HomeMy WebLinkAboutPermit Mechanical 1994-09-22SPFrI FIELO
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Of {ice: 726-3759
LoCATION OF PFIOPOSED WoRK:
-
272-\'A4th
ASSESSORS MAP
JOB NUMBER
225 Fifth Street
Springf ield, Oregon 97 477
TAX LOT:
SUBDIVISIONLOT:BLOCK:
726-4\45PHONE:
9747P,ZIP:STATE
\:r/
ORspringfield
Cliff HembreeOWNEFI:
272 N. 44th Street
CITY:
ADDFIESS
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK InstaII heat pump
MECHANTcAT: Comfort Flow Heating Sss,lal. -1st Eu gene, WAOT OOa6O 6/n /95 3a2-
EXPIRES PHONE
ELECTRICAL:
CONTRACTOR'S NAME ADDRESS
CONST.
CONTRACTOR #
G EN ERAL:
PLUMBING
_ OFFICE USE _
LAND USE:
# OF BDRMS
OUAD AREA: -
+ OF UNITS:ZONING CODE:
FLOOD PLAIN
r OF STORIES:
, OF BLDGS: -- --
WATER HEATER:---
SECONDARY HEAT:
SQUARE FOOTAGE:RANGE:
-
CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP: _---
Tc request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REOUIRED INSPECTIONS
Ternporary Electric Rough Mechanica! - Prior to Final Plumbing - When all
plumbing work is complete.
Site lnspection - To be made
af ter excavation, btrt Drior to
setting forms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location. bond
beams, grouting.
Foundation - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Prior
to filling trench.
Underlloor Plumbing/ Mechanical
- Prior to insulation or clecking.
Post and Beam - Prior to floor
insulation or decking.
Floor lnsulalion - Prior to
decki ng.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Water Llne - Prlor to fillinq
trench.
Electrical - Prior to
Electrical Service - Must be
approved to obtain permanent
electrical power.
Fireplace - Prior to facing
materials and framing lnsp.
Framing - Prior to cover
Wall/Ceilin-q Insulation - Prior to
cover.
Wood Slove - After installation
lnserl - After firel)lace approval
and instaliation of unit.
Curbcut & Approach - After
forms are erected but pricr to
placement of concrete.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Fence - When completed
Street Trees - V/herr all require'J
trees ^re pianted.
Vy'l:inat Electrical - When all,ldelectrical work is complete.
il7 finat Mechanical - When all
ui^:srechanical work is complete.
ft*l'
L-l
Final Building - When all
required inspections have been
approved and building is
completed.
Other
MOBILE HOME INSPE TIONS
Blocking and Set-Up - When all
blocking is complete.
Plumbing Connections - When
home lras been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.Rough Plumbing - Prior to
cover.
E
E
E
tl
tl
tl
E
tl
r
E
r
il
E
E
I
|-l Drywall - Prior to taping.
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
p.u. I usr GAFt
N
S
E
ACC
,5 THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OFI ON
THE HISTORICAL REGISTER? _-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
VALUE
(A)
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construciion shall, in all respects, conform to the Ordinance
adopted by tl.re City of Springfield, including the
Developrnent Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
Plan Check Fee:
Date Paid
Receipt Number:--
Fleceived By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developrnent Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDlTIONAL COMMENTS
,-SA4?z#-
-1s-
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
No
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
/4 ?,
/5: o,rQta'
/ D,x
(D)
N0
MECHANICAL PERMIT
Mechanical Permit
lssuance
State Surcharge
Total Permit
. 2J-___4_-^6?
Fu rnace
Exhaust Hood
Vent Fan
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, 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 Division.
I furtlrer certily that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
prolect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, thal the permit card is located at the front
e approved set of plans will remain
t,/z>/24-Date
-
I
of the property, and
on the site
Xnnu,,,"
r7
ring construction.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricaD '^A ,4(A, I, C, D, and E Combined)
Z
o
DATE PAID
AMOUNT RECEIVED
RECEIVED BY -_
VALIDATION:
RECEIPT NUMBER __.
FT.
/fr--@-
CITY OF OREGO'U
.[v
zoning, and
approval.
SPFINGFIELC'
BIJCTRTCAL PERI{IT APPLTCATION225 PITTE SI?BET
SPRTNGFIELD, ORBGON 97477
INSPBCIrON REOTIBSTI 726_3
OPFICE: 726-3759
Electrical Contractor C
Address
does not requiro speclflc land
A
B. Services or Feeders
fnstallation, Alterations
or Relocation:
c.
D
l-)6r',
769 lA-t{-1
1 LOCATTON OP INSTALI"ATION
LBGAL DESCRIPTION
oo bm
JOB DESCRIPTION
a
Permits are non-trallsferab e and expire
if vork is not started vithin 180 days
of lssuance or lf vork ls suspended for
180 days.
2. COIIIRACITOR TNSTALI.ATTON ONLY
City Job Nunber
BBLOV
New Residentlal-Single or
MuIti-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Hone or
-Modular Dvelling
Servlce or Feeder
s 8s.00
$ 1s.00
$ 40.00
Atrthsrized Signature
Sum
ci ptrone {41 -A gto
Supervisor License Number tb8 AS
Exp iration Date to- l-q5
Constr Contr. Numbe r0 s{,1
Expiration Date I - I -QS .
Signature of Supervlsing Electrician
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
0ver 1000 amps/vo1ts
Reconnect 0nIY
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or }ess $ 40.00
201 amirs to 4oo amps
-
$ 55.00
over 4b1 to 600 ambs
-
$ 80.00
0ver 600 amps or fbOO voTts see uB" a56E
Branch Circuits
New, Alteration or Extension Per Panel
$ s0.00
$ 60.00
$100.00
s130.00
$300.00
$ 40.00
-/€z '|r'?
t
Owners Name
Address t\,
cit Phon"!ab4)45
OgNER
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ocners Signature:
DATB:
One circuit I $ 35.00 35,ao
Each Additional
Circuit or vith Service
or Feeder Permi t | $ 2 .00 /'. OO
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _Sign/OutIine Lighti.g-
Limited Energy/Res
Limi ted Energy/Comm
5. SUBTOTAL OT ABOVE
5f State Surcharge
g r'lo TOTAL
c
.00
.00
.00
.00
rQ
$40
s40
$20
$36
(l
I
RECEIVBD