HomeMy WebLinkAboutPermit Mechanical 1998-11-17-\
BESIDENTIAL
PERMIT APPLICATION
lnspections:726.3769
Oftice: 726.3759
:;PFlINGFTELD
JOB NLjMBEN /(/
225 Fif tlr Strcct
Sprirr g tic:ld, Orcgou 97 477
LOCATION OF PROPOSED WORI(415 S +ZM.S}
Firr
PHONE
zn9
STAI'E:7-tP
|lzb'wtq
CITY:
ADDRESS:
OWNER:
ADDITION DEMOLISI.I OTIjEN
DESCRIBE WORI(:
NEW- REMODEL
'/
ADDRESS EXPIIlES PI.ION E
7A-5tbDDD
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL;
CONST.
CONTRACTOR /
GENERAL:
PLUMBING
FLOOD I)LN IN:
S HALL ERPIHFI FfiflFwoRK-_
SECONDA|IY I.IEAI-:
PFRl.rtRouAnF. FOOT^C E
ASSESSORS MAP:l1 2,3rt TAX LOT 0b5ob
LOT
-.--
BLOCK: SUBOIVISION: _
To rcquest an lnspcction, you must call 726.3769. Tlllmade the sanre worklng cJay, lnspcctions rcquestcd
Temporary Elactric
s ls a 24 lrour rccordrng. Ail inspcctiorrs rc(luestcd bcforc 7:00 a.rn. wlll bcaftcr 7:00 a.m. will bc macje thc following work day.
REQUIRED INSPECTIONS
Rouglt Mcchanical - prlor tocover.
Site lnspcclion - To lrc macle
af ter excavation, but 1:rior tosettlnO forrns.
[-_| Unctcrslab plunrbing/ Elcc rrical /
-
Mechanical - prior to covcr.
Foollng - Alter trenches arcexcavated,
Masonry - Steel locatlon, boncJbeams, grouting.
Fourrdatlon - Aftcr (orms arcerccted but prior to concretcplacernen t.
Floor lnsulation - prior todeckl ng.
Storrrr Sewcr - l)rior lo fillingtrench,
Watcr Llrrc - prlor to fillin 0
t rench
Rough Plunrbing - prior to
cover.
Final Plurrrbing - !ryhs6 s13pluntt:ing worl( is complet,c.
IFirr:rl Elcctlical - Vy'hc11 allL'lcctrical worl( is corrrplctc.
Rough Electrical - prior tocovcr.
cover
Wood Stovc - nftcr lnstailiriion.
Sidewalk & Drivcwal, - Attc.rcxcavatiort is complctc, foilr)san(l sul).base rnalcrial irr ;tl;rco.
Fencc - Wllcn colnplctcd
Elcctrical Scrvlcc - Mtrst bcal)provccl to clbtain pctrnancr.ll
clectrlcal l)ower.
Flrcplace - prlor to faclng
materlals and (raming lnsp.
Framlng - prlor to covcr.
Wall/Cclling lnsulation _ prlor to
cclranical - Wlren all
Ira nical worl( ls cornplctc.
Final tiuilciirrg - Wl.ren allrcquired inspcctlons have becnapproved and builcling is
c orn plo t0d.
fl UnOerground ptunrbino - prior
'J to fllllng trcncn [-_l Drywatl - prlor ro raplr]g.
Underlloor Plumblng/ Mcclranical
- Prior to Insulatloh or dccl(in0.
Post and Bcam - prior to floorlnsulatlon or decl(lng.
MOBILE I.IOME INSPECTIONS
Sanitary Scwcr - prior to fillingtrcnch.
Curbcut & /\1rl.rroaclr - Attcrlorms arc croctcd bUt prior loplaccrncl) t o( co,.lcrclc.
[--l tnscrt - Alrcr ltret)lacc approval
-
and installatlon ot unit.
[l S]ockirrg an<I Ser.Up _ Wtlcn ail
-
btocl(in0 ls cornplcte.
Pltrrnbirrg Conrrcctions _ WhcnIrornr: lr;rs bcen coltrlected tow;itcr;,tn(l sevJ()r.
fl Utccrrit:al Corrrrcctior) - Wl.lcn* l>locl<ir)0, scl.up. and pltrnrbinginspoclions ltnvc bccn oppror6dilrlcJ tllc trornc is connccted tothc scrvico f)ancl.
[_l {;troot Trccs - Wt]cn ail rcqulrecJ
-
lrccs arc plantcd.
Firral - Af tcr all rcquircdlnspcctions arc approvcd andporclrcs, sl(irting, decks, andvcntlng havc bcen lnstalled.
%Y,
rl
l----l otho.
Lol faccs
Lot sq. ttg.
Lot coveraoc
Topography
Total lrclght
Lot 'fyl)c
-
lnterior
--
Corner
-
Panhandlc
-_- Cut-ilc-sac
Sc t l)acl(:;
PL.H5tr GAR
N
S
I
E
i-'rs rur PBorrosE.D woHl( iN TtiE .
IJISTORICAL DISTRICT, OR ON
TI]E IIISTORICAL REGISTER?
-
l( yes, this application must be slgned
arrd approvcd by the Hlstorlcal
Coordinator prior to permit issuance.
APPROVED
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Tlris pcrnritis granted on thc cxprcss conditiorl that ttre said
construction slrall, in all respccts, conform to thc Ordinance
adoptcd by thc City ot Springticld, including the
Dcvclopment Coclc, rcgulating the construction and use ol
buildirrgs, and may bc suspelrded or revol<cd at any tl,ne
upon violation of arry provisions oI said ordinances.
DatcPlans Flcvicwcd BY
Plan Chccl< Fcc:
Datc Paid
Bcceipt Nutttbcr:
Rcccived By:
BUILDING
VALUE
(^)
x $/so. r--T,
PERMIT
ITEM
Main
Garagc
Carpott
Total Valuc
Building Pcrmit Fcc
Slatc Surclrargc
Total Fcc
Systcms Dcvclopmcnt Chargc is duc on all undevcloped
propcrties within thc City linrits whiclr arc bcing improved.SYSTEMS DEVELOPMENT CHARGE (SDC)
(El)
ADDITIONAL COMMENTS
ITEM
Fix tu res
Rcsldcntial Bath(s)
Sanitary Sewcr
Watcr
Stortn Sewcr
Mobllc Flotnc
FEE
(c)
NO
,--'i:
t:T.
FT.
PLUMBING PERMIT
Plurnbln0 Pormit
statc surcharoe
Total Cltarge
/
By slgrrature, I statc ancJ agree, that I have carcf ully examined
the cornplctcd a1ll>lication and do hercby certlty that all
lrrformatiorr hercorr is true all(l corrccl, ancl I Iurther certi(y
that any and all work pcrformcd shall be done in accordance
with tlrc OrcJinariccs of tltr.l City ot Springflcld, arrd tlrc Laws
of tlrc Statc of Orcgon l.rcrtairring to thc worl< described
hercin. and tlrat NO OCCUPAITICY will bc trracJe of any
structurc wlthout pcrtnissiorr ot lhe Buildlng Sa[ety Division'
I turtlrer certity tirat only contractors and enrployecs who
arc in cotnpliancc witlr ORS 701.055 wlll bc used on this
p ro icc t.
lfurtlrcr agrec to cnsurc tlrai ;rll rcquired inspcctions arc
rcqucstcd at thc propcr tirne, tl)at cach address is rcadablc
hc pernrit card ls locatcd al the f ront
c approvcd sct of plans will remain
Slgnatu
Date
Iralrom thc strc
rty, ano[ thc pro
on.s duflng corl son the si at al
Wood Stovc/ lnscrt/Flrcplacc UrliI
Drycr Vont
MISCELLANEOUS PERMITS
Mobilc Honte
Statc lssuancc
Stata Surchalgc
Sidewall< _-_- ft
Curbcut
--
ft
Dcmollllon
Stalc Surchargc
Total Misccllaneous Pcrlnits (E)
MECHANICAL PERMIT
/(, t'-
/,) ,,,
,K 1?f_zcu
t(bS
(D)
N0
Mcclranical Pcrrllit
lssu ancc
Statc Surchar0e
Total Pcrtnlt
Furnacc
Exhaust Hood
Vcnt Fan
4
VALIDATION
RECEIPT NUMBEF'I
DAI'E PAID
AMOUNT RECEIVT..D
05zc't I
<
TOTAL AMOUNT DU E (oxclucling olcclrical)
(A, B, C, D, and E Corttt:it'tcd)FIECEIVED BY _
(.2
lSP CiFICLO
J:;&':#'J'rffi ,ffi A1ffi.p,g1*t
iY
225 ttYm SIts"EET
SIRINGFTELD, OREGON 9
IilSPEgTTOil REOUEST:
OPEICB:' 726-3759
BI.ECTRICAL PERI{IT APPLTC,ATTON
Ci ty Job Huuber ?fu q t,r
COI{PIJTE PBE SCEEDI'LE EELOS
Neu Resj.dential-Single or
llultl-FauilY Per dvelling unlt'
Service IncLudedt ,,"r. cost
1000 sq.ft. or less S 85'00
Pact, adattional 500
fiftd6dr' Portion g 15.00
m+U Us Uf,'!.Home. or
-,{e'-hH}:_ffi5ffiyu*.*
SglijitiSl8o DtseerEDor,,i ri i rn o
Ins tillrttonry,'*1 te r8t idnS' ""
s 60.
s100.
s130.
s300.
$ 40.
[rrro ll-t1
?6t7J,.ir"o
726-376
1. II}CATION OT INSTALI.A:TTON
DESCRIYTION
JOB DESCRIPTION
l-cJ ?--P
3
A
B.
Sum7
Ar ? Ja-O
Pernlts are non-transferable and explre
tf vork is not started vlthin 180 days
oi fisuanc€ or if uork ts suspended for
180 days'
2. OSfTRAqTOR INSTALIIITTON OIILT
Elec trieal Con tr acrct Y1 et ciF Q c- fu"o.,h-t, f*,ot Reloca t ion :
Address
CLty tt*t --c-. - Phone-&-d&:-6Hlo-
Supervlsor Llcense Numbe rA-.}Jf<--
ExP iratlon Date /tt - I -Ail
Constr Contr. Nunber 9opP7
Expiration Date
c.s or Feeders
yoru r8eloca tion
the Oregon Uti
ilihre ru les arq qat *!a'55
80
Nev, Alteration or Extension Per Panel
Ioneclrcult I s35'oo
Each Additlonal
fio,
ServicT
$2.00 7'alt
E. Hlscellaneous (Servlce/feeder not tncluded)
-Each instalLEtion
Pump or irrlgation
Sign/Out1lne Ltghti
Linited Energy/Res
Llnlted EnergT/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Adminlstrative Fee
TOTAL
20O anos or less
iOf auis to 400 anPs :
401 aaps to 600 saPs
-
601 aaps to 1090 anPs-
Over 1000 anps/volts
-
Reconncct OnIY
00
00
00
00
00
00
s s0.
N,
i 1'1
.00
.oo.00
-tBtr affiSlgnature of Supervtsing Electrician
orners nane L 0+cz- . L)WtltA
Address 4 r r- 3 -?2 nrp s f-
ct Phone $L "-) yj$
OIINEB TNSTALI.A'TION
The installation ls belng made on
property I ovn uhich is not intended
for saIe, Iease or rent.
(hmers Signature:
DATE;
n
n
Clrcuit or vith
or Peeder Pernit
n8_$ 40.00
s 40.00
$ 20.00
$ 36.00
j7,Da
aC/,TY OF D OREGON
RBCEIVED
5
7 f.tL
D.
LLrt>
€nA, -firatn