HomeMy WebLinkAboutPermit Mechanical 1999-10-04RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726.3769
Offlce:726.3759
LOCATION OF PROPOSED WORK:
SPRINGFIELE,
&fr,
JOB NUMB
225 Fifth Street
Sprlngfleld, Oregon 97477
253b tc
0t 24 ?LlASSESSORS MAP:
LOT:
TAX LOT 6 ol
SUBDIVISION:
-
, *
-
BLOCK:
?o P/7 ZC.PHONE:
q7q7AtLZIP:STATE:
n lz
257
CITY:
ADDRESS:
OWNER:
/+i^;rDESCRIBE WORK:
ADDITION DEMOLISH OTHERNEW- REMODEL
ADDRESS PHONE
IFTIIEWORK
4to
EXPIBES a
ISABANDONEDFOROR
CONTRACTOR'S NAME
* OF UNITS:
PLUMBING:
WATER HEATER:
ZONING CODE:
BANGE:
MECHANICAL:
ELECTBICAL:
CONST.
CONTRACTOR #
LANDUSE:T@OUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
# OF BDRMS: _.-
FLOOD PLAIN:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must calt 726'3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll bemade the same worklng day, lnspectlons requested after 7:00 a.m. wlll bo macte the followlng work day.
REQUIRED INSPECTIONS I
Temporary Electrlc J_l Rough Mechanlcat - Prtor to|J cover.
Flnal Plumblng - When allplumblng worl( ls complete.
Slte lnspectlon - To lre mado
after excavatlon, but prlor to
settlng forms.
Rough Electrlcal - Prlor to Flnal Electrlcal - When all
electrlcal work ls complete,
Flnal Mechanlcal - When all
mechanlcal work ls complete.
cover.
Underslab Plumblngl Electrlcal /
Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be
approved to obtaln permanent
olectrlcal power.E Footlng - After trenches are
excavated.Flnal Bulldlng - When ail
requlred lnspectlons have been
approved and bulldlng ls
completed.
Flreplace - Prlor to faclng
materlals and framlng lnsp.
Masonry - Steel locatlon, bond
beams, groullng.Framlng - Prlor to cover.6 6rt, rr.*Foundatlon - After forms are
er€cted but prlor to concrete
placement.
ther
6*q I
WaltrC'oltlng lnsulatlon - Prlor to Ut*
cover.
Underground Plumblng - Prlor
to fllllng trench.Drywall - Prlor to taplng.
E MOBILE HOME INSPECTIONS
Underlloor Plumblngl Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulatlon or decklng.tl lnsert - After flreplace approval
and lnstallatlon oI unlt.
Blocking and Set'Up - When alt
blocklng ls complete.
Floor lnsulation - Prlor to
decklng.Curbcut & Approaclr - After
forms are erected but prlor to
placoment of concrete.r
E
Sanitary Sewer - Prior to fllllng
trench.Eleclrlcal Connecllon - When
blocklng, set-up, and plumblng
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Storrn Sewer - Prior to fllllng
trench.
Sldewalk & Driveway - After
excavatlon ls complete, forms
and sub-base materlal ln place.
Waler Llne - Prlor to filllng
trench.n Fence - When coiirpleted.
Rough Plumbing - Prlor to
cover.
;Strest Trees - When all requlred
trees are planted.
Flnal - After all requlred
lnspectlons are approved andporchos, sklrtlng, decks, and
ventlng have been lnstalled..
GENERAL:
OCCY GROUP:
* OF STORIES:
[--l Wood Stovo - After lnstallatlon.
l-l Plumbing Connecllons - WhenlJ home has been cgnnected to
water and sewer.
E
t
I .--
' i"',, o..ooli
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
tot Type
: tnterlor
' . Corner
-
Panhandle
-
Cul-de.sac
i;
IS THE PROPOSED WORK IN THE.. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTEFI?
-
lf yes, thls appllcatlon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
D:
ACC-P,L.HSE GAR
N
I
I
E
VALUEITEM
(A)
c penffirr q
"'i
tBUILDIN
SQ. FT. X $/SQ. FT.
Main
Garage
Carport
Total Value
Bulldlng Pejrmit Fee
State duicharge
Total Fee
EurioiNc rAl0e, FtRu cHEcK
AND BUILDING PERMIT
Thls permit is granted on the express condition that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Sprlngfleld, includlng the
Dovelopment Code, regulatlng the constructlon and use of
bulldlngs, and may be suspended or revoked at any tlmo
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
Plan Check Fee:
Date Pald:
Beceipt Num
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties wlthln tlre City llmits which are being improved.
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N.
FT.
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Furnace
Exhaust Hood
Wood Stove/ lnsert / Flreplace Unlt
6,0 o
Dryer Vent
/),Ott
)4..n)
I
(D)
No
l. rL
Vent Fan
f,0s
tf.ooMechanlcal Permlt
lssuance
State Surcharge
Total Permlt .
By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs of the Clty of Sprlngfield, and the Laws
o( the State of Oregon perlalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Bullcling Safety Divislon.
I further certify that only contractors and employees who
are ln compllance with ORS 701.055 will be used on thls
prolect.
I further agree to ensure that all required lnspections are
requested at the proper 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 remain
on the slte at all times durlng constructlon.
ftr-46--
-Date
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut ..- ft
l
Demolltlon
State Surcharge
Total Mlscbllaneous Permlts (E)
TOTAL AMOUNT DUE (excludlng electricat)
(A, B, C, D, and E Comblned)
J;-9,
{
L J-O
loDATE PAII)
AMOUNT BECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
s
,Astgnature
-SPFlINGFIEL(,
h,h'ffi
225 FIFTE STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
r. rllr trl frzgd
ALLATION
Signature1. LOCATTON OF INST
*lt
LEGAL DESCRIPTION
)a 63 243 ,+6 ot6/
JOB DESCRIPTION
a
Permits are non-transferable and expire
if vork is not started vithin 1'80 days
of issuance or if vork is suspended for
180 days.
2. COIITRACTOR INSTALLATTON ONLY
Electrical Contractor
Address
cit Phone
sup ervi.sor License Number 3.llCt'S
Expiration Date toltloc
Constr Contr. Number
Expiration Da rc ll./S f oi
SignEpure of Supervi Electrician
'fhe tollowing project as submitted has the lollowing
zclning. and does not require specific land use,#J Tffi
CAL PERHIT APPLICATION
b Nunber q? \ 3>1
FEE SCEEDULE BELOS
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home- or
Modular Dvelling
SerVice or Feeder
s 8s.00
s 1s.00
/d A.
B
L
C
Sum
s 40.00
Services or Feeders
Ins tallation, Alterations
or Relocation:
000 amps
ps/voIts _
1y
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps o
20L amps t
40L amps t
601 amps t
0ver 1000
Reconnec f
r
o
o
o
am
0n
1
4
6
1
s s0.00
s 60.00
s100.00
s130.00
$300.00
$ 40.00
ess
00 amps
00 amps
200 amps''or less
201 amps to 400 amps _Over 401 to 600 amps
Over 600 amps or 1000 voIT
s 40.
s ss.
$ ao.'s see tt
31,oo
00
o0
00
B" aSoE
00
00
00
Ovne^,,
Address
Ci ty Phone
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
D. Branch Circui ts
Nev, Alteration or Extension Per Panel
one circui t / S 35. oo 35 'oo
Each Additional
Circuit or vith Service
or Feeder Permi t I $ 2.00 -{1o
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/0ut1ine Lighting_
Limited Energy/Res
Limi ted Energy/Comm
..*me
)4=<, t (-+r----
-"J
s40
$qo
s20
s36
00
5 SUB)lz TOTAL OF ABOVE
State SurchargeDATE:0- t- 1
3Z Admini.strative Fee
TOTALRECEIVED B ft1o-
h.\/