HomeMy WebLinkAboutPermit Mechanical 1995-08-08SPRINGFIELE)
RESIDENTIAL
PERMIT APPLICATION
lnspections:726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK
JOB NUMBER 5^
ASSESSORS MAP;/)-a?-=2-77
225 Fifth Street
Springfleld, Oregon 97477
TAX LOI:42Sa'e
LOT:BLOCK:SUBDIVISION
4/i4"- -PHONE:
o<ZIP:STATE:
u?.r -t./bt!--78;"OWNER:
ADDRESS:
CITY:
*L s/u * eP /a*ua-a<
OTHEBffi;_DESCRIBE WORK:
UADDITION DENEW- REMODEL
ADDRESS EXPIRES PHONE
/S- 3lY rrFl
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
ELECTBICAL:
coNsT.
CONTRACTOB #
RANGE:
- OFFICE USE -
LAND USE:
WATER HEATER:
ZONING CODE:
FLOOD PLAINOUAD AREA:
I OF BLDGS:
SECONDAFIY HEAT:
SOUARE FOOTAGE:
OCCY GROUP:
I OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a24 hour recordlng. All inspections requested before 7:00 a.m. will be
made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electric [71 Rough Mechanlcal - Prlor tol! cover.
[-l Rough Electrical - Prior tot-l cover.
I-_l Flnal Plumbing - When aillJ plumbing work is complete.
tl Slte lnspection - To be made
after excavation, but prior to
setting forms.
Final Electrical - When all
electrical work is complete.
Underslab Plumbing/ Electrical /
Mechanlcal - Prior to cover.Electrical Servlce - Must be
approved to obtain permanent
olectrlcal power.
w Final Mechanical - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
Final Building - When all
requlred lnspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prior to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
B Other
Walt/Celling lnsulation - Prlor to
cover.
Underground Plumblng - Prior
to filling trench.Drywall - Prlor to taping.
MOBILE HOME INSPECTIONS
Undertloor Plumblng/ Mechanlcal
- Prior to lnsulation or decking.Wood Stove - After lnstallation.
Post and Beam - Prlor to floor
lnsulatlon or decking.lnsert - After flreplace approval
and lnstallatlon of unit.
Blocking and Set.Up - When all
blocklng is complete.
Floor lnsulalion - Prior to
deckl ng.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanltary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Water Llne - Prlor to filling
trench.
Fence - When completed
Rough Plumbing - Prior to
c0ver.
Street Trees - When all required
trees are planted.
Flnal - After all required
inspectlons are approved and
porches, skirting, decks, and
ventlng have been lnstalled.
a_./:f
# OF BDRMS: .---
# OF UNITS:
-
tl
E
E
E
E
E
E
tl
E
E
tl
E
E
E
E
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Tyr
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
tback IS THE PROPOSED WORK IN THE
HISTORICAL OISTRICT, OR ON
THE HISTORICAL REGISTEFI?
-
lf yes, this applicatlon must be signedand approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
PL,HSE GAR ACC
N
S
E
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
(A)
X $/SQ. FT, = VALUE
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUTLDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls 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 ofbuildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Receipt Number:_
Plans Revlewed By Date
Plan Check Fee:
Date Paid
Beceived By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Flxtures
Resldential Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
No
FT.
FT.
FT.
(c)
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMI
Furnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
/f.n
/p-*-- -zil
- {_<
zz3.za
,?
4d:^-:- .
(D)
'[4rou
/aae?-e
Mechanical Permit
lssuance
State Surcharge
Total Permit
By slgnature, I state and agree, that I have carefully examined
the completed appticaUon and do hereby cerilfy that all
lnformation hereon is true ancl correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs of the City of Springfield, and the Laws
of the State of Oregon pertainlng to the work described
herein, and that NO OCCUPANCy will be made of any
structure without perrnission of the Buildirrg Safety Divislon.
I further certify that only contractors and employees who
are ln compliance with OFIS 701.O55 will be used on thisproject.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will remaln
on the site at all times during constru
7s'o
lon.
G^ 3o-
Slgnature
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk _ ft
Curbcut --- ft
Demolition
State Surcharge
Total Miscellaneous permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
-2A
SPFIII\.(;FIELO
Qfr,l',
il
:llowinq proiect as submltted has the fotl6r,yino
', j i . ,,i,$ alot rcquite Spegiii6 l.lr,.-l ;..se
225 FIFTr STREET
SPRINGFIELD 0REGON 97477 "E:-8-,.74'--7
INSPECTION REQUEST:726-3769.,
tr.r' r-.r,. I).goatuio.OFPICE: 726-3759
1 OF INSTAIT^A ON
.JOB
Permits are non-transferabLe and exp lre
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTPECTOR INSTALI.ATION ONLY
*U."-- citY Job Number 4st tot-
ELECTRICAI PERHIT APPLICATION
COHPIJTE FEE SCMDUI.E BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Service fncluded:Items Cost
1000 sq.ft. or less
\Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Modular Dvelling
Sertice or Feeder
s 8s.00
s 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
0ver 1000 amps/volts
Reconnect OnIy
3
A
B
Sum
a6ove
Electrical Contractor
Address P.O t&6-l w 81-,s s0.00
s 60.00
s100.00
s130.00
s300.00s 40.00
cit enone'l4l -X,0,,3L
Supervisor L cense Number r6g6s
Expiration Date ta-l -gs
Constr Contr. Number O3S,l9
Temporary Services or Feeders
Installa.tion, Alteration or Relocation
C
Expiration Date 9-t-95 .00
.00
.oo
fiBfl
200 amps''or less
201 amps to 400 amps _
Over 401 to 600 amps
0ver 600 amps or 1000-7oITs,ure of Supervis ].ng Electrician
$
s
$
40
55
BO
see
Ovners Name
Address
cir Phone 1+1 1133.
OVNER IN ALI.,ATTON
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
D- Branch Circuits
E
Nev, Alteration or Extension Per Panel .
one circuit I S 35.00 35.Oo
Each Addi tional
Circuit or vith Service
or Feeder Permit I S 2.00 A_AO
Hisceflaneous (Service/feeder not' included.)
-Each installation
Pump or irrigation S 40.00
Limited Energy/Res
-
S 20.00
Limited ener[y/Comm S 36.00 .
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
5
DATE:l,ll
T,DAErTITCN 3q,qb
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