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Home My WebLink AboutPermit Mechanical 1993-4-14 BESIDENTIAL PERMIT APPLICATION . Inspections: 726,3769 Office: 726,3759 SPRINGFIELD .' r/A' n-f ~T LOCATION OF PROPOSED WORK: 21') ~ ") ASSESSORS MAP: /7(23 -:2 C; J 2... LOT' BLOCI<" OWNER: ADDRESS' CITY' -\-lou) t.~~ Kt:Re:;E.R ~D3q r:\~11-I ~T, S~ ~\\\)bt=\t.~ DESCRIBE WORK' \ \\~\ h..\.-\... NEW REMODEL ADDITION CONTRACTOR'S NAME GENERAl' STAT'" DR t\....-E:(l.TR\Q, FuRNA~5 DEMOLISH OTHER 'f 01, (;1)0 JOB NUMBER 7''?t2:/'3/ 225 Fiflh Street Springfield, Oregon 97477 TAX LOT: r" f!; CLO SUBDIVISION' PHON'" '14h -tj.{)/ ~ ZIP: 91l)'11'f /5Ku) RE-'Pk.ft{1,E, ADDRESS CONST, CONTRACTOR' EXPIRES PHONE PLUMBING: MECHANICAL: (\nffib-t- t:\hlll ~(l{.\~ '855 Ii), )~+ ft\q~\'\Q. ELECTRICA' ' oDLl-LiO iR./C),'1 /93 ~l);l.-8J6/ - OFFICE USE - QUAD AREA' LAND USF' FLOOD PLAIN: . OF BLDGS: . OF UNITS' ZONING CODE: OCCY GROUP' CONSTR, TYPE: . OF BDRMS' . OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER' RANGE: SQUARE FOOTAGE: To request an inspection, you must call 726-3769. This Is a 24 hour 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. o Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing/Electricall Mechanical - Prior to cover. o Footing - After trenches are excavated. o Masonry - Steel location, bond beams, grouting. o Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. o Undcrfloor Plumbing/ Mechanical - Prior to insulation or decking. o Post and Beam - Prior to floor insulation or decking. o Floor Insulation - Prior to decking, o Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling trench. o Water Line - Prior to filting trench. . D Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS o Rough Mechanical - Prior to cover. o Rough Electrical - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framIng Insp. o Framing - Prior to cover. o Wall/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. o Wood Stove - After installation. o Insert - After fireplace approval and installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Drivcway - After cxcavation is cO/11piete, forms and sub.base :T1atcrial in place. o Fence - When completed. "0 Stroet Trees - W':-Icn all required trees are planted. o Final Plumbing - When all plumbing work is complete. ~inal Electrical - When all p.electrical work is complete. ~inal Mechanical - When all ~eChanical work is complete. o Final Building - When all required inspections have been approved and building is completed. OOlher \ MOBILE HOME INSPECTIONS o Blocking .and Set-Up - When all blocking Is complete. o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blockIng, set-up, and plumbing inspections have been approved and the home is connected to the service panel. o Final - After all required inspections are approved and porches, skirting, decks, and venting have been Installed. . . Lot Type Setbacks "- IS THE PROPOSED WORK IN THE , .... Interior I PL. I HSE I GAR ACC I HISTORICAL DISTRICT, OR ON IN I I I THE HISTORICAL REGISTER? Corner If yes, this application must be signed Panhandle Is I I I and approved by the Historical Iw I I Coordinator prior to permit issuance. Cul.de.sac IE I I APPROVED' Lot faces Lot sq, fig, Lot coverage Topography , Total height , \ \ BUILDING PERMIT ITEM SQ, FT, X $/SQ, FT, VALUE Main Garage Carport Total Val ue Building Permit Fee Stale Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' Sanitary Sewer FT, FT, FT. Water Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT ,M/A) Furnace Exhaust Hood Vent Fan N' Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit J -;::;: CJr:) I/) eX) ,71 ? _ <:;, ?T" Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk fI Curbcut fI Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) -?S7S' BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permil 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 buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee: Date Paid: Receipt Number" Received By: Plans Reviewed By Date Systems Development Charge is due on 'all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS By signature, I state and agree, that I have carefully 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 OrdinancE;ls of the City of Springfield, and the Laws of the Stale of Oregon perlalning to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certi fy that only contractors and employees who are In compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address Is readable from the street, that the permit card Is locate I at the front of the property, and the approv d set of plan will remain on the site at a~II}il,es durn< constructio , X -1 . If Ignature ~ _ . Dalo t/ ij'-/?'-7J VALIDATION: RECEIPT NUMBER 2512. ( ~//'t1,~s ./p?~ DATE PAID AMOUNT RECEIVEn RECEiVED BY . . ';J . ~ SPRINGFIELD .' r.'l ~': ~f') (;y- . v.r\. ~ _&\ , . . ...,.....Q...O;\'\':>\\_. .., J 225 FIFTH STREET -;"^"0~:i:>\cQ"- \, ~~LE' CAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477:,;.:,'j';)'~""",,: -.t' . n 0~n \ INSPECTION REQUEST: 726-:-)769 '1,.0';\", \)\~) 1>' City Job Number '-"VI ~ OFFICE: 726-3759 Ilr ,\/". ../ - - .... u'...........:: ,//" c.\~f"'" 3. COHPLETE FEE SCHEDULE BELOV 1. LOCATION OF INSTALLATION,0" ~ ~\\,.. O' i'''\''~ A. New Residential-Single or Hulti-Family per dwelling unit. Service Included: ...,l~~~:01)loS(l) JOB DESCRIPTION ~~ "r. , n~a"T.. ~1rtf(\nM 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~Rfta"~nl"'I~' Addre~s P.I). W, It/.g''J--> 1 Cit~ Phone '14-1-1./), "?Jf., Supervisor Llcen,se Number 1" lito ,') Expiration Date ID- /-q5 Constr Contr. Number (J1I9.4if .. Expiration Date If - I -q 3 Signature of Supervising Electrician f::~ :.~f~';dW~ Addressjn~q 1-.;('\j~" Ci ty~ r 1\.i~Phone ~ b- 4-0 I ~ OVNER IN~ALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: /J. ~ .~/ .f )~ -' ~ 1- ~./:-Lr ~~----' , '4~TEf1Y ~ =---- RECEIPT I: I 0 -' . r~J) RECEIVED B~,Cl1- ~)I..h _ ' Items Cost Sum 1000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Hanuf'd Home or Modular Dwelling Service or Feeder $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less $ 50.00 201 amps to 400 amps $ 60.00 401 amps to 600 amps $100.00 601 amps to 1000 amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $ 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 "B" above D.' Branch Circuits New, Alteration or Extension Per Panel One Circuit Each Add it ional Circuit or with Service or Feeder Permit $ 35.00 ~O $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00; 5,. SUBTOTAL OF ABOVE .::jS',OO 5% State Surcharge I. 1!\ TOTAL ' ~t,. '75