HomeMy WebLinkAboutPermit Mechanical 1998-08-05RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3169
Oftice:726.3759
LOCATION OF PROPOS
SP,lIN GFIELI)
ED WOll7oFIK:aYb a-3-oflt
JOB NUMBER ?fo7 v7
225 Fifth Street
Springfleld, Oregon g7477
TAX LOTASSESSORS MAP:7L L{o
LOT
-
BLOCK:SUBDIVISION: -----
NJoN '7 V6-tbelPHONE:*Ybx
? 7V77o4.ZlPiSTATE:
,trrl-b6<
N. Vo th
/d
VD ,"r+N € JoOWNER;
ADDRESS:
CITY:
o FhDESCRIBE WORK:
ELEgTRICAL:
ADDBESS
w ()a(o.v
EXPTRES ,3 PHONE
Lo-?t-Zt 7 v6-/6)(
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
CONST.
CONTRACTOR #
To request an lnspectlon, you must call 726-3769. Thls ls a24 hour recordlng. All inspections requested be fore 7:00 a.m. wlll be
made the same working day, lnspections requested after 7:00 a.m. wlll be made the following work day.
l--_l Temporary Electricll
RED INSPECTIONS
Mechanlcal - Prlor to Final Plumblng - When all
plumbing wgrl( is complete.
h
r.
Slte lnspection - To be made
after excavatlon, but Prior to
setting forms.
Underslab Plumbingl Electrical /
Mechanlcal - Prior to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but Prior to concrete
placement.
Underltoor Plumblng I Mechanlcal
- Prior to lnsulatlon or decklng'
Post and Beam - Prior to floor
lnsulation or decklng.
Floor lnsulation - Prior to
decki ng.
Sanitary Sewer - Prior to fllling
trench.
Stonn Sewer - Prior to l'illlng
trench.
Water Llne - Prlor to {itling
trench.
cover
Rough Electrical - Prior to
cover,
Electrical Service - Must be
approved to obtain Permanent
electrlcal power.
Fireplace - Prior to faclng
materlals and framing lnsP.
Framlng - Prior to cover.
Wall/Celling lnsulation - Prlor to
cover.
Drywall - Prior to taping
Wood Stove - After lnstallation
lnsert - After firePlace approval
and installatlon of unlt.
Curbcut & ApProach - After
forms are erected btlt Prior to
placement of concrete'
Final Electrlcal - When all
electrical work ls complete.
echanical - When all
work ls complete.
MOBILE HOME INSPE TIONS
Blocking and Set'UP - When all
blocklng is comPlete.
Sidewall< & Driveway - Atter
exlavation is comPlete' (orms
anO suU'Uase material in Place'
Fence - lVhen colnPleted'
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set'uP' and Plumbing
inipections have been aPProved
..,d th. home is connected to
the service Panel.
Final - After all required
i.,=iu"tiot. are approved and
til".H""'"="u'[.?.o,""T="i'ilo
Bough Plumbing - Prior to ?,,J::, J'"Ti"ilu}.nu'
ar I requi red
Final
NEW
-
REMODEL ADDITION DEMOLISH OTHER --
E
E
E
E
E
E
E
E
tr
[--1 Underground Plumbing - Prior| ' to filllng trench.
[--l Final Building - When alllJ required lnspections have been
approved and building is
completed.
[--l other
E
E
E
E
n
n
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total height
Lot Typt
-
lnterior
-
Corner
"- Panhandle !
-
Cul-de-sac
P.L.HSE GAR ACC
N
S
E
IS THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT' OR ON
THE HISTORICAL REGISTER? -.-
lf yes, this application must be signed
and aPProved bY the Historlcal
Coordinator prlor to permit issuance'
APPBOVED:
kr3
This pernrit 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
Development Code, regulating the construction and use of
ouildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
Receipt Numbe
BUI LDI NG
AND BUIL
LAN CHECK
iMIT
LU E
RGNPD
Plan Check Fee:
Date Paid
Fleceived By:
VALUE
(A)
Mrr
Total Value
Building Permit Fee
State Surcharge
Total Fee
-'7
X $/SQ. FT.
BUILDING PER
ITEM SO,
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within tl.re City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
FT.
Nc
FT.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby cerilfy that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Ordinanccs of the City of Springfield, and the Lawsof the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCy will be made of any
structure without perrnission of the Building Safety Divislon.I further certify that only contractors and employees whoare in qernpliance with ORS 701.055 wiil be used on thisproiect.
I further agree to ensure that all required inspections are
ted at the proper time, that each address is
the street, that the permlt card ls located atof the property, and the approved set of plans wi
E-t-1t
,P fr-'() ,
reques
v-
readable
from the front
ll remainon the site at times du tion.
Signature
Date
Wood Stove/ lnsert/ Flreplace Unit
MISCELLANEOUS PERMITS
MECHANICAL PERMIT
Total Miscellaneous perrnits
tb
(D)
(E)
No
Dryer
/S nt
IO,QPMechanical Permit
lssuance
State Surcharge
Total Permit
Mobile Home
State lssuance
State Surcharge
Sidewalk .-- ft
Curbcut .-- ft
Demolition
State Surcharge
Furnace
Exhaust Hood
Vent Fan
TOTAL AMOUNT DU
(A, B, C, e and E Co
E (excluding electrical),mblned)
VALIDATION:
FIECEIPT NUMBER
DATE PAII)
AMOUNT RECEIVED
07 o?z I
?
RECE'VED BY
LO
€/ t{-;rb
4
.IGFIELEl
1 -1%
ELECTRICAL PERMIT PLICATION
by the'09tg )/ou . City Job Nunberto
FEE SCEXDUI.E BELOV
the
of
e idential-Single or
0y-p amily per dvelling unit.
ice fncluded:
I tems Cos t
s 85.001000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home. or
Modular Dvelling
SerVice or Feeder
s 1s.00
$ 40.00
s s0.00
s 60.00
s100.00
s130.00
s300.00s 40.00
e
loca t i on
s 40.00
$ ss.00
s 80.00
225 FIFTH STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
OFFICE: 726-3759
1 LOCATION OF INST
PTI
i4
the
ob rso/
I
VA
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if uork is suspended for
L80 days.
2. CONTRACT0R INSTALLATION ONLY B. Services or Feeders
Installation, Alterations
Electrical contract". RU i defs gteckf'C lfp6. Relocation:
Address nb tsD.l 200 amps or less
ZL 201 amps to 400 amPs
Ci ty Phone
Supervisor License Number 2%o-s
Expiration Date lo - l-g
constr contr. Number 2O-\LC
FOR
Exp ir:arion o",u lo 'l -9 8 201 amps to 400 amPs
Signature of Supervising Electrician Over 401 to 600 amPs
0ver 600 amps or 100 O-vofTs see "B" aEove
Owners Name I crn D€n \oh O,'1
D. Branch Circuits
Add ress Z t\Nev, Alteration or Extension Per Panel
Sum
"5D
40.00
40. 00
Ci ty Aed Phone
OIINER INSTALLATION
The installation is being made on
property I ovn r,rhich is not intended
for sale, lease or rent.
0sners Signature:
DATE:
onecircuit I s35'oo
Each Addi tional I
Circuit or vith Service
or Feeder Permit S 2.00
E. Miscellaneous (Service/feeder not included)
-Eaeh installation
Pump or irrigation
-
Sign/0ut1ine Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
S
$
s
s
,B
RECEIVED B
5
20.00
36.00q)
JOBDOe
tr,3,e,e o 600 amps
o i.000 amps
Anty
ess
(/