HomeMy WebLinkAboutPermit Mechanical 1999-06-14RESIDENTIAL
PERM!T APPLICATION
lnspectlons: 726-3769
Offlce: 726-3759
SPRINGFTELD
JoBNUMBEa%
225 Fifth Street
Sprlngfleld, Oregon 97477
LOCATION OF PROPOSED WORK:e Ll4 3n
ASSESSORS MAP:TAX LOT:.-2 z
SUBDIVISION: ---LOT:BLOCK:
PHONE:
OL
7
STATE:ZIP:1'V ,1"7
OWNER:
ADDRESS:
CITY;
NEW
-
REMODEL ADDITION DEMOLISH OTHEFI
-
DESCRIBE WORK:
ADDRESS
#'a
CONST,
CONTRACTOR EXPIRES .l PHONECONTBACTOFI'S NAME
MECHANICAL:
ELECTRICAL:
GENERAL:
PLUMBING
- OFFICE USE -
ZONING CODE:
FLOOD I)LAINQUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SOUARE. FOOTAGE:
, OF BDFIMS:
-
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
'r OF UNITS: --.--
LAND USE:
WATER HEATER:RANGE:
To request an lnspoctlc;i
made the same worklng
, you s]ust cali 726-3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll beday, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - prlor to
cover.I-_l Flnat ptumblng - When ails plumblng worl( ls complete.
Slte lnspectlon - To lre mado
after excavatlon, but prlor to
settlng forms.
Rough Electrical - prior to
cover.
Underslab Plumblngl Electrlcal /
Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
E Flnal Mechanlcal - When allmechanlcal work ls complete.
Footlng - After trenches are
excavated.Flnal Butldlng - When ail
requlred lnspecilons have been
approved and bulldlng ls
completed.[l Masonry - Steel locaflon, bondu beamg, groutlng.
Flreplaco - Prlor to faclng
materlals and framlng lnsp.
Framlng - Prlor to cover.
Foundatlon - After forms are
erectod but prlor to concrete
placomont,
Other
Wall/Celllng lnsulatlon - prlor to
cover.
E lf'ffiH!"llll"ln'.'-orng - Prior l-l orywan - prror to taprns.
E Undertloor Plumblng/ Mechanlca!
- Prlor to lnsulatlon or decklng.
MOBILE HOME INSPE TIONS
Wood Stovo - After lnstallatlon.
Post and Beam - prlor to floor
lnsulatlon or decklng.Tl lnsert - After flreptace approval
-
and lnstallatlon of unlt.
[-l Blocklng and Ser.Up - When all
-
blocklng ls complete.
Floor lnsulatlon - Prlor to
decklng.Curbcut & Ajrproach - After
forms are erected bUt prlor toplacomont of concrete.
Plumblng Connectlons - Whenhome has been connected towater and sewer.
l-l Sanltary Sewer - prtor to filungu trench.
Storm Sower - Prlor to filling
trench.
Sldewalk & Drlveway - After
excavatlon ls comploto, forms
and sub-base materlal ln place.
Electrlcal Connection - Whenblocklng, set.up, and plumbing
lnspectlons have been approved
and the home ls connected tgthe servlce panel.
Water Llne - Prlor to filling
trench.l-l Fence - \,Vhen coi-,tpleted.
[l Rough Plumblng - prtor tou cover.
Slreet Trees - Whon all roqulred
traes are plantod.
Flnal - After all required
lnspectlons are approved andporchos, sklrilng, d6cks, andventlng have been lnstalled.
[-l Flnat Etectrlcat - When ail'J electrlcal work ls complete.
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterlor
-
Corner
-
Panhandle I
-
Cul-de-sac
,.HE PROPOSED WORK TN THE.
HISTOBICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Hlstorlcal
Coordinator prlor to permit issuance.
APPROVED:
PL.HSE GAR ACC
N
S
E
VALUE
(A)
',t
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
X $/SO. FT,
BUILDING PERMIT
ITEM SO. FT.
Main
,l
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express conditlon that the said
constructlon shall, ln all respects, conform to the Ordinance
adopted by the City of Springfleld, includtng the
Development Code, regulating the constructlon and use of
bulldings, and may be suspended or revoked at any tlme
upon violation of any provisions of sald ordinances.
Plans Revlewed By Dale
Receipt Numbe
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties withln the City limlts whlch are belng improved.
ITEM
Flxtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
N',__ -
FT.
FT.
FT.
(c)
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
,@
Wood Stove/ lnsert/Flreplace Unlt
Dryer Vent
/+r-''-r"-€--Ja.--'__#
24.2?
/htr
(D)
#
N0Vent Fan
Mechanical Permlt
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby cerilfy that all
lnformatlon hereon ls true and correct, and I turther cerflfy
that any and all work performed shall be done ln accordance
wlth the Ordinances of the City of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCy wlll be made of any
structure wlthout perrnission of the Bulldlrrg Safety Divislon.
I further certlfy that only contractors and employees who
are In compllance wtth ORS 7Ol.0S5 wlll be used on this
proiect.
I further agree to ensure that all required lnspections are
requested at the prgper tlme, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
on the slte at all times durlng construcilon.
I
Slgnature
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
--
ft
Demolitlon
State Surcharge
Total Mlscellaneous Perrnits (E)
TOTAL AMOUNT DUE (excludtng electrtcat)
(A, B, C, Q and E Comblned)
DATE PAII)
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
,C'TY OF
IJGAL DESCRTPTIONAdd L L;re-/ 71 2 )1/ L o.bao
PFlINGF]ELO
1000 sq.ft. or less
Each additional 500
sq. ft or portion
The following project as submitted has the lollowino
iil['r;i"t does not require speciric t""o ri1rtar*rcAr pERHrr ApplrcATroN225 FIFTE STREET
SPRINGFIELD, OREGON 91477
INSPECf,I0N REQUEST: 726-3
orFrcE: 726-3759 Date
Job Nu.ube, ?'10 7 f Z
3. COHPI.JTE FEE SCBEDUI^E BELOV
A. Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:Items Cost Sr
L
7
1. LocArroN oF TNSTAL#+i'6fft signature
>1117 /lf,.35ia
JOB DESCRIPTIONAv4 c
1 ons
$ss
$ ts
$40
s300
s40
rs
Relo
$40$ss
$eo
see
.00
.00
.00
.00
.00
.00
.00
.00
cation
.00
.00
.00uBu aEiI
Permiif voof is
180 d
2.
EIec
Addr
Ci ty
ts are non
rk is not
suance or
ays.
CO}I'I:.TACTOR
tric.rl Con
ess 4055
Eugene Phone 687-5770
20L amps to 400 amps
401 amps to 600 amps
ss0
s60
s100
s 130
Supervi.s,'rr Li cense Number 3872s
OTlCESonnect 0nIy
Expirati,ln Date 1
EXBTR E dETliEd/VOFHd e
Constr c )ntr. Number 104929 ATJTHOFIZE{D ut brn qH rs pL mrff iS Rlbf '
Expirati rn Date 3/14/00
ing Electrician
,l
601 amps to 1"000 amps_
Over 1000 amps/voIts
Over 401 to 600 amps
0ver 600 amps or 1000-1d[ts
Signat
Ovners
Address
S
fo^.
D. Branch Circuits
Circuit or vith Serviceor Feeder Permit $ 2.00
E
Nev, Alteration or Extension Per Panel
rlone(circuit I $3s.oo 7fEach'AdditionalCi ty Phone -14 L -1 5 C?
OVNER INSTALI.ATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
Oyners Signature:
O$E: I
5
Hiscellaneous (Service/feeder not include
-Each installation
Pump or irrigation $ 40.00
Limited Energy/Res $ 20.00
suBrorAl oF ABovE "r +52 State Surcharge
-'f-T3Z Administrative Fee T gU
TOTAI --------27 -RECEIYED B
FOR
400 ampsAI\ Y 180