HomeMy WebLinkAboutPermit Mechanical 1994-06-09.t.
SPrlI
o N
BESIDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Oftice: 726'3759
LOCATION OF PROPO D K:
ASSESSORS MAP:
T//
JOB NUMBER
225 Flfth Street
Sprlngfleld, Oregon 97 477
TAX LOT:
SUBDIVISION:LOT: - BLOCK:
776 -€66)t,fDs PHONE;
zlP;STATE:
7o4ra7/o
CITY;
ADDRESS:
OWNER:H E r(,/t/L * vrtl L)4,t4
-s,//f///(, {/€.1
NEW
--
REMODEL ADDITION DEMOLISH OTHER
.?-27-ea# *,4 rf {,e,+/?;7ro4 ra'7
DESCRIBE WORK ?7rc7nzr 6ns
GENERAL:
PHONECONST.
CONTFIACTOR #EXPIRESADDRESS
M EC HAN rcA L' -LL&t&l*/Z Zal/t -
gil Eoer,t77.705q t,2-?:7f =7o7 u
CONTRACTOR'S NAME
ELEcTRICAL, C* 4
PLUMBING:
E-
* OF BDRMS:
-oF
ZONING CODE:
FLOOD PLAIN
OUAD AFIEA:
* OF UNITS:
LAND USE:
SECONDARY HEAT:
SQUARE FOOTAGE:
WATER HEATER:
OCCY GROUP:
I OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request-aJ1 ins.oecllon, you must call ?216 9z69. Thls ls a ?4 hour recordlng, All lnspectlons reques
made the same working day, lnspectlons requested atter 7:00 a.rn, wlll be made the following work
ted before 7:00 a.m. wlll be
clay.
REOUIRED INSPECTIONS
Temporary Eleclrlc Rough Mechanlcal - Prlor to Flnal Plumbing - When all
plumblng work ls complete.cover.
Slte lnspection - To be made
a{ter excavatlon, btrt Prior to
settlng forms.
Rough Electrical - Prlor to Flnal Electrlcal - When all
electrlcal work ls complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Electrical Servlce - Must be
approved to obtain Permanent
electrlcal Power.
Final Mechanical - When all
mechanlcal work ls comPlete.
Footlng - After trenches are
excavated.[---l FlrePlaco - Prlor to faclngu rnaterlals and frarnlng lnsp.
Flnal Bulldlng - When all
requlred InsPections have been
approved and bulldlng ls
Masonry - Steel locatlon, bond
beams, grouting.
compl d.
Framlng - Prior to cover'
ther
Foundatlon - After forms are
erected but Prlor to concrete
placement.
Wall/Celllng lnsulatlon - Prlor to
cover,
Underground Plumblng - Prior
to lilllng trench.Drywall - Prlor to taPlng.
MOBILE HOME INSPE TIONS
Underlloor Plumblng/ Mechanlcal
- Prior to insulatlon or decklng.Wood Slove - After lnstallatlon
Post and Beam - Prlor to floor
lnsulation or decklng.lnsert - After flrePlace aPProval
and lnstallatlon of unlt.
Blocklng and Set'UP - When all
blocklng lls comPlete.
'1.: .
Plumblng Connecllons - When
home has been connected toFloor lnsulatlon - Prlor to
decklng,Curbcut & APProach - After
forms are erected but Prlor to
placement of concrete'
Sanllary Sewer - Prior to filling
trench.Sldewalk & DrlvewaY - After
exoavatlon ls complete, forms
and sub-base materlal ln Place.Storm Sewer - Prlor to fllllng
trench.
Water Llne * Prlor to fllllng
trench.
Rough Plumblng - Prlor to
cover.
Streel Tlees - When'all
trees are planted.ven tlng have
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[-l fonce - When comPleted.
blockl
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Lot coverage
TopograPhY
Total height
_- Panhandle
-
Cul'de'sac
P,L.HSE ACC
W
E
1 j THE PBOPOSED
HISTOBICAL DISTRI
THE HISTORICAL R
APPROVED:
WOBK IN THE
CT, OR ON
EGISTEH?
ll yes, this appllcation must be signed
and'aPProved bY the Historical
Coordinator prlor to permit issuance'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Developtnent Co<Je, regulatlng the construclion and use of
bulldlngs, and may be suspencled or revoked at any tlme
upon vlolation of atry provisions of said orclitrances'
Fleceipt Nutnber:
Plans Reviewed By Date
Plan Check Fee
Date Paid
Fleceived By:
BUILDING PERMIT
ITEM SO. FT. X $/SQ. FT.VALUE
)
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limits which are being itnproved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
FT.
No
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fi replace Unlt
Dryer Vent
?G-2 a(D)
N0Vent Fan
Mechanlcal Permit
lssuance
Stale Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agtee, that I have carefully examined
the completed application and do hereby certify that all
lnformation hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, 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 Divislon.
I further certlfy that only contractors and employees who
are ln compliance with ORS 701.055 will be used on this
project.
I f urther agree lo ensure that all required inspections are
requeste<j at the proper time, that each address is readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans wlll remain
Sign
Date
re
\
on the sit all tirnes during struction
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolltion
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excludlng electrical)
(A, B, C, Q and E Comblned)&N
ER
VALIDATION:
BECEIPT NUM
DATE PAID
AMOUNT R
FIECEIVED
GAR
S
"+p
CITY OF OFEGO'U
SPET,{GFTELO
Tho lollourlng proiec-t rs eubmHed hes the
:oning, and doee not
approval.
require epecllic lsnd use
225 FTYTB STREBf,BLBCTRICAL PERHIT APPLICATION
SPRTNGFIEII)OREGON 97477 Zonlng-
City Jo b Nunber ?rfOB 16INSPECTION REOTIEST:7zffi6e-.
OFPICE: 726-3759
Atrrhorized siigfisturo@B SCEBDT LE BBLog
1. LOCATION OP INSTALI,ATION A. Nev Residential-Single or
HuIti-FamilY Per dvelling unit.
Serviee Included:
m
TAGAL DESCRIPTION
JOB DBSCRIPTION
Electrical Contractor
Address
permits are non-traflsferable and expire
if vork is not started vithin 180 days
of l""u"nce or if vork ls suspended for
180 days.
2. COI|TRACTOR INSTALI,ATION ONLY
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
Hodular Dvelling
Servlce or Feeder
Serviees or Feeders
Installation, Alterations
or Relocation:
200 arnps or less
201 amps to 400 amPs
-401 amps to 600 amps
-
601 amps to 1000 amPs-
Over 1000 amps/volts
Reconnect OniY
Items Cost Sum
$ 8s.00
$ 1s.00
$ 40.00
B
c Phone rl{L>- 5+blo
s so.oo
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
ci
Supervisor
Exp lration Date D - I - q5
Constr Contr. Humber O 3 84Q
Temporary Services or Feeders
Installation, Alteration or Relocationc
lration Date q -t-q+Exp
cen-se Number 86S
of Supervlqing Blectrician
Phon"j.h-- 54bb
200 amps or less
201 amps to 400 amps
-Over 401 to 600 amps
0ver 600 amps or 1000 voTt
$40
$ss
$80s see
.00
.00
.00
uBu a56F
t D. Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit I $ 35'oo 35'co
Each Additional
Circuit or vith Service
or Feeder permi t I g 2.00 A,O C_,
B. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/0utline Ligh t ing-
Limited Energy/Res
Limited Energy/Comm
-SUBTOTAL OF ABOVE
5LState Surcharge
2,c1c TOTAL
0vners Name
Address
Cl ty
O9NER
The installation is beirig made on
property I ovn which is not intended
for sale, lease or rent.
Omers Signature:
$ 40.00
s 40.00
$ 20.00
$ 36.00
5
DATB:
RECBIVED
3?, o
ture
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