HomeMy WebLinkAboutPermit Mechanical 1994-10-14T
B
P
iESIDENTIAL
ERMIT APPLICATION
lnspectlons: 726.3769
Offlce: 7264759
SPRIhrGFIELc)
Zfr,
JOB NUMBER
225 Flfth Street
Sprlngfleld, Oregon 97477
LOCAT]ON OF PROPOSED WORK:
ASSESSORS MAP:TAX LOT
SUBDIVISION:_
PHONE:
o(,ZlPiSTATE:
6i llne b
lLl AN bA
bp Nrs Rn
tB Pal
OWNEB:
ADDRESS:
CITY:
NEW- REMoDEL,-,- AoDITIoN
I
ed
DEMOLISH OTHER
OESCRIBE WORK:
ADDRESS EXPIRES PHONE
lSL?d,
.l_
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
ELECTBICAL:
- OFFTCE USE -
I OF BDRMS:
FLOOD PLAIN
OUAD AREA:
, OF BLDGS:
OCCY GROUP:
r OF STORIES:
SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTB. TYPE:
HEAT SOURCE:
LAND USE:
WATER HEATER:-
,f OF UNITS:
-
To request an lnspecilon, you must call 726-376g. Thls lsmade the same worklng day, lnspectlons requested afte
a24 .hour recordlng. All lnspecilons requested belore 7:00 a.m. wlll ber 7:00 a.m. wlll be made the followlng work day.
l-l Slte tnspectlon - To be macteu after excavatlon, but prlor tosettlnO forms.
[-l Understab plumblng/ Electrlcat/
-
Mechanlcal - prlor to cover.
fl Footlng - After trenches are
-
excavated.
[-i nlaaonry - Steet tocailon, bond,J beams, groutlng,
E Foundallon - After forms areer€cted but prlor to concreteplacement.
ffi(rnur Mechanlcat - When ail
z/-----Jr,$echanlcal work ls comple te.
Flnal Bulldlng - When allrequlred lnspectlons have beenapproved and bulldlng lscompleted.
Flnal Electrlcal - \Mren allrlcal work ls complete.s
Other
Temporary Electrlc
Floor Insulallon - prlor to
decklng,
Sanllary Sewer - prlor to fllllng
trench.
Slorm Sewer - Prlor to fllllng
trench.
REQUIRED INSPECTTONS
t---2ffi Roueh Mechanlcal - prtor to
-\over.
ffinorgL Electrlcal - prlor to-z----\,J --.._-_. \cuver.
Electrlcal Servlco - Must beapproved to obtaln permanent
electrlcal power.
[-l Flreptaco - prtor to factng'J materlals and framlng lnspl
[-_| Framlng - prtor to cover.
i
WaltlCelllng lnsrJtatlon - prlor to
[-_l Flnat ptumbtng - When ail
-
plumblng work ls complete,
t] l'Jfiiffilii,li"ln'."orns - Prror [l Drywan - prror ro taprns
E
Underlloor Plumblng / Mechanlcat
- Prlor to lnsulatlon or decklng.
Posl and Beam - prlor to floorlnsulatlon or decklng,l--l tnsert - After ftreptace approval
-
and lnstallatlon of unlt.
[-_l elocklng and Ser.Up - Whep ail
-
blocklng ls compleie.
cover.
Wood Stovo - After lnstallatlon.
MOBILE HOME INSPECTIONS
Plumblng Connectlons - Whenhome has been connected towater and sewer.
l-l Water Llne - prlor ro fiiltng|J trench.
Rough Plumblng - prlor to
cover.
Curbcut & Approach - Afterforms are erected but prlor toplacoment of concrete.
Sldewalk & Orlveway - Afterexcavatlon ls complete, formsand sub.base materlal ln place.
Fence - When completed.
Slreet Troes - When all requlredtrees are planted.
Electrlcal Connecfion - Whenblocklng, set.up, and plurpblng
rnspecilons have been approvedand the home ls connected tothe servlce panel.
Final - After all requlredInspectlons are approved and,porches, sklrUng, decks, andventlng have been lnstailco.
ult Q P",l AFI\ Al
1-7
CONST.
CONTRACTOB .|
tl
tl
E
IS THE PROPOSED WOBK IN THE .. HISTOBICAL DISTRI T, OR ON
r.'THE HtsroRlcAL REGISTER?
lf yes, thls applloatlon must be slgned
and apProved bY the Hlstorlcal
Coordlnator prlor to permlt lssuance'
APPROVEDI
GAR ACC'P.L.HSE
N
S
E
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total tlelght
Lot Type
-
lnterigr
-
Corner
-
Panhandle
-
Cul-de'sac
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express condltlon that the sald
consiructlon shall, ln all respects, conform to the Ordlnance
adopted by the City of Sprlngfleld, lncludlng the
Development Code, regulatlng the constructlon and use of
bulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provlslons of sald ordlnances.
Plans Bevlewed By Date
Plan Gheck Fee:
Date Pald:
Recelpt Num
Becelved By:
SO. FT. X $/SO. FT. - VALUE
BUTLDING PERMIT
(A)
ITEM
lv!ain
Gaqage
Carport
Total Value
Bulldlng Permit Fee
State Surcharge
Total Feo
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmont Charge ls due on all undeveloped
propertles wlthln the Clty llmlts which are being lmproved.
ITEM
Flxturest.
Besldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
Ne
FT,
FT.
(c)
PLUMBING PERMIT
Plumblng Permlt
State. Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMI
Furnace
Exhaust Hood
Wood Stove/ lnsort/ Flreplac_e Unlt
Dryer Vent
(D)
1qtu_#/-t-_
N0
aC)
fri)'t,
Vent Fan
Mechanical Permit
lssuahce
State Surcharge
Total Permit
,M,
,7f_--7#
By slgnature, I state and agree, that I have carefully examlned
lhe completed appllcatlon and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done ln accordance
wlth the Ordlnances of the Clty of Sprlngfleld, and the Laws
of the Stats of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Bulldlng Safety Dlvislon.
I further certlfy that only contractors and employees who
are ln compllance with ORS 701.055 wlll be used on thls
prolect.
I further agree to ensure that all requlred lnspectlons are
requested at the proper tlme, that each address ls readable
from tho street, that the permlt oard ls located at the front
of the property, and tho approved set of plans wlll remaln
A-onb
tlmes durlng constructlon.
Date
MISCELLANEOUS PERMTTS
Moblle Homo
State lssuanoe
State Surcharge
Sldewalk
-
ft
Gurbcut
-
ft
Demolltlon
Stato Surcharge
Total Mlscellaneous Permits (E)
z
0
e
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT BECEIVED
RECEIVED BY -
TOTAL AMOUNT DUE (exctudtng etectrtcat)
(A, B, Cr Q and E Comblned) ^Z zo
.. i:- 'r1.
CITY OF OBEGO'V
Ii;
225 FIFTH STREET ' . -!PF
SPRTNGFTELD, OREGON-g7 477
SPIllINGFIELD
Ci ty Job Number
gnatut o lt tq3. COHPLBTE FBE SCffiDIILE BELos
INSPECTION
OFFICE: 72
1.OP
ElectricaL Contractor
Address
Ci ty
.following proJect as submitted has fherng, and does not roquire specific landroval,'Trccrnrcal PERurr APPLTcATToN
5a?69 l0-
Auihciizod S;
ALLATION
TEGAL DESCRIPTION
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vsrk is suspended for
180 days.
2. COMIRACTOR INSTALLATION ONLY
Nev Resi.dential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
Supervisor License Number /a@aJ
Expiration Date
Constr Contr. Number
Expiration Date
Signa ture of Supervising Electrician
Ovners Name
Address
Ci ty
., OI,INER INSTALLATION
The installation is being made on
property f ovn vhich is not intended
for sale, Iease or rent.
Owners Signature:
DATE:
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf 'd llome or
Modular Dvelling
Service or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amPs _
40L amps to 600 amps _
601 amps to 1000 amps-
Over 1000 amps/voIts
Reconnect 0n1y
D. Branch Circuits
SUBTOTAL OF ABOVE
52 State Surcharge
3% Administrative Fee
TOTAT
Temporary Services or Feeders
Installation, Alteration or Relocation
A
B
C.
$ 8s.00
$ 1s.00
$ 40.00
Sum
above
rf lr ,-
7, ? , en."" 7f(-22 5(,
$ s0.00
s 60.00
$100. 00
$130.00
$300.00
$ 40.00
200 amps or less
201 amps to 400 amps
-Over 401 to 600 amPs
Over 600 amps or fbOO voT[s
$ 40.
$ ss.
$ 80.
see rr
00
00
00
Btt
Phone
Nev, Alteration or Extension Per Panel
one circuit t --' $ 35.00 Str
Each Additional
Circuit or vith Service
or Feeder Permit- -l-- $ 2.00 4
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
r,iili ted Energy/Res
-
$ 20.00
E
5
RECEIVED
,@ 4q