s
I
ADDITION
CITY:
ADDRESS:
OWNER:
DESCFIIBE WORK:T
NEW- REMODEL DEMOLISH OTHER
GENERAL:
ADDRESS
(t {.tr
EXPIRES ,A PHONECONTRACTOR'S NAME
PLUMBING:
MECHANICAL:
ELECTRICAL:
coNsT.
CONTRACTOR #
Notllication
LAND USE:QUAD AREA:
A OF UNITS:,orauoek
o c cY G H o tTF{ l$PER}v+lF$FrArLf;xP I R E I F f fl \frirA l{rY
P E :
-
inOAFgE2'001
, OF STORIASTHOBIZEO UNSER THIS PENIfflFtS frBYRCE:----€OgO-Ysu
may
honecatling the
wArER Ne66Mlde,Ueen-0"ilS*gRNDON EA4qSFF-:
-nummrtorthe
_ OFFICE USE -
tl st cal 726-3769.Ttr s ls a 24 h our rec ordl ng AI n ons re qu ES ted be 7:OO a.m. wlll be
To reques n NS pec o n,you mu work day.
mad the wo rkl ng d ay,NS pect ions requested af ter 7:00 a.m. wlll be made
REQUIRED INSPECTIONS
he fol low ng
e s anl e
fl remRorarY Eleclrlc Rough Mechanlcal - Prlor to
cover.
Flnal Plumblng - When all
plumblng worl< ls comPlete.
SIte Inspectlon - To be made
after excavatlon, but Prlor to
settlng forms.
Rough Electrlcal - Prlor to Flnal Electrlcal - When all
electrlcal work ls comPlete.cover.
Underslab Plumblngl Electrlcal I
Mechanlcal - Prlor to cover.
Electrlcal Servlce - Must be
approved to obtaln Permanent
electrlcal Power.
Mechanlcal - When all
anlcal work ls comPlete.
Footlng - After trenches are
excavated,[l Flreplace - Prlor to faclngu materlals and framlng lnsP.
Flnal Bulldlng - When all
requlred lnspectlons have been
approved and bulldlng ls
completed.
Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prlor to cover.
Olher
Foundallon - After forms are
erected but Prlor to concrete
placemont.
Wall/Celllng lnsulatlon - Prlor to
cover,
Underground Plumblng - Prlor
to fllllng trench.f--l Drywall - Prlor to taplng,
MOBILE HOME INSPE TIONS
tl Underltoor Ptumblng I Mechanlcal
- Prlor to lnsulatlon or decklng.[--l Wood Stovo - nfter lnstallallon
Post and Boam - Prlor to floor
lnsulatlon or decklng.lnsert - After flrePlace aPProval
and lnstallatlon ol unlt.
Blocklng and Set'UP - When all
blocklng ls comPlete'
Floor lnsulallon - Prlor to
decklng.Curbcut & AlrProach - After
forms are erected btlt Prlor to
placement of concrete.
Plumblng Connectlons - When
home has been connected to
water and sewer.
Sanltary Sewer - Prlor to fllllng
trench.Electrlcal Connection - When
blocklng, set-uP, and Plumblng
lnspectlons have been aPProved
and the home ls connected to
the servlce Panel.
Slorm Sewer - Prlor to lllllng
trench.
Water Llne - Prlor to filllng
trench.
Fough Plumblng - Prlor to
cover.
Stroet Tre€s - When all requlred
trees are Planted.
Flnal - After all required
lnspectlons are approved and
porches, sklttlng, decks' and
ventlng have been lnstalled.
F
fellew rules forth
[---l Sldewalk & Drlveway - AfterL-J excavatlon ls comPletc, forlns
and sub-base materlal ln Place'
l-l Fence - When coiirPleted'
E
tl
E
Lot faces
Lot sg. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
--
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
PL.}JSE GAR ACC
N
S
E
IS THE PFIOPOSED WORK tN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
APPFIOVED
BUILDING PERMIT
ITEM SO. FT.
Main
I
x $/so. FT.VALUE
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee (A)
BUILDING VALUE
AND BUILDING P
.|.
, PLAN CHECK
ERMIT
This permit is granted on the express condition that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Springfleld, includlng the
Development Code, regulating the constructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of sald ordinances.
Plan Check Fee:
Date Paid
Recei pt Number:-
Received By:
Plans Rcviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties withln tlre City limlts which are being improved.
PLUMBING PERMIT
ITEM
Flxtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
N.
. FT.
FT.
Plumblng Permlt
State Surcharge
Total Charge (c)
ADDITIONAL COMMENTS
v(06
L&Ltc7 ttt tt l^t
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/Flreplace Unit
Dryer nt
/0, n
Mechanical Permit
lssuance
State Surcharge
Total Permit
/{'to
(D)
/ o. t)J;fr_
Z( zo
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolitlon
Slate Surcharge
Total Mlscellaneous Perrnits (E)
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
ln{ormatlon hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the Cily of Sprlngfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
herein, and that NO OCCUPANCY wlll be made of any
structure wlthout perrnission of the Bulldlrrg Safety Dlvislon.
I further certify that only contractors and employees who
are in compliance wlth OBS 701.055 wlll be used on thls
proiect.
I lurther agree to ensure that all required lnspections are
requested at the proper tlme, that each address ls readable
from tlre street, that the permlt card ls located at the front
of the property, and the approved set of plans wlll remaln
on the slte at all tl s durlng constructlon.
l
Slgnature
0Date
TOTAL AMOUNT DUE (excluding elec
(A, B, q D, and E Comblned)
r)
VALIDATION:
BECEIPT NUMBER
DATE PAID
AMOUNT FIECEIvT
4Lo/
(,
RECEIVED BY
FT.
RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Offlce: 726-3759
LOCATION OF P ROPOSED WORK:
ASSESSORS MAP:0
SPrrINGFTELE,?I /SLl
@fi,
1\\ac
JOB NUMBER
225 Fif th Street
Sprlngfleld, Oregon 97477
TAX LO'I:
SUBDIVISION
2r1
3
LOT: BLOCK:
PHONE:
ZIP:
\
?{L
L..L.
t-.
ut&(f*eOWNER:
STATE:
ADDRESS:
CITY:
\l^a-c4.
S
CCor
DESCBIBE WORK:
ADDITION DEMOLISH OTHERNEW- REMODEL
ADDRESS
\r g
-]
EXPIRES ,t PHONE
(cq)
CONTFIACTOR'S NAME
MECHANICAL:
ELEfiRICAL:
PLUMBING:
GENERAL:
CONST.
CONTRACTOR #
to
LAND USE:ouADARk
, oF BLDEHTffiE trTHEfl,bHil,r.,
occv oFAtlW pERMlf Sf'flf ' rYPE:
# oF srcg0fUWONED ffif,r souRCE:
;V PERION RANGF.:WATER H
- OFFICE USE -
must cal 726-3769.Th S a 24 ho ur rec o rd ng ns pec tions requested be
lowlng work daY.
tore 7:OO a.m. wlll be
To req UC St an n S pec tl o n you
uested after 7:00 a.m. wlll be made
REQUIRED INSPECTIONS
he fol
made he SA me workl ng day,n pec ti o ns re q
[--l remPorarY Electrlc Rougtt Mechanlcal - Prlor to
cover.
Flnal Plurnblng - When all
plumblng worl< ls complete.
Slte tnsPectlon - To lre madc
after excavatlon, but Prlor to
settlng forms.
Rough Electrlcal - Prlor to Flnal Electrlcal - When all
electrlcal work ls comPlete.cover,
Understab Ptumblng/ Electrlcal /
Mechanlcal - Prlor to cover'
Etectrlcal Servlce - Must be
approved to obtaln Permanent
electrlcal Power.
Final Mechanlcal - When all
mechanlcat work ls comPlete.
Footlng - After trenches are
excavated.[-l Flreptace - Prlor to faclngU materlals and lramlng lnsP.
Flnat Buildlng - When all
requlred lnsPectlons have been
approved and bulldlng is
completed.
Masonry - Steel locatlon, bond
beams, groutlng'I-l Framlng - Prlor to cover'
(}
Foundatlon - After forms are
erected but Prlor to concrete
placemont.
Underground Plumblng - Prlor
to fllllng trench.
Wall/Celllng lnsulatlon - Prlor to
cover,
Drywall - Prlor to taplng'
MOBILE HOME INSPECTIONS
[-l Underlloor Plumblng/Mechanlcal ,.--l wood Stovo - After lnstallatlon.I t
- Prlor to lnsulatlon or decKlng' I I
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnsert - Alter flrePlace aPProval
and lnstallatlon ol unlt.
Btocklng and Set'UP - When all
blocklng ls comPlete.
Floor lnsulatlon - Prlor to
decklng.
Sanltary Sewer - Prior to fllllng
trench.
Curbcut & AlrProach - After
forms are erected but Prlor to
placement of concrete.
Plumbing Connecllons - When
home has been connected to
water and sewer.
Storm Sewer - Prlor to lllllng
trench.
Sldewalk & Driveway - After
excavation ls complete, Iorms
and sub'base materlal ln Place'
Eleclrlcal Connectlon - When
blocklng, set'uP, and Plumbing .
lnspections have been aPProved
and the home ls connected to
the servlce Panel.
Water Llne - Prlor to lilllng
trench.
l--l Fence - lVhen cornPleted'
Final - After all required
lnsoectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled'Rough Plumblng - Prlor to
cover.
Streel Trees - When all requlred
trees are Planted'
ls
fl
tl
E
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterior
-
Corner
-
Panhandle i
-
Cul-de-sac
Setbacks
PL.}JSE GAFI ACC
N
S
E
I IS THE PROPOSED WOFIK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be slgnedand approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
BUILDING PERMIT
ITEM SO, FT.X $/SO. FT.VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee (A)
BUTLDING VALUE
AND BUILDING P
i|.
PLAN CHECK
RMIT
t
E
This permil is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfleld, inctuding the
Development Code, regulating the constructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid
Receipt Number:-
Received By:
Plans Flcviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties withln tha City linrits which are being improved.
PLUMBING PERMIT
ITEM
Flxtures
Flesidential Bath(s)
Sanitary Sewer
Waler
Storm Sewer
Moblle Home
FEE
Nt
. FT.
FT.
Plumblng Permit
Stats Surcharge
Total Charge (c)
ADDITIONAL COMMENTS
4 L\C
111.0D
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan No
Wood Stove/lnsert/Flreplace Unit
r Vent
2-o t
Mechanical Permit
lssuance
State Surcharge
Total Permit
lC.o u:
f o. ct-,
(D)
+s/ 7t_.=-t-_-
L0 t4
By slgnature, I state and agree, that I have carefully examlned
the completed applicatlon and do hereby cerilfy that all
lnformation hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon perlainlng to the work descrlbed
herein, and that NO OCCUPANCY wlll be made of any
structure wlthout perrnission of the Bulldlng Safety Divislon.
I further certily that only contractors and employees who
are In compliance with OBS 701.O5S wlll be used on thls
proiect.
I further agree to ensure that all required lnspections are
requested at the proper tlme, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
on the slte at all tl s durlng constructlon,
Slgnature
Date Q- 114fi
MISCELLANEOUS PERMlTS
Moblle Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
--
ft
Demolltlon
State Surcharge
Total Mlscellaneous Perrnits (E)
VALIDATION
FIECEIPT NUMBER
q
DATE PAID
AMOUNT RECEI'^1
RECEIVED BY
/L{
t",o
TOTAL AMOUNT DUE (excluding ele<
(A, B, C, D, and E Comblned)
rl)
FT.
(
Mu1 t i-Fami IY
Service IncI
SPFTIA ,ELt)
pe
ude
r dvelling uni t.
d:Items Cost
CAL PERUIT APPLICATION
b Nunber ?8 tSf
OFFICE: 726-3759
1 ION OF
3. COHPLETE FEE SCEEDTILE BELOV
A. Nev Residential-Single or
IJGA,
t7a 3
- DESCRIPTION .'>r( 79 O0 9rt Sum
Permi ts irre non-transf e rable and e
vi thin LB0
xp-ittEE
if vork ls not started d a{s
1000 sq.ft. or less
Each additional 500
. se:. ft or Portion
i^ '" thereof
Each Manuf'd Home or
-.l-'loduIar DvelIing'S'ervice or Feeder
JOB I)ESCRIPTION
C( Llt*t
s 8s.00
s 1s.00
s 40.00
s s0.00
s 50.00
s100.00
s130. 00
s300.00s 40.00
tra
of issuartce or if vork is su
1.80 days.
2. CO}I'I ACTOR INSTALLATION ONLY
EIectric,rl Contrac tor JB Electrlc, Inc.
Add res s 4065 W. 1ith, #18
Ci ty Euqrene Phone 687 770
Supervis,rr Li cense Number 38725
B. 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-
Over 1000 amps/vo1ts
Reconnect 0n1y
s pended !Of
Expirati:n Date
Constr C rntr. N
10/1/01
Exp ir:ati >n Date
Signatur:Electrician
Ovners N,rm 140 oJ l,*r STe
Address 2t7t l7
city 5lu Phone-.--.----7-
O\INER INSTALLATION
The installation is being made on
property I oun r,,hich is not intended
for saIe, lease or rent.
0'rners S ignature:
umber 104929
C. Temporary Services or Feeders
InstalIation, Alteration or Relocation
3/14/ 00 200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000-voT[s above
s 40.00
s ss.00
$ 80.00
see ItBrt
oT
D. Branch Circui ts
Nev, A1 teration or E.:tension Per Panel
Circuit or vith Service.
or Feeder Permil / S Z
o
E. Misceflaneous (Service/feeder not included)
-Each ins tallation
Pump or irrigation
Sign/0ut1ine Lighting_
Limited Energy/Res
Limited EnergY/Comm
-t- s 3s:oo 3fOne Circui t
Each Addi tional
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
Z00
s 40.00
s 40.00
s 20.00
s 36.00
:37 -
5
1 / "6J-
DATE:
RECEIYED B
/./ I
)1.8 Q
1
SPFtINGFIELO
%
225 FIFTE SIREET
SPRINGFIELD, OREGON 9
INSPECf,ION REQIIEST:
OFFICE: 726-3759
1 I.OCATION OF INST
7 qqZ ///-
ALI.ATION*b pL
COHPI.ETE FEE SCEEDTTIJ BELOV
Nev Residential-Single or
Hulti-Family per dvelling unit.servic6,ftFc[i"o' ,..*" cos t sum
i::fl eHE6ffi hffi:ersne rr i,s';31* - -,ili#ffi,ffijffi-#ffi:rHx*---
Hodular.'DvelIing
Service or Feeder S 40-00
Services or Feeders
Installation, Alterations
ELECTRICAL PERHTT APPLICATION
Job Nunber qfrw
res you to
Notificatton
100.
130.
300.
40.
JOB DESCRI
DESCRIPTION 0v4 1
PTION IL (t*c^'f/t-u C
oo 1r
3
A
.8.
= Permits are non-transferable and expire
lf vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days
2. CONTRACTOR INSTALI,ATION ONLI
' -":Electiical Contractor
Address
Phone
Supervisor Licen m ber(
ExP irati T'"
Cons t tr. Numbe
Expiration e
Signature of Supervising trician
Ovners Nane
Address '5
^ o-,. 2'17 7 /1
Ci ty C v Phone
OVNER INSTALIJ\TION
The installation is being made on
property I ovn vhich is not intendedfor saIe, lease or rent.
Ovnerslsigna ture:
0090.
num
C. TemporarY Serv
Installation, Alterati
(4
00
00
00
00
00
00
s so.
$ 50.
Ci ty
s40sss
$80
see
Feeders
on or Relocation
200 amps"or less 4A
201 amps to 400 amPs -Over 401 to 600 amps
0ver 500 amps or fOOO-voI-[s
.00
.00
.00nB" aEi6
ME
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit
-L
g 3s.oo {
Each Additional
Circuit or vith ServicP ^,-
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/Outline Ligh ting-
Limited EnergY/Res
-
Limited EnergY/Comm
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
$ 40.00
s 40.00
$ 20.00
s 36.00
5f,DATE:
RSCETVED
o
aa
zonlng,