HomeMy WebLinkAboutPermit Mechanical 1997-06-10RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Of fice: 726-3759
LOCATION OF PRO
SPRINGFIELE)
JOB NUMBER
q
225 Fif th Street
Springf leld, Oregon 97477
63o
w
ASSESSORS MAP:t/
TAX
LOT:BLOCK:SUBDIVISION
1_
PHONE:
\STATE:o P ZIP:1q1Ll7CITY:
OWNER:
ADDRESS:
)oADDITION DEMOLISI-I OTHEFI
DESCRIBE WORK
NEW---- REMODEL
ADDFIESS
EXPII]ES PHONE
4t
CONTRACTOR'S NAME
ELECTFIICAL
MECHANICAL:
CONST.
CONTRACTOR #GENERAL:
PLUMBING
_ OFFICE USE _
LAND USE;
WATER HEATEFI
* OF UNITS:
FLOOD I)LAIN
# OF BDFIMS
RANGE:
QUAD AREA:
r OF BLDGS:
OCCY GROUP:
r OF STORIES:
ZONTNG CODEr
SECONDARY HEAT:
SQUARE FOOTAGE;
CONSTR. TYPE:
HEAT SOURCE:
To regu ES a n n p ec on,you mu s c al 26-3 769.T S a 24 h I record ng.AImadehesarlleworkinsday,NS pe ct ion req ueste d a(ter 7:0O a.m requesled before 7:00 a.m. wlll beg work day.
fiii#"{'iil'rr#iJ?;3',"""
7 h S rU
b e m ad e
lnspecilons
the followin
Other
Temporary Eteclrlc
l,,l^u_,l"o""tion - To be madc
S:l:t?ii,Htion' but prior to
H':*:"Jf"i!H[i i S, :c
rrica, /
L9_"-,J"g - After trenches areexcavated.
[l:lv - Steet tocailon, boncJDeams, grouilng.
F.orndatlon _ After forms are:l::l"d but prlor to concretepracement.
t';'ffiIfl;.,i,3d Prumbins - Prior
3 E:lj,,.lJ,?Yffj,i:i, 31";*[,,ff ]
,?".uu1 j,?j^i",,Xi,;,
XJI "' to rr oo r
Floor lnsulation _ prlor todecklng.
Sanltary Sewer _ prirrench. or to fliling
ilt-tf Sewer - Prror ro flilngtrench.
Y:::l Ltne - prtor to filrinsIrench.
Hrr: Ptumbins - prtor to
iEQUIRED INSPECTIONS
I:in_,, Mechantcat _ prior tocover.
I:y^nn Etecrricat - prior rocover.
I::9,*. - prlor to facinsmaterlals and traming tnspi
Framlng - prlor to cover.
W:ll/Celling lnsutatlon _ prlor tocover.
Drywall - prlor to taplng.
'/y'oqd Stove _ Afler lnstaliatlon
9"." Il";,fl l,L',J; rJ li; a p p rovq,
,Clj:_b_cut & Alrproach _ Af tertorms are erected but prior toplacemcnl of concrete.
Sidewalk & Drivewal, _ Af terlllryolign ts compllte, formsano sub.base material in place.
Fence - Vvhen coinpleted.
{ilreet Tr€es _ When all requiredIrees are planted.
MOBILE I.IOME INSPECI'IONS
E |,'S"'f,'lf ,i"j"i#;yg- when a,,
llTol_", connections _ when
Il.?T9 hr: been connected towater and sewer.
,sjff i'i?:!il,i::",:r;#Hl
#"f#HTffii;*:ltfi:x.
i,:ffi+*[1i*+*$*,*
SllilftUt-' ;y,fflfl]
5,'iiJ,.,:'i,"f :",il, ; l,j ill fl l
Eleclrical Service _ n
:lu?ti;,-.%[,i":,;J;:1,*, E ;-ngffjTt?,;"yffi?"iJ:
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
._- lnterior
-- Corner
-__ Panhandle I
-
Cul-de-sac
P.L.HSE GAR ACC
N
S
E
S bac
BUILDING PERMIT
SQ. FT.VALUE
(A)
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fec
,1
X $/SQ. FT.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties withln tl.re City linrits which are being improved.
ADDITIONAL COMMENTS
ITEM
Fixtures
Resldentlal Bath(s)
Sanltary Sgwer
W"t"t
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
N
(c)
FT.
-
FT.
Plumblng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
Mechanical eermit {
lssuance
"o,. ",,.n.
,o" +3'L%fot lduu;>-
ylArli\/
r'7
Total Permit
16W
(D)
NoVent Fan
MECHANICAL PERMIT
Fu rnace
Exhaust Hoorj
By slgnature, I state and agree, that I have carof ully examlned
the completed appllcatlon and do hereby certlfy that all
lnformatlon horeon ls lrue and correct, and I lurther certlly
that any and all work performed shall be done ln accordance
wlth the Ordinanccs of the Clty of Sprlngfleld, and the Laws
of the Statc of Oregon pertalnlng to tho work descrlbed
horoln, and that NO OCCUPANCY wlll be made ol any
structUrewlthoutp6rmls8lonoftheBulldlrlgS6letyDlvlglon.
I further certl(y that only contractors and enrployees who
are ln compllance wlth ORS 701'055 wlll be used on thls
proiect.
to snauro that all requlred lnspectlonB aro
r tlme, that oach addreEE lB r€adabls
te at all times during constructlon'
slg
Date
re
on
I f urther agree
requ€eieci at ihe ProPo
pormlt card la located at tho frontlrom tho stre€t, that th9
approved set ol Plans wlll remalnperty, and theof theMISCELLANEOUS PERMITS
Mobile Home
state lssuance
State Surcharge
Sidewalk
-
(t
Curbcut .- ft
Demolition
State Surcharge
(E)
Total Miscellaneous Perlnits
UM R
VALIDATION:
AMOUNT RECEIVT"D
RECEIVED BY
RECEIPT N
DATE PAII)
TOTAL AMOUN
(A, B, c, D, and
T DUE (excluding electrical)
E Combined)
APPROVED;
Plan Check Fee
Date Paid
Receipt Number:_
Received By:
Plans Rcviewed t3y
PROPOSED WORK TN THEICAL DISTRICI OR ON
Date
IS THE
HISTOFI
THE HISTORICAL REGISTER?
-
lf yes, thls applicauon must be signedand approved by the HistorlcatCoordinator prlor to permit issuance.
PV.ID_|NG VALUE, PLAN CHECKAND BUILDING PERMIT
This permit is granted on the express condiilon that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the Ciry of Springfield, inctuding theDe.velopment Code, regulating the Jonstrucilon and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances.
FT.
a
DESCRTPrtON -1
JOB DBSCRTPTTON
wrnr a/c ufrrr
Permits are non-transferable and expirelf vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days
2. COMSASIOR INSTALIATION ONIY
Electrical Contractor S@FIE[,D EI,ESIRIC
Address PO BOX 2765
City gtJGBlE, 97402-Phone 686-8612
Supervisor License Ndmber 508-5
Expiration Date 1 0-1 -98
Constr Contr. Number 038702
Expiration Date 12-21-97
Signature of Electrlcian
Ovners Name I.OCT(E
Address 912 SUMMIT A\IEX\UE
ci Phone 726-6628
OIINER INSTATIATTON
The installation is being made on
property I om vhich is not intended
for saIe, lease or rent
Omers Signature:
DATts:
RECBIPT
:r--rr Hulti-Fanily per dvelling unit.
ServiC6 fncluded:Items Cost
City rob Nuabe'Qlqq 15
3. CO}TPL TE FgE SCEEDTII.B BELOS
A. Nev Residentlal-Slngle or
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular Dvelling
Service or Feeder
s 8s.00
s 1s.00
$ 40.00
B. Services or Feeders
Installation, Alterations or
Reloca t ion :
sr !rr rN(:IrlELEl
EIECTRTCAI.
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect Only
SIIBTOTAL OF ABOVE
5I State Surcbarge
37" City
TOTAL
j.r
2?5 frFIE, SlBgEf,
SPRIIGEISID, OREGON 97477
INSPECf,I0N RBQIIESE: 726-3169
oFBICE: 72d3759 I
APPIJCATTON
1. roc3lToN 0P
912 ST]MMJT AVEIIUE
4il
/,4
l^ n,
-Jj
SumL
c.Temporary Services or Feeders
fnstallation, Alteration or Relocation
200 amps or less S 40.00
Over 401 to 500 amps _ $ 80.00
0ver 500 amps or 1000 volts see rrBtr above
D. Branch Circuits
Nev, Alteratlon or Extension Per Panel
one ci.rcui t I S 35. oo W)Each Additional
Circuit or vith Service
or Feeder Permit e S 2.00 _@
E. Hiscellaneous (Service/feeder not included)
$ 50.00
$ 60.00
$100. 00
$130.00
s300. 00
s 40.00
39 oa
lc6
l. t '7
-Each installation' Pump or irrigation S
Sign/outline Lighting- S
- Limited Energy/Res S
40.00
40.00
20.00
36.00
RECET\IED BI:
a 5
ata IA
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