HomeMy WebLinkAboutPermit Mechanical 1998-05-15RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WOR}(:5
ASSESSOBS MAP;o
LOI BLOCK:
SPrIINGFIELD
q ,h
JOB NLJMBER QrD q
225 Fifttr Srrect
Spri rrg tlerld, Oregon g7477
TAX LOT:
SUBDIVISION: --
0tn#PFION E
STNTE
5
-t
o f)K ZIP q1
l-<t L a,n i +(" -
, 3q+b
OWNER:
ADDRESS
CITY:
A
ODEL
-
ADDITION DEMOLISFI OTHER
ADDRESS EXPIIIES PHON E
-c)
CONTBACTOR'S NAME
ELECTRICAL:
MECHANICAL:
PLUMBING:
CONST.
CONTRACTOR #
GENERAL:
TH,S PEHM
ANY 180 DAY
frr,8pcBfir,T{sr{CIr..-_
_ OFFICE USE -NOTICE
WATER HEATEFI:
FLOOD I)LAIN
SECONDNNY Fi EAI:
QUAD AREA:
* OF BLDGS:
' LAND USE:
OCCY GROUP:
r OF STORIES:
ZONING CODE:
--
SOUAni: FOOT^GE: --
To request an lnspcctlon, you must call 726-3769. Thls is a 24 hour rccor<1ing. All lnspections requested bcfore 7:00 a.rn, wlll bemade lhe sante worklng day, lnspections requested after 7:OO a.m. will be macje the following work day.
REQUIRED INSPECTIONS
Temporary Eleclric Rouglr Mechanical - Prlor to
cover.
Final Plr.rnrbing - When allplumbing worl( is completc.
Final Etcctlical - Wlren ail
Site lnspection - To be madc
af ter excavation, but prior tosetting forrns.
Rough Elcctrical - Prior to
c ove r.elc rical work is complete,
Underslab Plumbing/ Electrical /
Mcclranical - Prior to cover.Electrical Servlcc - Must be
approved to obtain pcrrnanent
electrlcal l)owcr.
Final Meclranical - Whcn allrnochanical worl( ls cornplete.
Footlng - Af ter trenches arc
excavated.Fireplace - Prlor to faclng
materlals and framing lnsp.
Final Builcling - Whcn allrequired lnspectlons have been
approved and building is
completcd.Masonry - Steel locatlon, bond
beams, groutinO.t
Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
O thcr
Wall/Cciling lnsulation - Prlor to
cover
Underground Plumbing - Prlor
to fllllng trench.l--l Orywall - Prior ro tapirlg
Underlloor Plumblng/Mechanical
- Prior to lnsulatlon or decking.
MOBILE I.IOME INSPECTIONS
Wood Stovc - Af tcr lnstall..ltion
Post and Bcam - Prlor to floor
lnsulation or decl<ing.lnsert - Aftcr flreplacc approval
and installatlon of unlt.
Bloclting and Set.Up - Wlren all
blt>cking is cornplete.
FIoor lnsulation - Prior to
decl<lng.Curbcut & l\1r;.rroaclr - Aftcr
forms are erccted but t)rior to
placcrncrrt oI corrcrctcr.
Plurnbin.q Connections - When
Irorno has bcen connected to
w;rtcr iiltcl sewer.
Sanitary Sewer - Prior to f llling
t rcnch.Elcctrical Cortrrcctiorr - When
[rlockrrrl;, sc.t.up, and plunrbing
Inspcclions lravo bccn approved
ilncl tllc trornc is connected to
tl-rc scrvicc;rancl.
Stornl Sewcr - l)r'ior lo filling
trench.
Sidewalk & Drivcwa'y, - Af tcr
cxcavation is completc, fol.lllS
ancl sul).base matcrial in placc..
Water Line - Prlor to filling
t rench.
Fence - Wtren cornpletcd.
Rouglr Plunrbing - Prior to
cover,
(itresl Trces - Wlrcn all rcqulred
trees are plantcd.
Firral - Af ter all required
lnspections are approved and
porclrcs, sI(irting, decl(s, and
venting havo bcen lnstalled.
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Lot faces
Lot sq. f tg.
Lot coverage
TopograPhY
Total hcigl.tt
Lot 'fypc
-
lnterior'
--
Cortrer
-
Panhandle
-
Cul'rje'sac
acl<s
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pcrmit is grantecJ on tl"le cxpress condition that the said
consiruction shall, in all respects, conlorm to the Ordinance
adopted by the City of Springtield, including the
Development Cocle, regulating the construction and use of
buildings, and may be suspendecJ or revokcd at any tirne
upon violation of arry provisions of said ordinances'
DatePlans Flcviewcd t3Y
Beccipt N r.rtnbc
Plan Check Fee
Datc Paid
Rcccived By:
VALUE
(A)
BUILDING PERMIT
Total Valuc
Building Pcrmit Fcc
Statc Surcharge
Total Fec
ITEM
Main
Garage
Carport
Systems Developmcnt Charge is due on all undeveloped
properties witlrin thc City linrits which are being improved.SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
FEE
(c)
N0
t--l:
FT.
Rcsidcntial Batlr(s)
PLUMBING PERMIT
Plumblng Pormit
State Surcharge
Total Charge
Sanitary Sewer
Watcr
Storrn Scwer
Mobile Horne
ITEM
Fixtures
/
By slgnature, I state and agree, that I hqve caref ully examined
the completed application and do hereby certlfy lhat all
information lrereorr is true ancl correct, and I f urther certlfy
that any and all work performed shall be done in accordance
with tl.rc Ordinancus oI thr: City of Springfield, and the Laws
of tlrc Statc oI Orcgon pertair.rlng to thc worl< described
hercin, and tirat NO OCCUPAI'JCY will be r.rracje of any
structurc without pcrrnission of the Buildirrg Satety Division.
I furthcr certify tl)at only contractors and enrployees who
arc in cornpliance witlr ORS 701.055 wlll be used on this
proiect.
I further agree to ensure tlrat all required inspections are
requested at the proper Lime, that each address is roadable
he pcrmlt card ls locatcd at the f ront
hc approved set oI plans will remain
5 -/+4{Date
f rom tl'rc slreet, th
d
s durion tlre site at .,a|
'-l ,c
g cons
of the property,
on.
Signatu re
Wood Stove/ lnscrt/Flrcplace Urlit
Dryer Vcnt
MISCELLANEOUS PERMITS
Mobilc Home
State lssuance
Stato Surchargc
Sidewalk
-
ft
Curbcul
-.-
ft
Domolition
State Surcharge
Jb.>d
Total Misccllaneous Pennits (E)
$te
No
+,(
Vent Fan
(D)
MECHANICAL PERMIT
Fu rnacc
Exhaust Hood
4ro. -
Meclranical Pcrnlit
lssuance
State Surcharsre
Total Permlt
TOTAL AMOUNT OUE (oxcturling ctcctricat)
(A, B, C, D, and E Cornbinccl)
VALIDATION:
RECEII)T NUMBER I ? (ai--
5-tr-1(
2b. >'o
DATE PAID
AMOUNT RECEIVED
FTECEIVED BY
ISTHE PROPOSED WORI( iN THE .
.HISTORICAL OISTRICT, OH ON
TIlE HISTORICAL REGISTER?
-
It yes, this application must be slgned
arrd apProved bY the Historlcal
Coordinator prior to permit issuance'
APPROVED:
SO. FT. X $/SQ .'T.
FT.
&
thotollori .--
CITY U': SPR"VGFIELD, OBEGOA'
h6 5PR._.IFIELO
The
NOTICE:
THIS PERMIT SHALL EXPIRE IFTHE WOBK
UNDEB THIS PERMIT IS NOT
Authofiz€d
225 FIFTE STREET COMMENCED OR IS ABANDONED FOR ELE TRICAL PBRHIT APPLICATION
iiy,ilSl Efl *3ffi33T m# I{q 16r
p E R I o D
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
8To rtr{
qTl^
I,EGALtToT 4o1/oo
JOB DESCRIPTION
Ci ty
Supervisor License Numbe , \"/'))5
Exp iration Date i o -t -1?
Constr Contr. Number ')Pq
Ci ty Job Nunber
3. COHPI,ETE FEE SCEEDT'I.E BELOII
A. Nev Residential-Single or
Multi-FamilY Per dvelling unit.
Service Included:Items Cost
$ 8s.00sq. ft. or less
additional 500
Sum
1000
Each
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. COMRACTOR INSTALI..ATION ONLY
EIec t r i car ..con t^rac to, { < / i f ,na c . Ah 0,-r,nl la# Reroca t i on :
f o-1e )t Phone 681--L>sL 401- amps to 600 amPs
-
601 amps to 1000 amPs-
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
$ 1s.00
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
Over 1"000 amps/vo1ts
Reconnect 0n1Y
$ s0.00
s 60.00
s100.00
$130. 00
$300.00
s 4o.oo
Expiration Dat elZ
Signa of ising Electrician
0vners Name l*; la*i 01"*
Address < q'< N \sTL
Ci ty J Phone ')U/,tqs6 /
OVNER INSTALLATION
The installation is being made on
property I ovn which is not intended
for sale, lease or rent.
Omers Signature:
C. TemporarY Services or Feeders
Installation, Alteration or Relocation
200 amps''or less $ 19'qq
201 amps to 400 amPs
-
$ Il'99over 4b1 to 600 amPs
-
$ 80'00
Over 600 amps or 1000 voTts see "Br above
D. Branch Circui ts ' .-
Nev, Alteration or Extension Per Panel
onecircuit I $35'oog;"h eaal tional ' '-r-
-cii.rit or vith Service
or Feeder Permit I $ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/Out1ine Lighting-
Limited EnergY/Res
-
Limi ted EnergY/Comm -_:-
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
- 1r,-q )
E
40
40
20
36
$
$
$
s
3
.00
.00
.00
.00
o)
RECEIVED
5
i,ll
5'?. ? L