HomeMy WebLinkAboutPermit Mechanical 1998-04-27SP,lINGFIELr)RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
Qvc ''t,JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
Z1i 3 Yo lo,,r)n
ASSESSORS MAP:lr o2_ tq v3 0TAX LOT
LOT:BLOCK:SUBOIVISION:
--
OWNER PHONE:
og,STATE:ZIP:
no
7 7
ADDRESS:
'z?
CITY:5
lc."*
A{{Aff
NEW
-
REMODEL ADDITION DEMOLISH OTHER _-
,,trnji{ hDESCRIBE WORK:
ADDRESS
dsft 'Jrra
Bi^,*c
EXPIRES ,l PHONECONTRACTOR'S NAME
GENERAL:
ELECTRICAL:
MECHANICAL:
PLUMBING:
CONST.
CONTRACTOR #
- OFFICE USE -
FLOOD I)LAIN:LA
EAI:
a
RANGE:
QUAD AREA:
I OF BLDGST
SQUARE FOOTAGE: _
OCCY GROUP:
* OF STORIES:
To request an inspectlon, you
made the same worklng day,
must call 726-3769' Thls ls a24hour recording. All lnspections requested before 7:00 a.m. wlll belnspections requested after 7:00 a.m. wlll be made the folrowrng work day.
REQUIRED INSPECTIONS
Rough Mechantcal - prlor to
cover.
E iJffiifl!"i,lfljn'.'-otns - Prior [--l orywau - prlor to tapins.
Underlloor Plumblng / Mechanlcat
- Prior to lnsulailon or ctecking.
l-_] Understab plumbing/ Etecrricat/
-
Mechanlcal - prior to cover.--/| fl Final Mechanlcal - When all
-
mechanical work ls complete.
Electrical Connection - WhenbJocking, set-up, and plumbinglnspections have been approvedand the home is connected tothe servlce panel.
Temporary Electric
Site lnspectlon - To be madeafter excavatlon, but prior tosetting forms.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bondbeams, groutlng.
Foundatlon - After forms areerected but prior to concreteplacement.
Floor lnsulation - prior todecking.
ly,zf Rough Electricat - prior to|J cover-
Eleclrical Service - Must beapproved to obtain permanent
electrlcal power.
Flreplace - prlor to faclng
materlals and framing lnsfl
Framlng - Prior to cover.
Wall/Celting lnsulallon - prlor to
Flnal Plumbing - When altplumbing worl< is complete.
al Electrical - When ailelectrical work is complete.
Flnal Buitdlng - When allrequired lnspectlons have beenapproved and building iscompleted.
Other
MOBILE HOME INSPECTIONS
cover.
Wood Stove - After lnstallation.
Sidewalk & Drivewav - Afterexcavation ls comp,ete, formsand sub.base material in place.
[-l Post and Beam - prior to floor
-
lnsulatlon or decking.
[-l Sanitary Sewer - prior ro fiiling.J trench.
Curbcut & AJrproach - Afterforms are erected but prior toplacement of concrete.
Storrn Sewer - prior to fillingtrench.
l-l Warer Ltne - prtor to fiilinglJ trench.I_l fence - When coi-,rpleted.
Rough Plumbing - prior to
cover.
l--l lnsert - After ftreptace approval
-
and installailon of unlt.
[-l Btocking and Set.Up - When alt
-
blocklng ls compleie.
Plumbing Connections _ Whenhome has been connected towater and sewer.
l--l Streer Trees - When ail required
-
trees are planted.
Final - After all requiredInspectlons are approved andporches, sklrilng, decks, andventlng have been lnstalled.
iiI
FOR
SHALL EXPIRE IF THE
UNDER THIS
WATER HEATER:-
CODE:
WORK
ZONING
IS NOT
'r OF BDRMS: _
E
!i:'
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Ty,_
-
lnterlor
-
Corner
I
-
Panhandle
-
Cul-de-sac
IS THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this appllcatlon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
P,L.HSE GAR ACC
N
S
E
BUILDING PERMIT I
VALUE
(A)
Total Value
Building Permit Fee
Stale Surcharge
Total Fee
ITEM
Main
Garage
Carport
SQ. FT. X $/SO. FT.
This permit is granted on the express condition that the said
construction shall, in 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 ordinances.
Receipt Number:-
iluru cHEcK
Plans Reviewed By Date
Date Paid
Received By:
Plan Check Fee:
RMIT
BUILDING VALUE, I
AND BUILDING PE
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
Nr
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
MECHANICAL PERMIT
{Lr--+1Q._1
(D)
N0
Mechanical Permit
lssuance
State Surcharge
Total Permit
,7r(+ ,45-
6h_2q
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure wlthout pertnission of the Building Safety Divislon.
I further certily that only contractors and employees who
are in compliance wlth ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper tlme, that each address is readable
from tlre street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
on the site at all times during constructlon.
(rsn",u," 7- /11 -t -27 -28(","
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surcharge
Total Miscellaneous Perlnits (E)
a15C /
?-o
DATE PAI[)
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding electrical)
(A, B, c, D, and E Combined)
. FT.
FT.
QITY /aF aiilt'Lilr" tlr.'tsI OBECON
.,prov8l.
SPRINGPIEIJ, OREcoNAfttr4h7r,ra
INSPECTTON REQITESTt 726-376I PERTOD
SPFIiJGFIELO
SHALL EXPIHE IF THE WORK
UNDEH THIS PERMIT IS NOT
OR lS ABANDONED FOH ELECITRI0AI PERI{IT A}pLrcATIoN
Ci ty Job Nrrnber o
3, COHPIJTE FEE SCEEDIN^E ggLOY
A. Nev Residentia]-Single or
Mul- t i-Family per duel).ing uni t .
Service fncluded:Items Cost
L000 sq.ft. or less
Each additlonal 500
sq. ft or portion
thereof
Each Manuf'd Home. or
-Modular Dvelling
SerVice or Peeder
$ 85.00
F ,+
NOTICE:
THIS PERiJlIT
AUTHORIZEDArll
225 FTrr,H SIts,EET
oFFTGE: 726-3759
1. LOCATION OT INSTALI.ATION
IJGAL DESCRTPTIOI.I
10
JOB DESCRIPTION
lkoj}- ?v,-,--+---
Permits are non-tran,sferabLe and expirelf vork is not started vithin 180 days
of issuance or if uork ls suspenried for
180 days.
2. COIT]SACTOR INSTAIJ.ATTON OM,Y
Electrical Contrac to, SrlUs {zC1-,,tL
Address Z/O /5 Fa
City EzSala Phone 6 z z-r5 c>
$upervisor. License Number -eA-{H
Expiratio"ouc. /0- / -78--c
Constr Contr. Number e>
Expiratio"o^r.. 6- b -?^3.
Sigua of Electrician
0vners Name Pyw
Address X a
Ci ty Phone
OSNER TNSTALI,ATION
The installation is being made on
property I ovn r,rhibh is not intenoed
for sa1e, lease or rent.
Ovners $ignature:
5
DATE;-a<
RgCEIVED
B. Services or Feeders
Installation, Alterations
or Relocation;
Sum
D
$ 15.00
$ 40.00
$ 50.Q0
$ 60.00
$100. 00
$130. 00
s300.00
$ 40.00
Temporary Servlces or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 atnps
401 amps to 600 amps
601 amps to 1.000 amp
0ver 1000 amps/voIts
Reconnect Only
200 anps"or 1
201 amps to 4
Over 401 to 6
Over 600 amps
One Circui t
Each Additlonal
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAI,
ess $ 40.00
00 amps S 55.00 --00 amos S 80.00
or 1000-VioTts see I'B'r aSoG-
D, Branch Circuits
Nev, Alteration or Extension Per Panel.
I $ 3s.oo @_-
Circuit or vith Serviceor Feeder Pernrit J_ $ 2.0
E. Hiscellaneous (Service/feeder not included)
o+>. -
-Each lnstallation
Pump or irrigation
Sign/0ut1ine Lighting--
Limi ted EnergT/Res
Limited Energy/Comm ^
-
$ 40.00
$ 40.00
$ 20.00
$ 36.00
Vq*z r/ola-*J=--_
s
$sl-:
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