HomeMy WebLinkAboutPermit Mechanical 1998-06-26RESIDENTIAL
PERMIT APPLICATION
lnspections:726-3769
Oftice; 726-3759
SPFIINGFIELD
JOB NL,IMEEN E
€Nv,
225 Filtlr Strcct
Springtlcld, Orcgorr 97477
LOCATION OF PROPOSED WOFI(:l39g
^l
..4+U s+
TAX LOT:
LOT:BLOCK SUBDIVISION:
OWNEB:PHON E,:1il-4q7,+
ADDRESS:
CITY:STAI'E:7-tP:
DESCRIBE WO
NEW REMODEL ADDITION DEMOLISI.I OTI1EN
ADDRESS
CONST.
CONTRACTOR //EXPI}:1E S PIlONE
GENEBAL:
PLUMBING
MECHANICAL:I Qst b
ELECTRICAL:
_ OFFICE USE _
QUAD AREA:
, OF BLDGS
LAND USE:FLOOD I)LN IN
II O[: UNITS:ZONING CODE:
OCCY GROUP:
, OF STORIES:
CONSTn. TYPE:
--HENT SOURCE SECONDNTIY FIEAN -.
WATEH FIEATEFI:RANGE:SOUN Ni:. FOOTAGE:
To rcquest an lnspcctlon, you must call 726-3769. Tllls ls a 24 ltour rccorcJlng. nll lnspcctions rc(luestcct bc(orc 7;00 a.rn, wlll bc
made the sanle worl(lng day, lnspcctlons rcquested aftcr 7:00 a.m. will bc maclc thc followlng work clay.
REQ IRED INSPECI'IONS
Temporary Elec tric ouglr Meclranical - Prlor to Final Plr.rrrrbing - Whcn allplunll)ing worl( is complet.c.c ove r,
Sitc lnspcction - To bc macJc
alter excavation, but prior to
settln0 forrns.
Rough Elcctricnl - Prior to Firrll Elcctr(ical - Wlrcn allclcctrical worl< is contplctc.covcr.
Underslab Plunrbing/ Elcctrical /
Mechanlcal - Prior to cover.Elcctrical Scrvlcc - Must be
a1>provccl to obtaitr pcrrnancnt
clcctrlcal I)ovr'cr.
al Mccharrical - Wlren all
rrroclranical r,vorl< ls cornplctc.
Footlng - Af ter trenchcs arc
cxcavatcd.Flrcplacc - Prlor to faclng
materlals and lraming lnsp.
Firral Builclirrg - Wlrcn all
requircd inspectlons have bccn
approvcd and builcling is
corn plc tod.Masonry - Stcel locatlon, bond
beams, groutln0.Franrlng - Prlor to cover.
Foundatlon - A(ter forms are
erected but prior to concretc
placernen t.
Othcr
Wall/Cciling lnsutatiorr - Pflor to
covcr,
Underground Plumbing - Prior
to fllllng trench.Drywall - Prior to talring.
MOBILE I.IOME INSPE TIONSUnderlloor Plumblrrg/ Mcchanical
- Prior to lnsulatlon or decl(ing.Wood Stovc - Altcr lnstall.rtion
Post and Bcam - Prior to floor
lnsulatlon or dccking.lnscrt - Allcr flreJ.llacc apl)roval
and installatlon of unlt.
Blockirrg and Set.Up - Wltcn all
blt':cl<i n11 i s cornplcte.
FIoor lnsulation - Prior to
dccki ng.Curbcrrt & l\1r1.rroirclr - nttcr
lorms arc crccted bUl prior to
,)laccrncl!t of cortcrotc.
Plrrrrrt:irrg Corrrrcctions - Whcn
Irornc lras bccn collnecteCJ to
w;ttcr itncl scv/er.
Sanitary Scwcr - Prior to filling
trcnch,Elcctri<:al Corrrrcctiorr - When
[>lockirrg, sct.up, and plunrbing
inspcclions llnvc bccn approvcd
ilrld tllc trornL' is connccted to
t lrr: scrvicc 1.ranc.l.
Storrn Scwcr - l)rior to tilling
trencl'1,
Sidewalk & Drivcw;r\, - nflcr
cxcav.rtiorr is completc, [oilns
and sul).basc rnalcrial i11 pl;rcc.
Watcr Llnc - Prlor to lilling
trench.
Fcrrcc - Wllcn colnplctcd.
{itroot Trcas - Wlrcn all rcqulrc<J
lrccs are plantccl.
Final - AItcr all requircd
lrrspcctions arc approvcd andporcltcs, skirting, decks, andventln0 havc been lnstalled.
Rough Plurnbing - Prior to
covcr.
t_l
rl 0L 30 0v o1tASSESSOBS MAP:
hg.
.s+, s
CONTHACTOR'S NAME
/ ol: LlDr-iMS: _
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Lot faccs
Lot sq. (tg.
Lot covcrago
Topography
Total hclght
Lot 'typc
-
lntcrior
--
Corrtcr
-
Panhartcllc
-
Cul.dc-sac
Sc ll;acl<s
P.L.HSE
N
t:
GAR
IS THE, PtlOI'OSED WORK iN TI-IE .
}.I ISTORICAL DISTRICT, OR ON
TIlE IJISTORICAL REGISTER?
-
ll yes, tlris application must be slgned
and approvcd by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
VALUE
(^)
x $/so. r--T,
Total Valuc
Building Pcrmit Fce
Stalc Surchargc
Total Fcc
BUILDING PERMIT
ITEM SO. FT.
Main
Garagc
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pcrnrit is grantcd orr the cxprcss conditiorr that thc said
construction shall, in all respccts, conform to the Ordinance
adoptcd by the City of Springficld, including the
Development Codc, rcgulating the construction and use of
buildings, and may bc susperrdcd or rcvol(cd at any tlrne
upon violation o[;.rrry provisions of said ordinances.
Plans Flovicwcd By Datc
Reccipt Nurrrbc
Plan Chcck Fcc:
Datc Paid
tlcccived By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systcms Developmcnt Chargc is due on all undeveloped
propcrtics witlrin tlrc City linrits whiclt are bcing improvecl,
ADDITIONAL COMMENTS
By slOnature, I statc anr.J agrce, that I havS carcf ully examlnecJ
the complcted application and do hereby certl,y that all
Information lrcrcorr is truc altcl correct, and I Iurther cerlify
that any and all work pcrformcd shall be done in accordance
with tlre Ordinanccls of ttrc City ot Springlicld, arrcl thc Laws
of thc St:.rtc ol Orcaon pcrlaining to thc work clescribcd
hcrcin, and tirat NO OCCUPAITICY will tic rrracic of any
struclurc without pcnnissiorr of the BuilcJing Sa[ety Division.
I [urtlrcr certi[y tl)at only contractors and enrployees who
arc in cornpliancc witlr ORS 701.055 wlll bc uscd on thls
p roicc t.
I Iurthcr agrec to cnsure that all rcquired inspcctions are
tinre, that cach address is readable
d thc aplrrovcd sct of plans will remain
Slgnat
Date
(
sttimcs d ng co
b-ab-%
rcqucstcd at thc
from thc sI it card ls locatcd at thc tronttthe p
of tlrc p
ctlon.on the
PLUMBING PERMIT
ITEM
Fix tu res
WoocJ Stove/ lnsclt/ Flrcplacc Urril
Drycr Vent
MISCELLANEOUS PERMITS
Mobile Honrc
Statc lssuancc
Slatc Surclrargc
Sidewalk
-
ft
Curbcut
--
ft
Domollllon
Stalc Surchargc
Total Misccllaneous f)crrnils (E)
FEE
N0
t:l',
-KALgf'*e..ag
Rcsidcntial Bath(s)
Vcnt Fan
(D)
(1,)
tE,'-
4Lw..--_:
No
Sanltary Scvrer
Watcr
Storrn Scwcr
Moblle Horne
MECHANICAL PERMIT
Fu rnacc
Exhaust Hood
Mcclranical Pcrrnit
lssu ance
Slatc Surch.rrgc
Total Pcrmlt
Plurnbln0 Pormit
Statc Surclraroc
Total Clrarge
TOTA L AMOUNT OUE (cxcludine clcctrical)
(A, B, C, O, and E Cotttbincd)
VALIDATION:
RECEIPT NUME}EF'I -__3eLb_g
DAI'E PAID b- ab-44
AI,/OUNT RECEIVED
FIE,CEIVED BY D
. t--l:
SPFl'..(GFIELt)
zcning, and
approval,
do€€nd requlrcr
225 FIFTH
SPRINGFIELD,
INSPEOIION REQLIEST| 726'3769
0FFICE:. 726-3759
1. LOCATION OF INSTALLATION
11^
LEGAI DES PTION
o o o fr
JOB DES PTION
Ut
,tZtt ,-, q v'r( 5t-
Mul-ti-Family per dvelling unit.
Service Included:Items Cost
1000 sq. ft. or less S 85.00
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 1s.00
s 40.00
s s0.00
s 60.00
$100. 00
s130. 00
$300. 00
s 40.00
Temporary Services or Feeders
Installation, Alteration or Rel"ocation
Supervirsor License Number 2() -Aft" <-
Fvn ir:ation Date / O - I '1?
Constr Contr. Number 2t
Expi::ation Date /> -3o ^q ,
Signature of Supervising Electrician
Ovners
Address
Name
Ci ty 5PrZ,-< 6r<crt-Phone' 2v)- ffi)L(-------..1I..--T
OIINER INSTALLATION
The installation is being made on
property I ovn r',hich is not intended
for sale, lease or rent.
Orners Signature:
DATE:
a+APPLICATION
.)
A.
C
E
S
SCEEDULE BELOV
tial-Single or
(*
Permits are non-transferable and expire
if vork is not started vithin 1"80 days
of issuance or if work is suspended for
180 days.
2. CONTRACTOR INSTALI.-ATION ONLY B. SCTViCES OT FCCdCTS
Installation, Alterations
Electrical Con traclor Y:S rt €clT?.c MCo""5*tluQr Relocation:
,,rC_
Address P. n 6o * "-Y C 2a 200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
Over L00O amps/volts
Reconnect 0n1y
Phone {. f6 -L>a L
Sum
" a66ve
200 amps''or less
20L amps to 400 amps _Over 401 to 600 amps
0ver 600 amps or 1000-7ofTs
s 40.0
$ ss.o
s 80.0
see ttB
0
0
0
00
00
00
$40
$40
$20
$36
D. Branch Circuits
Nev, Alteration or Extension Per Panel-
q,sOneCircuit I $35.00
Each Add i. t i onal
Circuit or vith Service
or Feeder Permi t S 2.00
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
Miscelfaneous (Servi.celfeeder not includeC)
-Each ins ta]lation
Pump or irrigation
Sign/Outline Lighting-
Limited Energy/Res
Limited Energy/Comm
00
5
oRECETVED BY:
-.9 s 35,
c"(.'3E3$
CiW te^t< *..<--
9go lKz