HomeMy WebLinkAboutPermit Mechanical 1994-8-16
tl613
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
SPRINGFIELD
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP'
LOT:
OWNER'
AODRESe::,
CITY:
, BLOCK:
STATF'
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JOB NUMBER
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225 Fifth Street
Springfield, Oregon 97477
5"11</.~O:F?E I' 9'7'117
TAX LOT: ~~
SUBOIVISION:
PHONE'
7 '1-7-/ "5t'
ZIP:
97 'f77
DESCRIBE WORK:
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(!) F h B<l-T-j) i.J W1fJ r' y-ilewt
NEW
REMOOEL
CONTRACTOR'S, NAME
GENERAl'
PLUMBING:
MECHANICAL:
AOOITION
DEMOLISH
OTHER
AOORESS
CONST.
CONTRACTOR #
PHONE
I-hht..U8l~/lIe/ce ~;;
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ELECTRICAL:
EXPIRES
00077
{0:..,3 {:o.''1tf1'1-6,~ 16~1
';;'" OFFICE USE -
QUAD AREA: LAND USE: FLOOO PLAIN:
# OF BLDGS: # OF UNITS: ZONING COOE:
OCCY GROUP: CONSTR. TYPE: # OF BORMS:
# 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/ Electrical/
Mechanical - Prior to cover,
o ,Footing - After trenches are
excavated, '
0' 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 Underfloor Plumbing/Mechanical
-, Prior to insulation or decking,
o Post and Beam - Prior to floor
insulation or decking. ,
, ' D,' FIO~~,I~~ulation"':' Prior'to
. decking., \.; '<. " '
\ ,,' \'. ~
o Sanitary Sewer - Prior to filling
trench,
D Slorm Sewer, - Prior to filling
trench, '
o Water Line - Prior to filling ,
trench, '
o Rough Plumbing..,... Priorto
cove~ '
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 F~aming -'- Prior to cover,
o Wall/Ceiling Insulati,on - Prior to
cover. '
o Drywall - Prior to_taPI~g.
o Wood Stove - After i~staIl8tlon.
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 - When completed. '
o Str,eet Trees ~ When 'alfrequlfed,' "
trees are planted.
o Final Plumbing - When all
plumbing work is complet,e.
o Final Electrical - When all
electrical work is cqmplete,
rn Final Mechanical - When all
. , mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
, 0 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 approved
and the home is c,onnected to
the service panel.
D Final - After all required ,
,," Inspections 8reapproved and
'porches, skirting. dElcks, and
venting 'have been installed.
Lot faces
LOt'sq..'ftg"
Lot coverage
Topography
';-otaltiel'ght
"Coo
Lot Type
, Interior
Corner
, Panhandle
~-.,C,ul:de-sac ';:
BUILDING PERMIT
ITEM SQ. FT, X $/SQ, FT,
Main '.J '.:'..: ',<< " '~'
Garage
Carport' "
~. '\. ..~~.
'\'" ,
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
Setbacks
I 'P.L HSE GAR
IN
\S
Iw. ,
""'E; '\
VALUE
,;
;
i
, '
~.~
ACC I
I
I
I
l E PROPOSEO WORK IN THE
"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit iS,granted on;the express cOl)dition that the said
constnicUbn' shall, In 'all respeCts, conform to the Ordinance
adopt,eE\, ~y..the. City, of Spr!ngfi,e,ld, including the
Develc)pmehtCode, regul9-ting the construction and use of
buildings, and may'"be::s.u's'p,?nded 9!\rey~ked at any time
upon violation of any provisions of said ordinances,
,Plan Check Fee'
;'1.;....
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Oate
.SYSTEMS DE;\f.El-0PMENTCHARGE ($'q'qf..' '.:'. '" Sys;~'m/Development Ch;rge is' due,'on'all undeveloped
. . pr~'peril~s wifH!;, th~ Cit~'limits ~h'i~h'~~~ being Improved.
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT,
"
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent . '
~'~~~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(B)
(C)
////7
~~
(D)
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, p, and E Combined)
FEE
/~., ..
/t? ~
:~~
--
216. 7U)
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 certify 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 located at the front
of the property, and the approved set of plans will remain
on the SltFall times dU~ng construction,
Signature ' J:~~ I~~ "..
("' -fb _ ic.L. (/ tf~ C-o"
Datp r I
VALlOATION:
RECEIPT NUMBER / V~ 9'5
8-/","9V
"26- :<(.';50
,.,.-:7~ .
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DATE PAID
AMOUNT RECEIVEO
RECEIVED BY