HomeMy WebLinkAboutPermit Mechanical 1991-7-17
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, COMMERCIAL/INDUSTRIAL.
PERMIT APPLICATION
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-JOB NUMBER 9/('.?6Z~
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225 Fifth Street. Springfield, Oregon 97477
INSPECTION LINE: 726.3769 .
OFFICE: 726.3759
'LOCATION OF PROPOSED WORK: /i..I'-! L/ YY\(}.. ,,\ f,r.
ASSESSORS MAP' /7~t:J'?- ~6.?' :2
22,p IrQ. (Q f'..Q.........
TAX LOT' c:;; ~~e-,
OWNER' . <frY\(,9 .{:b~.t:\. >
ADDRESS: 11../ L.j (fl VVLru"N"< ~f chtl; h, lA-
CITY: ~j J'o()0~U '
1J.1
DESCRIPTION OF WORK: ~V\~(\ 1 j 1 m~
NEW REMODEL ADDITION
PHONE:
7J(n-7'Jc( q
STATE: ro/lll( IY\ ) ZI P: q 7 d., '77 .
UnfiX a)LG ~ ~lA'rf),{) (1"LM1/.1~~,,/AI. .A1M1;I?)
DEMOLISH OTHER ~ VALUE:
NAME
ADDRESS
PHONE
ARCHITECT:
CONTRACTOR'S NAME
GENERA' .
PLUMBINC"
ADDRESS
CONST.
CO NT RACTO R .
EXPI RES
PHONE
(7\I1Jl U
<3'yIVlN
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MECHANICA' .
ELECTRICAl'
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1
1
1
1
1
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1
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PLUMBING
MECHANICAL
Nfl ~~~ ,...u^o~e
Furnacel burner & vent
< 100.000 BTUs
Furnacel burner & vent
> 100.000 BTUs
Floor furnace and vent
Suspended wall or floor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Single
duct
Vent System apart
from AC or htg.
v--- Mechanical exhaust Io/I'A/ J5"OO
hood and duct
Permit Issuance $10.00
TOTAL PERMIT 25"00
FEE
CHARGE
Single Fixture
'Relocated Bldg.
(new fix. addtl)
Water Service
It.
Sanitary Sewer
It.
Storm Sewer
It.
Backffow Device
TOTAL PERMIT
- OFFICE USE -
HANDICAP ACCESS'
FLOOD PLAIN'
OUAD AREA
LAND US".
. OF BLDG'"
. OF UNIT'"
CONSTR. TYPF'
ZONING:
LIGHTING POWER BUDGET:
OCCY GROUP'
. OF STORIES'
HEAT SOURCE:
WATER HEATER'
sa. FT.
$/sa. FT.
VALUE
SO. FTG MAIN
SO. FTG ACCES"
SO. FTG OTHER
X
X
X
TOTAL VALUE OF PROJECT
PLAN CHECK FF~ ,
RCPTH
DAT"
BY
1 BUILDING PERMIT
15% State
SurcharQe
1 MECHANICAL
15% State
Surcharae
1 PAVI NG
1 PLUMBING
15% State
Surcharqe
1 FENCE
VALUE $
1 SIDEWALK-
I CURBCUT
FT.
I DEMOLITION
25pO
12-5'"
FT.
SUBTOTAL
PERMITS
SYSTEMS
DEVELOPMENT
- I
TOTAL" PERMIT FEES
EXCLUDING ELECTRICAl
:26 ,z-s
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. REQUIRED INSPECTIONS .
It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, cail
726.3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready
for Inspection. Requests received before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m. will be made
the following work day.
SITE INSPECTION, To be
made after excavation, but
prior to setup of forms.
UNDERSLAB PLUMBING,
, ELECTRICAL &
MECHANICAL: To be made
before any work Is covered.
:><. ROUGH PLUMBING,
4LECTRIl-'Jn. &
--MI::CHANICAl;;,No work is to
be covered until these
inspections have been made
and approved.
PAVING, After gravel Is In
place but prior to placing
asphalt. ~>r concrete.
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel in place, but
prior to placing concrete.
FIREPLACE: Prior to placing
facing materials and before
framing Inspection.
SPECIAL INSPECTIONS: In accordance
Section 306 of the State Specialty Code
a special inspector shall be employed
by the Ownerl Contractor during
construction of the following work. A
copy of the special testing reports shall
be furnished to the Building Division.
ATTIC DRAFT STOPS &
CURTAIN WALLS
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FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are in
place and all pi pes, chimneys
and vents are complete and
the rough electrical, plumbing
and mechanical are approved.
STRUCTURAL CONCRETE: In
excess of 2500 PS,1. (306 a.1)
CONCRETE SLAB: To be
made after all Inslab building
service equi pment, conduit,
piping, accessories and other
ancillary equipment items are
in place but before any
concrete is placed.
STRUCTURAL WELDS:
Performed on the job. (2722 f)
UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
INSULATION & VAPOR
BARRIER: To be made after all
insulation and required vapor
barriers are in place but
before any lath or gypsum
board Interior wall covering Is
applied.
HIGH STRENGTH BOLTING:
During all bolt installation and
tightening operations. (306
a.6)
SPRAYED ON
FIREPROOFING: U.B,C.
Standards 43,8.
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor Insulation, decking or
floor sheathing.
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
SPECIAL GRADING,
EXCAVATION AND FILLlN'G:
During earthwork. (306 a.11 &
Chapter 29)
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LATH AND/OR GYPSUM
BOARD: To be made after all
lathing and gypsum board,
interior and exterior, is in
place but before any
plastering is applied or before
gypsum board joints and
fasteners are taped and
finished.
GLU-LAM BEAMS: Inspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (2501 U.B.C.
STDS. 25-10,11).
POST & BEAM: To be made
prior to installation of floor
insulation, decking or floor
sheathing.
STRUCTURAL MASONRY: (306
a.7)
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
SIDEWALK & DRIVEWAY:
Required for all concrete
paving within street right of
way, to be made after all
excavating complete and form
work and sub-base material in
place.
-In addition to the inspec-
tions specified, the Building
Official may make or require
other inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
ROOF SHEATHING,AND
NAILING: Prior to Installing
any roof covering.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
FINAL PLUMBING
SITE PLAN REVIEW BOARD: Must be requested 2 days In advance
of the date you wish Inspection. All project conditions such as
landscaping, parking lot striping, etc. must be completed before
requesting this Inspection.
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FINAL ELECTRICAL
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FINAL MECHANICAL
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FINAL BUILDING: Requested after the final plumbing, electrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
Certificate of Occupancy has been issued by the Building Division
and posted on the premises.
Y FINAL FIRE DEPARTMENT
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ADDITIONAL COMMENTS'
OU/N;<;? 4//{/C,) TIMr ~ oWDS 7nE
7RE &/6i'~( A'-'r 7/;7< M,w/-,:,,;,;(
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SI/"gJa;;7 N/IVt5e7Z/ }
atJ~ An":5
PLANS REVIEWED BY
o/~
DAT~
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Information
herein 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 further certify that only contractors and employees
who are in compliance with ORS 701.055 will be used on this project.
inspections are requested at the proper time, that project address Is readable from the
the front of the property, and the approved set of plans will remain on the site at all
'I
Date
/7/;17/1/
GMOUNT RECEI D: .c5-', /0
RECEIPT ': -2'=?:?:<""
DATE PAID:
RECEIVED BY:
'7 -/?-"? /'
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225 FIFTH STREET
SPRINGFIELD, OREGON 97477
INSPECTION REQUEST: 726-3769
OFFICE: 726-3759
1. LOCATION OF INSTALLATIO~ /Y'
144L..J---'L4t1 ;N\ ~r 5p.\.(Q. ( l))v
LEGAL DESCRIPTION
I /-6J"'3 - 36' -'3':>... eo> ==3-_,--,
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JOB DESCRIPTION
! (OV\~fl I 0 (ll)y,(\~V1JlJJ'n,'r,O A ~.
, Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
'180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical Contractor
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
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Owners Name ~n.(lo (;/(),SI1 t- \
Address luLl ( r? rY7 () i IY) ,,<;;f f)nlh -tt-
City +Jf19P,Q)& Phone 721o-7:;Cf1
OWER INSTALLATION
The installation is being made on
property I own which is not intended
RECEIPT 1I: ~oC' ~ -
RECEIVED Bo/ 1:-_ __ 4
'l-
SPUINGFIEU)
Ci ty Job Number 9'1 ~ q, -;; f1-,
3. COMPLETE FEE SCHEDULE BELOV
A.
New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost
Sum
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
$ 85.00
$ 15.00
$ 40.00
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less
201 amps to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000 volts
$ 40.00
$ 55.00
$ 80.00
see fiB"
above
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circuit 1/ $ 35.00 ?5 </0
Each Additional
Circuit or with Service
or Feeder Permit ) $ 2.00 ?-.~
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not included)
$ 40.00
$ 40.00
$ 20.00
$ 36.00
5.
'2'7(),;J
- /.$~
'<~.'20~
SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL
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Permit No:
q/0f33~
/4'-11 M/!/-<J or;
~/.J'
Address:
Issued by:
Date:
FOR OFFICE USE ONLY
STATEMENT:
'INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
followin9 statement before the building permit can be issued. Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 2B:
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1. L-...J I own, reside in, or will reside'in the completed structur!3.
2. A. c::::::J My genera,I' contractor is
Contractor registration number
,
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
B. '15><:1 I will be my own general contractor.
,
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. If I change my mind and 00 hire a Qeneral
contractor, I will contract with a contractor who is registered with the
Construction Contractors Board and I will immediately notify the office
issuing this building permit of the name of the contractor.
I hereby cermJthat the above information is correct and that I have read and understand
the Information Notice;;.o P operty Owners about Construction Responsibilities on the
reverse side of this form.
X r;p,,1#~.J?t, ~ lJ/r;/9/
'ghature of eeram Jl:Pplica Date' .
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CONSTRUCTION CONTRACTO
0244J 1/90
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WHITE COPY TO ISsUING AGENCY PERMIT FILE
PINK COPYTO APPLICANT
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