HomeMy WebLinkAboutPermit Mechanical 1997-08-04ELE,
RESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PRO
ASSESSOBS MAP:
:+
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
SUBDIVISION:
.?
-S5
LOT:BLOCK:
?3;E
D,)J'a',-STATE:ZlPi
s
PHONE:z4b*Z 1,LL{** s4
CITY:
ADDRESS:
OWNEB:
OTHER
DESCRIBE WORK:
NEW- BEMODEL ADDITION
GENEBAL:
ELECTBICAL:
lo{
ADDRESS
Pci t
EXPIRES ,' PHONECONTRACTOR'S NAME
MECHANICAL:
PLUJT4BING:
CONST.
CONTRACTOR '
- OFFICE USE _
180OAr
t-'
1\{\s
\F$E
\S No1FLOOD
r OF BDRMS:
WATER HEATER:RANGE:
LAND
HEAT
PLAIN:OUAD AREA:
, OF BLOGS
SECONDARY HEAT:
SQUARE. FOOTAGE:
F%*,*e coDE:
OCCY GROUP:
I OF STORIES:
#oF
coN
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUTRED INSPECTIONS
Temporary Electrlc M.ftugn Mechantcat - Prlor to|E cover-
Flnal Plumbing - When allplumblng work ls complete.
Site lnspectlon - To tre made
after excavation, but prlor to
settlng forms.
l--l Rough Electricat - Prior tot--J cover.fl Flnal Electrlcal - When all
electrical work ls complete.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Electrical Servlce - Must be
approved to obtaln permanent
olectrlcal powor.
f-VFlnal Mechanlcal - When altu mechanlcal work ls complete.
Footlng - After trenches are
excavated.n Flreplace - Prlor to faclng
materlals and framlng lnsp.
Flnal Buildlng - When att
requlred lnspectlons have been
approved and bullding ls
completecl.Masonry - Steel locatlon, bond
beams, groutlng,Framlng - Prlor tg cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Celling lnsulatlon - Prlor to
cover.
Underground Plumblng - Prior
to fllllng trench.Drywall - Prlor to taplng
MOBILE HOME INSPECTIONSUnderlloor Plumblng/ Mechanlcat
- Prior to lnsulatlon or decklng.tl Wood Stovo - After lnstallatlon.
Post and Boam - Prlor to floor
lnsulatlon or decklng.lnsert - After flreplace approvql
and lnstallatlon of unlt.
Blocklng and Set-Up - When all
blocklng ls complete.
Floor lnsulatlon - Prlor to
decklng.Curbcut & Alrproaclr - After
forms are erected but prior to
placement of concrete.
Plumblng Connectlons - When
home has been cgnnected to
water and sewer.
Sanitary Sewer - Prlor to fllllng
trench.
Storm Sewer - Prlor to fllllng
trench.
Sidewalk & Drlvewav - After
excavatlon ls complete, forms
and sub-base materlal ln place.
Fence - When coi'rrpleted.Water Llne - Prlor to filling
trench.Flnal - After all required
lnspectlons are approved and
porchos, sklrtlng, decks, and
ventlng have been lnstallecl.
Street Trees - When all requlred
trees ar6 planted.
Bough Plumblng - Prlor to
cover.
E
TAX LOT
E
E
E
E
E
E
tl
E
E
D
E
E
E
E
tl
E
tl Electrlcal Connectlon - When
blocklng, set.up, and plumblng
lnspectlons have been approvecl
and the home ls connected to
the servlce panel,
' 1,',lq ,';l
Lot faces
Lot sq. Itg.
Lot coverage
Topography
Total helght
Lot Trype
-
tnterlor
-
Corner
-
Panhandle !
-
Cul-de-sac
Se IS THE PROPOSEO WORK TN THE.
HrsToRlcAL DtSTRtCr, oR oN
THE HISTOR]CAL REGISTER?
-
lf yes, thls appllcatlon must be slgnedand approved by the Historlcal
Coordlnator prlor to permlt issuance.
APPROVED:
t
P,L,HSE GAR ACC
N
S
W
E
VALUE
(A)
, j,:
BUILDTNG PERMIT '
SQ. FT.ITEM
Main
Garage
Carport
Total Value
Bulldlng Permit Fee
State Surcharge
Total Fee
iit
x s/so. FT.
Thls permit is granted on the express condiilon that the sald
constructlon shall, ln all respects, conform to the Ordinance
adopted by the City of Springfleld, inctudtng the
Development Code, regulatlng the construction and use of
bulldings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Recelpt Number:-
Plans Reviewed By Date
,
E
BUILDING LUE
Date Pald
Received By:
Plan Check Fee:
AND BUILDING P
i5mru cHECK
,RMIT
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
propertles withln tlre City linrlts which are being improved.
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
Nt
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
Wood Stove/ lnsert / Fl replace Unlt
Dryer Vent
No
13'6
Mechanical Permlt
Vent Fan
lssuance
State Surcharge
Total Permlt
MECHANTCAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby certlfy that all
lnlormatlon hereon is true and correct, and I lurther cerilfy
that any and all work performed shall be done ln accordance
wlth the Ordlnances of the Clty of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCy will be made of any
structure wlthout permission of the Bulldlng Safety Dlvislon.
I further certlfy that only contractors and employees who
are ln compllance wlth OBS 701.05S wlll be used on thls
prolect.
I further agree to ensuro that all requlred lnspecilons 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 wlll remaln
on the slle at all times durlng construct
Date s/q4q
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surcharge
Total Mlscellaneous Permlts (E)
TOTAL AMOUNT DUE (excludlng electrical)
(A, B, C, D, and E Comblned)
VALIDATION:
BECEIPT NUM
OATE PAID
AMOUNT
RECEIVED BY
FT,
(D)
dte40
CITY OF SPF OREGO'U
N
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORTZED U NDER TH ts PEmfl.TJ $'N8J as ru b m itod
SPF|l. --.lELD
tt-t
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home. or
Modular Dvelling
Sertice or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
s ths follorving
ICIiC uuilErccrnrcei- PERt{rr APPLTcATToN
h,
DORIS ire spocific
FfiQH225
INSPECf,ION REQUEST:
OFPICE: 726-3759
1. LOCATION OF INST
I.,EGAL DESCRTPTION
11 0 )..3t>
726-376\,-3111
S lrr?)
City J
lv COHPLETE FEE SCEEDULE BELOII
ob Nurnber ?l I I -7 )
Nev Residential-Sing1e or
Mutti-Family per dvelling unit.
Service Included:Items Cost
TI
pr o
A
C
E
200 amps
201" amps
40L amps
601 amps
Over 1000
Reconnec t
200 amps''or I
201 amps to 4
Over 401 to 6
0ver 600 amps
less
600 amps
L000 amps
mps /voI ts
nly
amps
1000 vofTs
Sum
s 8s.00
s 1s.00
$ 40.00
ee ItBtt a5ove
JOB ION
Permits are non-transferable and expire
if vork is not started vithin 1'80 days
of issuance or if vork is suspended for
1.80 days.
2. CONTRACTOR INSTAILATION ONLY B
Electrical Con tractor
Address
,
s s0.00
s 50.00
s100.00
s130.00
s300.00s 40.00
or
to
to
to
a
0
s
$
)
s
3'l, oo
t, ,:i
Ltl
39.qh
cit Phone 1+l -A,a31.
Supervisor L Number I /" 86 SI Cense
Expiration Da te iO - I - 18
Constr Contr. Number o 3 e,4q
Expir.ation Date
ture of S upervising Electrician
Temporary Services or Feeders
Installation, Alteration or Relocation
psam
ess
00
00
or
40.00
s5.00
80.00S
Ovners Name
Address
cir
OVNER I ON
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
0vners Signature:
D. Branch Circuits
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
Nev, Alteration or Extension Per Pane1
One Circuit I $ 35.00 3,r.OC
Each Additional
Circuit or vith Service
or Feeder permir I S 2.00 _ArOo
Miscel-laneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
sign/outline Lighting- $ 40.00
Liilited Energy/Res S 20.00
Limited enerEy/comm $ 36.00
pnor. '14 b - )fl Kl
5
DATB:
RBCEI
l-)
RBCEIVED D
Zoninct
n