HomeMy WebLinkAboutPermit Mechanical 1999-05-03RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
SPRINGFIELl)
?70floJOB NUMBER
225 Fifth Street
Springfleld, Oregon 97477
LOCATION OF PROPOSED WORK:a555 rUo Rfl e. tsr sT
ASSESSORS MAP:/10 zqnL
TAX LOT:o/3 o/
SUBOIVISIONLOTBLOCK:
an3PHONE:
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STATE:
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OWNEB:
ADDRESS:
CITY:
ADDITION DEMOLISH OTHER
IDESCRIBE WORK:
NEW- REMODEL
o
ADDRESS
4bal
\o
o
EXPIRES ,' PHONE
-oo -7I
CONTRACTOB'S NAME
GENEflAL:
PLUMBING:
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
FFICE USE -
\s1
qU
E:
$at
tne10{
WATER HEATER:
FLOOD I)LAIN
* OF UNITS:
SECONDABY HEAT:
SOUARE. FOOTAGE:RANGE:
ZONING CODE:
CONSTB. TYPE:
HEAT SOURCE;
OCCY GROUP:
*,OF STOBIES:
QUAD AREA:
* OF BLDGS:
To request an lnspectlon, you must call 726'3769. Thls ls a 24 hour recording. All lnspections requested before 7:00 a.m. will bemade the same worklng day, lnspections requested after 7:00 a.m. wlll be macJe the following work day.
REQUIRED INSPECTIONS
n femporary Etectrlc Rough Mechanical - Prior to
cover.
Final Plumbing - When ailplumbing wgrl( ls complete.
SIte lnspectlon - To be made
after excavatlon, but prior tosetting forms.
Rough Electrical - Prlor to Final Electrical - When alt
electrical work is complete.cover.
n UndErslab Plumbingl Electrical/u Mechanlcal - Prlor to cover.Electrlcal Service - Must be
approved to obtaln permanent
electrlcal power.
al Mechanical - When all
ical work ls complete.
Flnal Building - When altrequired lnspections have been
approved and building is
completed.
Flreplace - Prlor to faclng
materlals and framing lrrsp.
Framlng - Prlor to cover.
Other
Wall/Celting lnsutatlon - Prlor to
cover.
l--l Drywatl - Prlor to raping.
Underlloor Plumblng / Mechanlcal
- Prlor to lnsulatlon or decklng.
MOBILE HOME INSPE TIONS
Wood Stovo - After lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or decking.lnsert - After firei:lace approval
and lnstallatlon of unit.
Blocking and Set.Up - When ailblocklng is complete.
Floor lnsulation - Prlor to
decking.Curbcut & AJrproaclr - After
forms are erected bUt prior toplacement of concrete.
Plumbing Connections - When
home lras been connected to
water and sewer.
Sanltary Sewer - Prior to fllling
trench,
n Storrn Sewer - Prior to fiillngu trench.
n Water Llne - prlor to fillingu trench.
l-l Rough Plumbing - Prlor rol-J cover.
Sidewall< & Driveway - After
excavation ls complete, forms
and sub-base material in place.
Electrical Connection - Whenblocking, set-up, and plumbing
inspections have been approved
and the home is connected tothe service panel.
Fence - When coit'lpleted
Slreet Trees - When all required
trees are planted.
Final - After all required
inspections are approved andporches, sklrllng, decks, andventlng have been lnstalled.
# OF BDRMS: _
fl
tl
fl Footing - After trenches are|J excavated.
n Masonry - Steel locailon, bond|J beams, groutlng.
n Foundatlon - After forms areu erected but prlor to concrete
placement.
l-l UnAerground Plumbtng - prtor
'J to fllllng trench.
E
E
E
E
n
E
E
tl
fl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-_
Corner
-- Panhandle
-
Cul-de-sac
. ,S THE PROPOSED WORK }N THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
arrd approved by the Historlcal
Coordinator priOr to permit issuance.
AP D:
PL.HSE GAR ACC
N
I
S
E
BUTLDING VhIdE, FLAU CHECK
AND BUILDING PERMIT
This permit is granted on the express condltion that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordlnances.
Receipt Number:-
Plans Rcviewed By
Plan Check Fee:
Date Paid
Received By:
i.:",*
BUILDING PERMIT ; i
VALUE
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
X $/SO. FT.ITEM
Main
Garage
Carport
SO. FT,
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties within tlre City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sgwer
Water
Storm Sewer
Mobile Home
FEE
(c)
N.
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certlfy that all
information hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
with the Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure without perrnission of the Bullding Safety Division.
I further certify that only contractors and employees who
are in compliance with OFIS 701.055 will be used on thls
proiect.
I further agree to ensure that all requlred lnspections are
requested at the proper tlme, that each address ls readable
from tlre street, that the permlt card ls located at the front
I
*
of the property, and the ap of plans will remain
on the site at times du
e.Signature
Date ;-3 -7?
Wood Stove/ lnsert/Fireplace Unit
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
/Cc'u
o. oo
V
,9D v
NoVent Fan
(D)
MECHANICAL PERMIT
Furnace
Exhaust l'lood
Mechanical Permit
lssuance
State Surcharge
Total Permlt
1
VAl-IDATION:
DATE PAID
957 rT
AMOUNT RECEIVED
RECEIVED BY
z(. Lo
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
t
Date
Drver Yentllc t tr 9rr=--
RECEIPT NUMBER
C'TY OF OFEGO'U
SPF"{GFIELO
l'hc f,rll4,/''rng projecl as submitted has the followino
"JJ;:;"i"t
does nol require tp".it"-irnJr!""''
Zoning {L
225 FTFTE STREET
SPRINGFTELD, OREGON
INSPECTION REQTIEST:
OFFICE: 726-3759
1
lJAre -\R-q PERHIT APPLICATION
3. COHPIJTE FEE SCEEDTILE BETOI{
Nev Residential-Single or
Multi-FamiIy per dvelling unit.
Service Included:Items Cost
t$:urebJilft0O0 v ess s 8s.00
n Center TnsqF fr
$ 1s.001-001 or
s 40.00
terat ions
It, i' c.
7tC-
amps
amps
amps
olts
City Job *r^r"r-?109?d77
LOCATION OF INSTALLATION- ltes z/l A
IJGAL DESCRTPTIONl'7o7 2'{'/z O/10/Sum
DESCRTPTION
C t tz a,t ,.'/
Permits are non-transferable
if vork is not started vithin
of issuance or if work is sus
180 days.
Address
Electrical contrac rcr60L E < he/-f/fc
A1--iEl\liiu
center.
numbe rforthe
2. COMRACTOR INSTALI..ATION ONIY Cente.6|s'l ces or FeedersInstallation, A1
or Relocation:
200 amps or less
201 amps to 400
40L amps to 600
601 amps to 1000
Over 1000 amps/v,
Reconnect 0n1y
kr s s0.00
$ 60.00
$100.00
s130. 00
$300.00s 40.00
cit
Sup
Exp
v Phone J-4t - 6W - 7?73
ervisr:rr License number# 3? 7,f - -t
iration o^rclnZzlgZ
Constr Contr. Number7, D. 3r2C.
Expiration Date o
Signa of Supe rv,.sI.Electrician
Ovners Name Gtz,f/
C. Temporary Services or FeedersInstallation, Alteration or Relocation
D. Branch Circuits
E
3?. n
/. ?(
200 amps"or less $ 40.00
201 amps to 400 amps
-
$ 55.00over 401 to 600 anips
-
$ 80.00
0ver 600 amps or 1000 voTts see rrgrr
"g[ft-
Address )< S j )-/
City S C/ phone 7 7 o/?3
OIJNER TNSTALLATION
DATE:
The installation is being made onproperty f ovn vhich is not intendedfor sale, Iease or rent.
0mers Signature:
Nev, Alteration or Extension per panel
OneCircuit / $35.00 J-t
Each Addi tional ---t--
Circuit or with Servicaor Feeder permit A S Z.OO 7
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0ut1ine Lighting-
Limited Energy/Res
-Limited Energy/Comm
-
$ 40.00
s 40.00
$ 20.00
s 36.00
5 SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL -it+-RECETVED B
(3,I