HomeMy WebLinkAboutPermit Mechanical 1995-6-21
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
-
LOCATION OF PROPOSED WORK: (f?)1)
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ASSESSORS MAP:
LOT:
BLOC!'::
.
JOB NUMBER qq/~tJ /
225 Fifth Street
Spflngfleld, Oregon 97477
, TAX LOT:
SUBDIVISION:
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PHONE:
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OWNER:
ADDRESS:
CITY:
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DESCRIBE WORI<:
NEW
REMODI::L
PHONE
CONTRACTOR'S NAME
GENERAL:
PLUMBING:... _
MECHANICAL: -A1-JJlfI1
ELECTRICAL: fJ1e1ej1~.
STATE:
rrfL
ZIP: Q1lf7,
OTHER ,{
ADDRESS
CON ST.
CONTRACTOR 1/
- OFFICE USE -
LAND USE:
1/ OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover,
D 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 Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - Arter
fOfms are erected bllt prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material In place,
o Fence - When completed.
o Street Trees - When all required
trees are planted.
EXPIRES
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ADDITION
f/1UILIY -
,
DEMOLISH
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QUAD AREA:
1/ OF BLDGS:
OCCY GROUP:
1/ OF STORIES:
WATER HEATER:
FLOOD PLAIN:
ZONING CODE:
1/ OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:_
To fequest 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 sanJe working day. Inspections requested after 7:00 a.m. will be made the following work day.
D Temporary Electric
D Site Inspection - To be made
after excavation. bu t prior to
selling torms,
D Underslab Plumbing I Electricafl
Mechanical - Prior to cover.
D 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 'IIIlnQ trench.
D Underlloor Plumblngl Mechanical
- Pflor to Insulation or decking.
D Post and Bea~ - Prior to floor
Insulation or decking,
o Floor Insulation - PriOf to
decking,
D Sanitary Sewer - Prior to filling
tfench.
D Storm Sewer - Prior to 'IIIIng
trench.
D Water Line - Prior to filling
tfench.
o Rough Plumbing - Prior to
cover.
D Final Plumbing - When all
plumbing W9rl{ Is complet,e,
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When al/
required Inspections have been
approved and building Is
completed.
o Other
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 appfoved
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 faces
Lot Type .
Interior
Lot sq. ftg.
Lot coverage Corner
Topography Panhandle
Total height Cul-de-sac
. ;'.THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
1/ yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
P.L. HSE GAR ACC
N
S
Iw
IE
BUILDING PERMIT
ITEM SO, FT, X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
'.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
SanltafY Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge JI1fP!t
Total Permit lfhn __ (0)
I "J.
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
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APPRPVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit 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 COl)itruction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions 0' 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 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 certi fy that only contractors and employees who
are In compliance with ORS 701,055 will be used on this
project.
I further agree 10 ensure that all required inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the front
of the property, and the approved set of plans will femaln
on the site at ~Imes dU~O~~ction.
Signature ~7X/ ~ -
Date ~/zl/9~
VALIDATION:
RECEIPT NUMBER 0 11q~
DATE PAID {II f!H1 qt{
AMOUNT RECEIVPi}, 'U. z,o
RECEIVED BY -+-1j'OJU..!