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Home My WebLink AboutPermit Mechanical 1997-05-07RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 SP FIELE, JoB NUMBER ?-Z ^ 225 Fifth Street Springfleld, Oregon 9? 417 LOCATION OF PROPOSED WORK:trtt Itr% Er ASSESSORS MAP;TAX LOT: LOI - BLOCK:SUBDIVISION: -- OWNER: fc STATE: [-\ar-t\ .e-€ar^-,,1-.-r{ I ADDRESS: 'Po Box 25 ZlPi Qz q77 ( 'u0 qJ (Lne +DOESCRIBE WORK:65{r-( NEW - BEMODEL ADDITION DEMOLISH OTHER ADDRESS EXPIRES PHONE CONTRACTOFI'S NAME MECHANICAL: ELECTRICAL: PLUMBING: GENERAL: CONST. CONTRACTOR # - OFFICE USE _ WATER HEATER: FLOOD })LAIN RANGE: QUAD AREA: r OF BLDGST SECONDAFIY HEAT: SOUARE FOOTAGE: , OF BDRMS: -- LAND USE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOUBCE: , OF UNITS: - ZONING CODE: _ To request an lnspectl made the same workl lon, you must call 726'3769. Thls ls a24 hour rccordlng. All lnspectlons requested before 7:00 a.m. wlll ben0 day, lnsp6ctions requested after 7:00 a.m. wlll be made the followlng work day. REQUIRED TNSPECTTONS n Temporary Electrlc w Rough Mechanlcal - prlor to Flnal Plumblng - When ailplumblng worl< ls complete.+/t Slte lnspectlon - To lre made after excavatlon, but prior tosettlng forms. Rough Electrlcat - prlor to Final Electrical - When allelectrical work ls complete.cover. Underslab Plumblng/ Electrical / Mechanlcal - Prior to cover.Eleclrlcal Servlce - Must be approved to obtalrr permanent electrlcal power. w Final Mechanical - When allmechanical worlr ls complete. f-l Footlng - After trenches arelJ excavated.Flnal Buildlng - When allrequlred lnspectlons have beenapproved and building is completed.n Masonry - Steet locailon, bondu beams, groutlnO. Flreplace - Prlor to faclng malerlals and framing lnsp. Framlng - Prlor to cover. Foundatlon - After forms are erected but prlor to concrete placemont.E ffi otno' Wall/Celllng lnsulatlon - prlor to cover. n Drywatl - prtor to taptng. MOBILE HOME INSPE TIONS Wood Slovo - After lnstallatlon lnserl - After flreplace approval and lnstallatlon of unlt. [-l Alocklng and Set.Up - When ail'J blocklng ls complete. Curbcut & Agrproach - After forms are erected but prior loplacemcnt of concrete. Plumbing Connectlons - When home lras been connected towater and sewer. Sldewalk & Drlveway - After excavatlon ls complete, forms and sub.base malerlal ln place. Eleclrical Connection - Whenblocklng, set.up, and plumbing lnspections have been approved and tlre home is connected tothe service panel. Water Llqe - Prlor ro filling trench. I [-l Fence - When compteted. Final - After all required lnspectlons are approved andporches, skirting, decks, andventlng have been lnstalled. Rough Plumblng - Prior to cover,n Str€et Troos - When all requlred|J trees are planted. nr/ PHoNE: u\ q33'/ /o ) (a)'7(7-3Xq E fl Underground Plumblng - prior.J to fllllng trench. n Underltoor Plumblng/Mechanlcal Prlor to lnsulatlon or decklng. n Post and Beam - prlor to floor - lnsulatlon or decklng. n Floor lnsulatlon - Prlor to - decklng. i-j Sanltary Sewer - Prtor to fiiling - trench. [--l Storm Sewer - Prior to fiiling - trench. tl E Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type - lnterlor - Corner - Panhandle - Cul-de-sac Set i - THE PROPOSED WORK TN THE. HlsroRlcAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, thls appllcatlon must be slgned and approved bY the Hlstorlcal Coordinator prlor to permlt issuance: APPROVED: ACCP.L.HSE GAR N S E try_ BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the cxpress condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, includlng the Development Code, regulating the construction and use of bulldings, and may be suspended or revoked at any tlme upon violation ol any provisions ol said ordinances' Receipt Number:- Plans Bcvlewed [3y Date Plan Check Fee: Date Paid: Received By: BUILDING PERMIT VALUE (A) SQ. FT. X S/SO. FT.ITEM Main Garagc Carport Total Value Building Permit Fee State Surcharge Total Fec Systems Development Charge is due on all undeveloped properties withln tlre City linrits which are belng lmproved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtures Resldentlal Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home FEE (c) N0 FT. FT. PLUMBING PERMIT Plumblng Permlt State Surcharge Total Charge . FT. By slgnature, I state and agree, that I have carofully examlned tlre completed appllcation and do hereby certlfy that all lnformatlon hereon ls true and correct, and I lurther certlfy that any and all work performed shall be done ln accordance with the Ordinances of thc City of Sprlngfield, and the Laws of the State ot Oregon pertaining to tho work descrlbed herein, and that NO OCCUPANCY will be made of any structure wlthout pennission of the Bulldlng Safety Dlvislon, I further certl(y that only contractors and employees who are In cornpllance wlth ORS 701.055 wlll be used on thls proiect. I further agree to ensure that all required lnspectlons are requested at the proper tlme, that each address ls readable the pcrmlt card ls located at the front d the approved et of plans will remaln co tructlon.on the site at Slgnatu re Date mes o;01-?] from tlre street, of the property, Wood Stove/ lnsert/ Fl replace Unil MTSCELLANEOUS PERMITS Mobile Home State lssuance Stato Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Mlscellaneous Perlnits (E) (D) NoVent Fan Mechanical Permit lssu ance State Surcharge Total Permit M ECHANICAL PERMIT Fu rnace Exhaust Hood W VALIDATION: RECEIPT NUMBER AMouNrFrEcErvED -2L REOETVED av , r4 a?-h-z-- *7-9>DATE PAID TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Comblned) 24_.?? _44 -/% 2.A-=- CITY OF OBEGO'U Date 1 97 Slgn stunc726- 1 F INSTALI.,ATTON gi af I,,EGAL DESCRIPTION JOB DESCRIPTION g< rm ts are non-tr ra 1e .and re if vork is not sta of issuance or if 180 days. rted vithin 180 daYs vork is susPended for 2. COMRACTOR INSTAIL,ATT0N ONIY it,(\*Lt* (.-\-^n,'- r t15' Electrical Co ntractor OLlne"'- eddress Po 'B-< Z5- Ci ty SP r ,^qfir-td o0- Phone 933 t tou Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician 0vners Name tlt,.x-trts' ," 7t) Bcrx 23 e\4(phone (su)q3)-((6-7/ ELECTRICAL PERHIT APPLICATION City Job tt*b", ?7224 3. COHPI,ETE FEE SCEEDTITE BELOS !iPR, FIELO Nev Residential-Sing1e or Multi-FamilY Per dvelJ-ing unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 . sq. ft or Portion thereof Each Manuf'd Home- or Modular Dvelling Sertice or Feeder $ 8s.00 s 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less -{20L amps to 400 amPs - 40i. amps to 600 amPS - 601 amps to 1000 amPs- 0ver 1000 amPs/volts - Reconnect 0n1Y appi-oval Zcnine 225 FITTE STREET SPRINGFIEI,D, OREGON INSPECf,ION REQIIEST: OFFICE: 726-3759 A Sum B C D E $ s0.00 s 60.00 $100.00 $130.00 $300.00 $ 40.00 _4-n 40.00 * s5. o0 80.00 ee rrBrr aSove Addre Ci ty Temporary Services or Feeders Installaiion, Alteration or Relocation 200 amps''or less 201 amps to 400 amPs -Over 401 to 600 amPs Over 600 amPs or iOOO voTEs Branch Circuits Nev, Alteration or Extension Per Panel one circuit s 35'oo Br"n aaaitional Circuit or vith Service , or Feeder Permit--- --4- $ 2'oo --e Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/0utIine Lighting- Limited EnergY/Res - Limited EnergY/Comm SUBTOTAL OF ABOVE 5% State Surcharge 32 Administrative Fee TOTAI $ $ $ s $ s $ $ OVNER INSTALLATION The installation is being made on prop"tty I ovn vhich is not intended for sale, lease or rent'40.00 ignat 40 20 00 00 00 ,o 5 RECETVED B 36 A/l /2€7^=z-7 t , 7 Permit # Address E4 Issued by Ztu Date'77 Statement: lnformation Notice to Property Owners About Gonstruction Responsibi lities Note: Oregon Law, ORS 701.055(4), requires residentiql construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from regtstration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 3,A. or 38 &l. I own, reside in, or will reside in the completed structure 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3,A'. My general contractor is Qllame) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certiff that the above information is correct and that I have read and do understand the Information Owners a onstruction Responsibilities on the reverse side of this form. (Signature of permit applicant) (LVhite copy to issuing agency permit file, pink copy to applicant) Notice to P (Date) 3,/4 I I I .: a .t, L. ; r1... i,- ..