HomeMy WebLinkAboutPermit Mechanical 1992-11-12COM M ERCIAL/ I N DUSTRIAL
PERMIT APPLICATION
225 Fifth Street, Springfield, Oregon 97477
s, _ TaGFTELO .-JOB
NUMBE
INSPECTION LIN E: 726-3769
OFFICE: 726-3759
Z / 5+'LOCATION OF PROPOSED WORK
ASSESSORS MAP:/7o) 3A 3Z TAX LOT:
I
?q7- a s3 LPHONE:
ore4,STATE:ZIP:?ztlz tlbz t. t<*
CITY:
ADDRESS
OWNER:
VALU
c\Ozrltb.-tZ'DEMOLISH OTHER
DESCFIIPTION OF WORK
NEW
-
REMODEL ADDITION
ELECTRICAL:
NAME ADDRESS PHONE
ADD RESS EXPI RES PHONE
tuLe ,L qb/o
CONTRACTOB'S NAME
ARCHITECT:
MECHANICAL
CONST.
CONTBACTOR #
GENERAL:
PLUMBING
PLU M BI NG
NO.FEE CHARGE
Single Fixture
Relocated Bldg
(new f ix. addtl)
Water Service
ft
Sanitary Sewer
ft
Storm Sewer
ft
Backflow Device
TOTAL PERMIT
M EC HAN ICAL
NN FFF CHAFIGF
Furnace/burner & vent
< 100,000 BTUs H
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
se parat e
Stationary evap.
cooler
Vent Fan/Single
d uct
Vent
f rom
System apart
AC or htg.
Mechanlcal exhaust
hood and duct
,k Lzs*Oaetso
Permit lssuance $10.00
TOTAL PERMIT .-vht),,/5a
- OFFICE USE -
LAND USE:
* OF UNITS:
HANDICAP ACCESS
FLOOD PLAIN
LIGHTING POWER BUDGET:
WATER HEATER:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS:
CONSTB. TYPEr
HEAT SOURCE:
SQ. FT,$/SQ. FT.VALUE
TOTAL VALUE OF PROJ
X
X
X
BCPT#PLAN CHECK FEE DATE BY
25.2r
BUILDING PERMIT PLU M BI NG DEMOLITION
5% State
Su rcharqe
5% State
Su rcharge
MECHANICAL /5e FENCE
VALUE $
5% State
Su rcharge ,75 SIDEWALK
FT.
SUBTOTAL
PERMITS
cgffi::
) S<.1*i2?E /o.ru CURBCUT
FT.
SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
?z / 56?
ZONING:
tr^T
SO. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
REQUIRED INSP. -TIONS
It is the responsibility of the permit holderto see that all inspections are made at the proper time. To request an inspection, call
726'3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be readyfor inspection. Requests received before 7:00 a.m. will be made the same working day, requests made after 7:OO a.m. will be madethe following work day.
SITE INSPECTION: To be
made after excavation, but
prior to setup of forms.
UNDERSLAB PLUMBING,
ELECTRICAL &
MECHANICAL: To be made
before any work is covered.
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel in place, but
prior to placing concrete.
CONCRETE SLAB: To be
made after all inslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment items are
in place but before any
concrete is placed.
UNDERGROUN D: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
UNOERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor insulation, decking or
floor sheathing.
POST & BEAM: To be made
prior to installation of floor
insulation, decking or f loor
sheathing.
FLOOR INSULATION &
ROUGH PLUMBING
No work is to
until these
ATTIC DRAFT STOPS &
CURTAIN WALLS
FIREPLACE: Prior to placing
facing materials and before
framing inspection.
FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are in
place and all pipes, chimneys
and vents are complete and
the rough electrical, plumbing
and mechanical are approved.
INSULATION & VAPOR
BARRIER: To be made after all
insulation and required vapor
barriers are in place but
before any lath or gypsum
board interior wall covering is
applied.
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
LATH AND/OR GYPSUM
BOARD: To be made after all
lathing and gypsum board,
interior and exterior, is in
place but before any
plastering is applied or before
gypsum board joints and
fasteners are taped and
f inished.
SIDEWALK & DRIVEWAY:
Required for all concrete
paving within street right of
way, to be made after all
excavating complete and form
work and sub-base material in
place.
inspections have been made SpECIAL INSpECTIONS: ln accordanceand approved. Section 306 of the State Specialty Code
PAVING: After gravel is in
place but prior to placing
asphalt or concrete.
a special inspector shall be employed
by the Owner/ Contractor during
construction of the following work. A
copy of the special testing reports shall
be f urnished to the Building Division.
STRUCTU RAL CONCRETE: In
excess of 2500 P.S.l. (306 a.1)
STRUCTURAL WELDS:
Performed on the job. (2722 tl
HIGH STRENGTH BOLTING:
During all bolt installation and
ti ghteni ng operations. (306
a.6)
SPRAYED ON
FIREPROOFING: U.BC.
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.1'l &
Chapter 29)
GLU-LAM BEAMS: lnspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (250.1 U.B.C.
STDS. 25-10,11).
STRUCTURAL MASONRY: (306
a.7)
*d**
-ln addition to the inspec-
tions specified, the Building
Official may make or require
other inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
uBc 2415.
RooF sHEATHTNG AND iHf;3^il?ttJ'"r::f""X,"
NAILING: Prior to installing erected but prior to placing
any roof covering. concrete.
FINAL PLUMBING SITE PLAN REVIEW BOARD: Must be requested 2 days in advance
of the date you wish inspection. All project conditions such as
landscaping, parking lot stri ping, etc. must be completed before
requesting this inspection.
FINAL BUILDING: Requested after the final plumbing, electrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
Certificate of Occupancy has been issued by the Building Division
and posted on the premises.
x FrNAL ELECTRTCAL
X.- FINAL MEcHANTcAL
FINAL FIRE DEPARTMENT
ADDITIONAL COMMENTS
o
PLANS REVIEWED BY DATE
durin
By signature, lstate and agree, that I have carefully examined the completed application and do hereby certify that all information
herein is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances
of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUpANCy
will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees
who are in compliance with ORS 701.055 will be used on this project.
I furtheragree to ensure that all required inspections are requested at the propertime, that project address is readable from the
at the front of the property, and the approved set of plans will remain on the site at all
/ tl Z -?---Date
the permit card is loctreet
construction
S
ti
VALIDATION 7-{)
L
AMOUNT RECEIVED
RECEIPT #RECEIVED BY:
DATE PAID
)E
'- 'il-].I= :
225 TITTII STRI.:IiT
SPTUNGFIELD, oRI':GoN 97477
INSPI'.CTION REQUIIST | 726-3769
OFPICE: 72.6-3759
1 ST
I.AGAL DESCRIPTION
Q//*Jr City Job Number
3 r E t,BB SCNEDULE BELOU
A. Nev ingle or
B
C
D
5t.t uN(;l: lr:Lt,
{
E
5. SI'DTOTAL OP ABOVB
5f State Surcharge
TOTAI,
HuIti-FamiIy per dwelling unit.
Service fncluded:Items Cost
1.000 sq.ft. or less
Each additional 500
sq. ft or portlon
thereof
Each Manuf 'd llome or
Modular Dwelling
Service or Feeder
$ 85.00
$ 1s.00
$ 40.00
Services or Feeders
fnstallation, Alteratlons or
Relocation:
200 amps or less
201 anrps to 400 amPs
-
40L amps to 600 amps
-
601 amps to 1000 amps-
0ver 1000 amps/volts
-
Reconnect Only
cb
APPLICATION
l5
Sum
DESCRITTION
Pcrmits arc non-transferable and expire
if vork is not started vlthin 180 days
of issuance or if vork Is suspended for
180 days.
2. CO}n?ASTOR INSTALLATION ONLY
,w.
Add r:css 7?
Con:;tr Contr. Number ?-
Expi ra t ion Da ru 7 -VA 42
Signaturc of Supervis n Elec t ri ci
cirv €@G t'none 7G-lUVf
Supervisor License Nr.imber 7Z
Iixpiration Date
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
InstaIIatlon, Alteration or Relocation
200 amps or less S 40.00
201. amps to /r00 amPs $ 55.00
0ver 600 amps or 1000 volts see I'8" above
Ouners N
Arld rcss
ci ty-Phone
OVNIIN INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, Iease or rent.
Ovners Signature:
DATE:
RIiCEI
Branch Circui ts
Nev, Alteratlon or Extension Per Panel
One Ci rcui t /s 3s.oo v5-
Eaclr Additional
Circui t or vi tlr Service
or Feeder Permi t s 2.00
I'liscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Ou tline Ligh t ing-
Limi ted EnergY/Res
-
Limi ted EnergY/Comrn
e
I
:
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$
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40
40
20
36
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