HomeMy WebLinkAboutPermit Mechanical 1999-12-21R.ESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WOFIK:
ASSESSORS MAP:
h
JOB NUMBER ??./7e<
225 Fi{th Street
Sprlngfleld, Oregon 97477
f 1
TAX LOT
SUBDIVISION: -BLOCK:LOTr
OWNER:
ADDRESS:
CITY:
1aPHON
STATE:ZIP:
Y\
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ELECTRICAL!
ADDRESS EXPIRES .3 PHONECONTRACTOR'S NAME
MECHANICA
CONST,
CONTRACTOR #
GENERAL:
PLUMBING
LAND USE:
RANGE:
r OF BDBMS:
- OFFICE USE -
FLOOD I)LAIN
* OF UNITS:
OUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUARF. FOOTAGE:
OCCY GROUP:
I OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REOUIRED INSPECTIONS
Temporary Eleclrlc a Rough Mechanlcal - Prlor to Flnal Plumblng - When attplumblng worl< ls complete.
Slte lnspectlon - To be mado
after excavatlon, but prlor to
settlng lorms.
octller./fu:at 4rchough Electrlcal - Prlor to Flnal Electrlcal - When all
electrlcal work ls complete.cover.
Underslab Plumblngl Eleclrlcal/
Mechanlcal - Prlor to cover.E Electrlcal Servlce - Must be
apprOved to obtaln permanent
electrlcal power.
w Final Mechanlcal - When all
mechanlcal wor]< is complete.
Footlng - After trenches are
excavated.E Flreplaco - Prlor to faclng
materlals and framlng lnsp.
Flna! Buildlng - When all
requlred lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.
f] Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prlor to concrete
placemont.
E Other
WalltColllng lnsulatlon - Prlor to
cover.
E
E
tl
tl
Underground Plugnblng - Prlor
to fllllng trench.Drywall - Prlor to taplng.
MOBILE HOME INSPECTIONS
Underlloor Plumblngl Mechanlcal
- Prlor to lnsulatlon or decklng.Wood Stovo - After lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnsert - After flreplace approvql
and lnstallatlon of unlt.
Blocklng and Set.Up - When alt
blocklng ls complete.
Floor lnrulatlon - Prlor to
decking.Curbcut & AJrproach - After
forms are erected but prior to
placemont of concrete.
Plumblng Connectlons - When
home has been connected to
water and sewer.
Sanltary Sewer - Prior to fllllng
trench.Electrlcal Connection - When
blocklng, set-up, and plumbing
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Storm Sewer - Prlor to fllllng
trench.
Sidewalk & Drlveway - After
excavatlon ls complete, forms
and sub-base materlal ln place.
water Llne - Prlor to filllng
trench,
Fenco - When coitlpleted.
Rough Plumbing - Prlor to
cover.
Street Trees - When all requlred
trees are planted.
Flnal - After all requlred
lnspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
tl
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WATER HEATER:
ZONING CODE:
E
E
n
tl
E
fl
E
,xE
E
E
fl
't'.' ., l:l r;
Lot faces
Lot sg. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
-
Corner
-
Panhandle !:
-
Cul-de-sac
I IS THE PROPOSED WORK TN THE ".'HISTORICAL
DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the H istorlcal
Coordlnator prlor to permit issuance.
PL.HSE GAR ACC'
N
S
W
E
BUILDINGPERIIJ|IT{ * f
VALUE
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
SQ. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
BUrLDrtiilG rfrt8e, Frar'r cneex
AND BUILDING PERMIT
Thls permit is granted on the express condition that the said
constructlon shall, ln all respects, conform to the Ordinance
adopted by the City of Sprlngfleld, lncluding 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 said ordinances.
Plans Reviewed By Date
Receipt Numbe
Plan Check Fee:
Date Paid:
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties wlthln the City llmits which are being improved.
ITEM
Fixtures
Residentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
Nt
FT
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
FT.
ADDITIONAL COMMENTS
Wood Stove/ lnsert / Fl replace Unlt
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Perrnit
*7r7
lVta ,t*.P
/a. -?
--T:A3;^vr26.fu
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby certlfy that all
lnformatlon hereon is true and correct, and I f urther cerflfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY will be made of any
structure wlthout permission of the Bullcllng Safety Divislon.
I further certify that only contractors and employees who
are ln compliance with ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all reqr,!lred lnspections are
requested at the proper.tlme, that each address is readable
,rom the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remain
Slgnat
Date
on the site at urlng constructlon,
MISCELLANEOUS PERMlTS
Mobile Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)a
DATE PAII)
AMOUNT BECEIVED
BECEIVED BY
VALIDATION:
RECEIPT NUMBER
Tmrt
SPFTNGFIELC,
zoning. and does not
approval
Zoning L>a
225 FIFTE SIREET
SPRINGFTELD, OREGON
INSPECTTON REQTIEST:
OFPTCE: 725-3759
,
ftgnature
1. LOCATTON OF TNSTAIIIIIONGLO.3.f,.sh
I.EGAI DESCRIPTIOIi
0
JOB DESCRTPTTOTI
Perni ts are non-r fera and expireif vork is not started uithin 180 daysof issuance or if L,oril is s uspended for180 cia1,s.
2. CONTRACTOR INSTAI,I.ATTON OTTLI
Electrical Contracto
3. COT{PI^ETE FEE SCEEDIiLE BEi,OV
A. Neu tesiciential-Sing.Le c:llulti-Fan:ly per dvei.:::g uni t.
Serr':, ce Included:
The following project as s ubmitted has
reguire speciric
the rollowing
land use
PEru{TT APPLTCATTON
11' Job Nu.uber ?Q fi
1000 sq.ft. or less
Each acidi tional 500
sq. ft or portion
thereof
Each Hanuf,d Eome. or
-Hodular Dvelling
Service or Feeder'
-8. Services or Feeders
Installation, Alteration_e
or Relocation:
200 amps or less
?91 *pr ro 400 aups
-401 amps to 600 anps
-501 aops to 1000 anps:-
0ver 1000 anps/volts
Reconnect 0n1y
s 50.00
s 60.00
s100.00
s130.00
s300.00
s 40.00
C
D. Branch Ci rcui. ts
Cos t
s 8s.00
s 1s.00
s 40.00
Sum
Address
ci
P-P B^)
hon€(3 1"9_L
Supervi License NumberffiJ5___
Expiration Dare. (^Ot -ot
Constr Contr. Num
Expirarjon Date
ber _\
Signa of Supervising Electrician
Ovner,. Irame
idciress bt 7
)x- t?o-
Teoporary Services or FeeciersInstallation, Alteration or Relocation
?99 -pr"or less S 4O.OO
201 amps to 400 anps
-
S 55.00
Over 401 to G00 aops
-
S 90.00
Over 600 amps or 10001;jrs see ,8,' aE?rG-
vr LJ Pnone
The installarion i_c being macie onpropertJ' i ovn vhich i_" not intendedior saie. lease or reni.
uers Signature:
Nev, A).ieration or Exten_"ion per panel
gne Ci:cui: ., I S 35.00 3S:Each Addi iional
Circuii o; vith Service
or Feeder pernir _ S 2.00
E. lliscell.aneous (Service,,:eeder not incluried,)
-Each instal.Lation
Punp or irrigation
Siga/Ou riine Ligh ting-Lidted Energy/Re
Lidted Energy/Conrn
SUBIUTAL OF ABOVE
?df State Surcharge
3f. Ad',inistrativi Fee
OSNEP. TNSTAII.ATION
s 40.00
s 40.00
s 20.00
s 36.00
DATE:5
RECETVED
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