HomeMy WebLinkAboutPermit Mechanical 1992-8-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726,3759
C1~ 'IIU
<:J..~ ",/~~ I
JOB NUM BER .:.::;16.-: J)/ /
225 Fi fth St reet
Springfield, Oregon 97477
LOCATION OF PROPOSED WOF1K: --,~~
ASSESSORS MAP: --I?-6:t.... ':::<~-~
LOT:
BLOCK: ~____~_,__~___~
OWNER: ~-/d2~ i (.:b~B~-_<;~c5-? <.
ADDRESS: ~,_~~~----
CITY: _'__~__' ----,--
STATE:
TAX LOT:
SUBDIVISION'
PHONF' '7Y~-~7"'<
ZIP:
DESCRISEWORI<: /~7'~.A'4_~-C~P &:;;~:2N~A/, rU/~ r P~75'~cv-~
-/-P~ "/ r . -/ /' . "0'--=-"" . ':#-~ r' / //.R /' r" / - ? ~~-
t~EW REMODEL_,____ ADDITION ____,_ _ DEMOLISH OTHER
CONTnACTOfl'S NAME
CfNrflAI'
ADllF1r::SS
CON ST.
CONTRACTOR /I
EXPIRES
PHONE
:~~M~~:~~AL:;f~~~~~~7"~~~ ~~/~;=;;;~~~~~~
ELECTRICAL: ____ u___,______________ -- -~ -------~-~---
QUAD AREA:"- ~ -~-----~-
It OF SLDGS: ___
OCCY GROUP:_
It OF STORIES:_
WATER HEATER: __~-
- OFFICE USE -
LAND USE:
/I OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE: ___
FLOOD PLAIN:
ZONING CODE:
/I OF SDRMS:
SECONDARY HEAT:
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.
D
Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D
Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling Irench.
o
Underfloor Plumbing/ Mechanical
- Prior to insulation or decl~ina.
o
Post and Beam - Prior to floor
insulation or decldng.
o
Floor Insulation - Prior to
decl<ina,
D
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench.
D
Water Line - Prior to filling
trench.
o
Rough Plumbinn - Prior to
cover.
REQUIRED INSPECTIONS
D
Rough Mechanical - Prior to
cover.
I I Rough Electrical - Prior to
cover.
o
Electrical Service - Must be
approved to obtain permanent
electrical power.
D
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.
CI 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 & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - Wilen completed.
i I Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing work is complete.
D
Final Electrical - When all
electrical worl~ is complete.
[K]
Final Mechanical - When all
mechanical work is complete.
o
Final Building - When all
required Inspections have been
approved and building is
completed.
o
Other
MOBILE HOME INSPECfIONS
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, sl<irting, decl<s, and
venting have been installed.
Lot fa~es
Lot Type
Setbacks
HE PROPOSED WORK IN THE
1-1ISTORICAL DISTRICT, OR' ON
THE HISTORICAL REGISTER?
If yes. this application must be signed
and approved by the Historical
Coordinatc~~ prior' to permit issuance.
Lot sq. Itg. . .
Interior
P.L.
HSE GAR Accl
I
Lot coverage
Corner
N
Topography
Total height..
'"
Panhandle
S
Iw
IE
Cul-de,sac
BUILDING PERMIT
ITEM , SQ. FT.
X $1 SQ. FT.
VA LU !;.'
Main
....."
Garage
Carport
Total Val ue
:,4;:
Building' Permit F:ee
State Surcharge
Total Fee
(A)
,." 'SYSTEMS DEVELOPMENT .CHARGE (?D~)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Hom'e
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood'
Vent Fan
NO
Wood Stove/lnserf/Fl.rep'ace Unit
Dryer Vent "", '
~riflYij~E5 )"/?fY. nL5. ~.
. .
Mechanical Permit
Issuance
/V:~
, ---
...75
75: ::::?)
State Su rcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile HOme
State Issuance
State Surcharge
Sidewalk
ft
"
, .
,
,.
Curbcut
ft
Demolition
State Surcharge
TotaIMisc!3I1'~neous Permits (E) ,
. 'TOTAL A~O~NT DUE (excluding electrical(:\6, f D
(A, B, C, D, and E Combined) .
. APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition.that the's~id
construction shall, in all respects, conform,to th~Ordina~ce
adopted by tile City of Springfield, includ(n'g the
. Development Code, regulating the construction a'nd use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances,
Plan qheck Fee:_
Date Paid:
Receipt Number'
Received By:
. Plans Reviewed By
Daie
".~ystem~' Dev~loPfnent Cllarge is due on all undeveloped
properties with'in the City limits which are being improved.
~
:ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully ex?mined
the completed application and do her'eby'certify'that all
info,:mation hereon is true and correct, and I further certify,
that any and all work performecj shallbedone in accordaricc
with the Ordinances of the City of Springfiei'd, and the Laws
of the State of Oregon pertaining to the work described
. here'iri, anit that NO OCCUPANCY will 'be made of any
structure willlOut 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 tllis
project.
I further agree to ensure that all required inspections are
requested at the proper time,.,that each address is readable
from the street, tllat the permit card i:3 located at the front
of 'tlle property, and tile approved set of planswill remain
on tile site at all times during c nstruction.
Sig~ature '-!4lt1l -,4~/
1-- /3~f?
Date
VALIDATION: 'g (/C1
RECEIPT NLlMBER , . L. \?;Rf \
DATE PAID h \. Y t)
- _ors.Vl~
RECEIVED B
. -......-
AMOUNT RE ,.