HomeMy WebLinkAboutPermit Mechanical 1998-10-08RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Otlice:726.3759
:;PFlINGFIELD
%,
JOB NL,,M T]Ei]/27
225 Filtlr Strcct
Springilr:l<J, Orogorr 97477
LOCATION OF PROPOSED WOBI(:7
TAX LOT aul atASSESSOBS MAP:t? 03 20 q4
LOT:BLOCK:SUBDIVISION
7t/L -7Z8LlPHON E.
STATE:ztPDtr
bo\rres On\J-\^OWNER:
ADDRESS:
CITY:
NEW
-
REMODEL '/ ADDITION DEMOLISI.I OTHEIl
DESCRIBE WORI(:
ELECTRICAL: .---
EXPII:1E,S PI.IONEADDRESSCONTRACTOR'S NAME
G E,N ERAL:
PLUMBING:
MECHANICAL;
CONST.
CONTRACTOR /
occy GRoup; calling the center. (NQtrl$fffb tpYffiene-
, oF sro^lES: ___ numberforthe OregonUlilitxMlification ' rv I rvb!
r is r -a-d65C$ f-XdilY.'' -----rHr$PERMlr
Notifieation Ce nte r. Thd$ePUJOSa+o€€t{ofrhF-
SECONDNNY FI ENT:
SHALL EXPIBE IF THE
uNm\{ t}fiSp8frtrYfi
WORK
on law requjrg$fQ$Eelsr -follow rules adopted by the Oregon Utility
FLOOD I)LAINQUAD AREA:
, OF BDF]MS:
W\TER I.IEATER RANGE:
---*UTl.tOfflZED
, oF BLDGS, --,*in
oAR 952-oo1-oo1
O0g0lrcUTnay obta
ZONING CODE:
To ns p cc o n you MU a 7 26-376 o Tlr s a 2 4 t1 o U rcc o
,il$i, r.:,6 $fl smNB}<SO I o o a.rn. wlll bcrcquCSan
csted a[tcr 7:00 a.rn. wilt dbl'lYatrifr
REQUIRED INSPECTIONS
mad hc s anle o rlcl n 0 d v,I1 p c c o n 5 rc q U t:hc Y clilow ir't g;wor l(cl ay.e
[-l Tcmporary Elcctricll
Rouglr Mcchanical - Prlor to
c ove r.
Firral Plurnbing - Whcn all
plr,rnrbing worlt is comPletc.
Site lnspection - To bc madc
alter cxcavation, but Prior to
settlng (ortTls.
Underslab Plunrbing / Elcctrical/
Mcchanlcal - Prior to cover'
Rough Elcctricnl - Prior to Firral Elcctlical - Vr'hcrl all
clcctrical worl< is cotrtPlctc.c ove r,
/
Fi
l'rl
rla Mcchanical - Wlrcn all
Electrical Scrvlcc - Mtlst be
approvecl to obtairl Pcrrllancnt
clectrlcal l)owcr.
nical worl( ls cotnPlctc.
Footlng - A(tcr trenchcs arc
excavatcd.Flrcplacc - Prlor to faclng
materlals and lramitrg lnsP.
Final tJuilcling - Whctr all
requircd inspcctlons have becn
approved and builcling is
corn plc tcd,Masonry - Steel locatlon, bond
beams, 9routln9.Franrlng - Prlor to covcr,
O thcr
Fourrdatlon - After (orms are
erected but prior to concretc
placetncnt.
Wall/Cciling lttsulatiotr - ltrrlor to
c ove r,
Undergrourrd Plunrbing - Prior
to fllllng trench.l_-] orywall - Prior to talrirlg
MOBILE I.IOME INSPE TIONS
Underlloor Plumblng/ Mcchanical
- Prior to lnsulatlon or decl(ing.Wood Stovc - A(tcr lnstall.rlion
Post and Boam - Prior to floor
lnsulation or dccl<lng.lnsert - Attcr fircPlacc aPProval
and installatlon oI unlt.
Blocking arrd Sct'UP - Whcn all
blockinll is colnPlcte.
Floor lnsulation - Prior to
deckl ng.Crrrbcrrt & Alll.rroacll - Altcr
lorms arc crcclcd btlt Prior to
l)l accrncll t oI coI]cr(l t(:.
Sanitary Scwcr - Prior to (illing
trcnch.Siclewalk & Drivcwll' - nftcr
cxcavatiotl is comPlctc, fottrts
and sut)'basc lnalcrial ill f)lilcL''
l---l lilcctrir:al Cortrtectiorl - WhcnI I L:locl<i,r0, scl'up, ancl pltrntbing
irt.';pcctiorrs ltnvc l)con approvcd
ilnd tltc ttotlto is connccted to
th() scrvicc f)arlcl.
Slortrr Scwcr - l)r'ior to (illing
trench.
Watcr Llrrc - Prlor to tilling
trench,
Rouglr Plunrbing - Prior to
cover.
{itroot Trocs - Wlrcn all requlred
trces are Plantcd.
Firral - Altcr all requircd
lrrspcctions arc aPProved and
porchcs, t l(irtin9, decks, and
vcntlns) havc bcen lnstalled.
,I
7n'r'-n
952-001-
rules Dy
E
tl
tl
[--l fcnce - Wlrcn cornPlctcd'
n
rl
rl
Ll
l--l Plrrrrtbirrg Corrtrccliotrs - WhcnU lrornr-l lr;rs bcen collllected to
w;ltcr ill)cl scv/(:r.
t_l
E
E
E
fl
E
E
tl
Lot laccs
Lot sq. f tg.
Lot coveragc
TopograPhY
Total lreiglrt
Lot'fypc .
_- lntcrio;
--
Cortlcr
-
Panlrancllc
--_ Cul'rJe'sac
SC ks
P.L.HSE GAR
N
S
E,
J T}IE PFOPOSED WOBI(iN TI.IE'-IlsroBtcAL DtsrRlcr, oR oN
TI1E, HISTORICAL HEGISTER?
-
I( yes, this application must be slgned
arrd aPProvcd bY the Historlcal
Coorclinator prior to permit issuance'
APPROVED
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Tlris pcrnrit is grarrtecJ o11 the cxprcss concjition tlrat tl're said
consiruction slr;rll, in all respects, con[orm Io the Ordinance
adopteci by the City ot Springfield' including the
Development Coc.jc, rcgulating thc construction and usc of
buildings, anc.l may bc suspcndcd or revol(cd at any tlrne
upon violation of arry provisions oI said ordinances'
Plan Cl'tccl< Fec:
--
DatcPlans Rcvicwcd lJy
Rcceipt N urnbe
Datc Paid
Rcccived By
BUILDING PERMIT
VALUE
(^)
SO. FT. X S/SO. F-TITEM
Main
Garagc
Carport
Total Valuc
Building Pcrnrit Fcc
State Surclrargc
Total Fcc
Systcms Dcvelopmcnt Chargc is due on all undoveloped
propcrties within tlrc City linriis wl'ticlr arc bcing improved'
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
Rcsidcntial Eatlt(s)
Sanitary Sgwer
Watcr
Storrn Scwer
Mobile Hotne
PERMIT
FEE
[:l'.
FT.
(c)
NN
t--'L
Plumblng Pcrmit
Stalc Surcharge
Total Cltargc
PLUMBING
ITEM
Fix tu res
/
By slgnature, I state and a0ree, that I have carcf ully examlned
tha completed application and do hereby certl[y that all
lrrformalion hcreon is true arrcl corrcct, and I Iurther certiIy
that any and all worl< pcrformcd slrall bc done in accordancc
witlr thc Ordinancr.ls of tlrr: City of Springf lcld, arrd tlrc Laws
of tlrc Statc oI Orcgon perlairring to thc worl< described
l'rclcin, and Ilrat NO OCCUPAi{CY will be rrracje of any
structurc wilhout pcrrnission of the Buildlng Safety Division,
I Iurthcr certify that only contractors and en'lployees who
arc in cornpliancc'vritlr ORS 701.055 wlll bc used on this
p ro jec l.
I further agrec to cnsurc ihat;-rll rcquircd inspections are
requcstcd at tho propcr time, tlrat cach address is rcadablc
frorn tl'rc strcet, tlrat thc permit card ls locatcd at thc front
of thc property, ::nd tl'rc approvcd sct of plans will remain
on thc sitc at all times during constructlon,
-2h>O*,/,o..,^
Date
Slqnaturc
WoocJ Stovc/ lnscrt / f:l rcplacr: Urri I
Drvcr Vcnt'rn
il-"^l * G'?5
MISCELLANEOUS PERMITS
Mobilc Honrc
Statc lssuancc
Statc Surchargc
Sidewalk
-
tt
Curbcut
-_
ft
Domolltlon
Statc Surchargc
Total Misccllancous [)crtnils (E)
/f,t s
Vcnt Fan
(D)
MECHANICAL PERMIT
Fu rnacc
Exhaust Hood
N0
Meclranical Pcrrnit
lssu ance
Statc Surchargc
Total Pcnnlt
TOTAL AMOUNT DUE (cxcludino clcctrical)
(A, B, C, D, and E Cottrbirtccl)
VALIDATION
RECEII]T NUME]LFI 03/ r 1l
DNTE }]AID
AMOUNT F''IECEIVED
FTECEIVED BY
1s
L
t
jt----
+t/?f
utz
(
tg /0/9t-
1. LOCATION OF ALI,ATION rL
follow rules
LEGAL DESCRIFTION oY/o Notification CeL
eddress O - <s 6,.r- 2 {? 33
Ci ty Phone Ltr6 -(o2 ZL
Supervisor License Number JO 'J8? <
Exp iration Date
Constr Contr. Number o gE 7
Exp iration Date /7- 30-?{
Signature of Supervising Electrician
D
Owners Name On Lo L"+ 5 r,-^"|tlL
Address lirJ r-/ C7zl.
SPI JFIELO
EI^ECTRICAL PERHIT APPLICATION
Ci ty Job Nunber 7 g/71 t
3. COHPI,ETE FEE SCffiDIILE BELOV
orIing unit.
Genter
tems Cost Sum
952-001 -001 0 through OAR bv $ Bs.oo
$ 1s.00
Each Manuf'd Home. or
Hodular 'DveIIing
Sertice or Feeder $ 40.00
Branch Circuits
Nev, Alteration or Extension Per Panel
E
one circuit I $ 35.00 97
Each Additional
Circuit or vith Service
or Feeder Permit
-
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/Outline Lighting-
Limited Energy/Res _Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3% Administrative Fee
TOTAI
f.u
The foltowing proiec{
"'^-li,?;i*
doee'not
afr,
225 FIFTE STREET
SPRINGFIEI,D, OREGON
INSPECTION REQIIEST:
OFFICE: 726-3759
l/-1
JOB DESCPJFTION 0090. You may
6 calling the
berforthe
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CO}ITRACTOR INSTALI,,ATTON ONLY B. SCTViCCS OT FCCdCTS
Installation, Alterations
Electrical Contractor kS eleClf 4C*tlrt, ltz or Relocation:
200 amps or less $ ry.qg
201 amps to 400 amps
-
$ qg.qq
A UT H0 R t ZL "'' iOO +.,Su rnnfffi
"t ff$tElffft}l,, $:Lteration or Relocation
200 amps"or less $ 19.9q
201 amps to 400 amps
-
$ tl.gqover 401 to 600 amps
-
S 80.00
Over 600 amps or 1000-6fts see I'Brr a5ove
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
DATE:
00
00
00
00
40
40
20
36
$
$
$
$
?I
RBCETVED B
5
lt)
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