HomeMy WebLinkAboutPermit Mechanical 1995-3-15
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
, I
SPRINGFIELD
LOCATION OF PROPOSEO WORK: ,+/5'
ASSESSORS MAP' /7~tP"3 - ~ ? ..~ t.,/
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LOT:
OWNER:
AODRESS:
CITY:
DESCRIBE WORK:
NEW
REMOOEL
ADOITION
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
ELECTRICAL:
1f~Vf:<l t-fJR.,~~ Co..
,
S Co 1=/'Elrl
BLOCK:
STATE:
CJR_
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)
9'~t:P~2.5'
DEMOLISH
OTHER
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
51:
TAX LOT: 02S-00
SUBOIVISION:
PHONE:
7 i-&.- 1ft fro
ZIP:
~ -, Y-77
I'
AOORESS
CONST.
CONTRACTOR #
EXPIRES
PHONE
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cove~ '
D Rough Electrical,- Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/Ceiling Insulatiqn 7 Prior to
cover. ' "
D Drywall - Prior toyiplng:
D Wood Stove - After I~stallation.
D Insert - After fireplac,e approval
and installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement 'of concrete,
D Sidewalk & Driveway - After
, excavation is complete, forms
and sub-base material in place,
D Fence"";:' When completed.
o Street rrees ..,... Whenall'requiredl
trees are planted. , "
t/07J 77
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7lf.6'-/6 a.l
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;... OFFICE USE -
QUAO AREA: LANO USF' FLOOO PLAIN:
# OF BLOGS: # OF UNITS: ZONING COOE:
OCCY GROUP: CONSTR. TYPE: #'OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONOARY HEAT:
WATER HEATER' RANGF' 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 7:00a.m. will be made the following work day.
o Temporary Electric
D 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, '
o Masonry ..,... Steel location, bond
beams, grouting, ,
o Foundation - After forms are
. erected but prior to concrete
placement.
D Underground PlumbinQ -:; Prior
to filling trench,
, '
D Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
D Post and Beam - Prior to floor
insulation or decking,
D Floor In,sulation - Prior to
decking, , .
-
o Sanitary Sewer - Prior to filling
trench,
o Storm Sewer - Prior to filling
trench,
. ,
O Water Line-- prior to filling
trench," , ,
o Rough Plumbing - Prior to
cover. .
, '
o Final Plumbing - When all
, plumbing work is complete.
IVl Final Electrical ..:...,When all
I;4-l electrical 'work 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. '
D 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, '
D Electrical Connection -- When
blocking, set-up, and plumbing
inspections have been approved
and the home is c.onnected to
the service panel.
o Final - After all required
, inspE;lctions are approved ar,d
, porches, skirting, decks, and
,venting have beenins~alled,
Lot faces
Lot sq. 'ftg.
Lot coverage
Topography
Total height
Lot Type
Interior
Corner
Panhandle
Cul-d,e:sac
BUILDING PERMIT
ITEM, SO, FT. X $1 SO; FT,
Main
,,' '. '.
.' '
Garage
Carport "
Total Value
Building Permit Fee
State Surcharge
Total Fee
\ . ~ ,~~:;' j<'. ....
(A)
-for
~,
l ,
Setbacks
HSE GAR ACC
I P.L.
IN
Is
I w..
IE"
VALUE
, .
.. .. ,,& "
\. j THE PROPOSED WORK IN THE
HISTORICAL OISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
" '
APPROVEO:
,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shaJl', in all fes'pects,conf0ri'nt6 the Ordinance
,adopted by the City of Springfield, including the
'Development-Code;' regulating the construction and use of
buildings, and may besuspe~~ed or,reyoked at any time
upon violation of any pr'ovis'ions'of saic(ordinances,
Plan Cheyk Fee:,
~ "i," . .
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
,SYSTEMS DEV,e~OPMENT .CHARGE (~D.,~L ,-: '~.>,~ys~~ms.~evelop,ment.,charg~ is d,ue,..o,n,~11 undeveloped
, properties within the City (imits which are'beingimproved,
(B) '.~ .
, 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
(C)
Dryer Vent
Wood Stove/lnsertl FI replace Unit
Mechanical Permit
Issuance
State Surcharge
Total Permit
~/ JfY'~
~f
. (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Oemolitlon
State Surcnarge
Total Miscellaneous Permits' '(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
/"7___ ~
. ,
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:?(~
26poo~
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 wili 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
onthe, site ~all tim,' e.s . ~g(~onstruction, ~
Slgnature{/~~'- Jt~]~. Co
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VALIDATION:
/~~:>
~..../,- ~:;:;;-
AMOUNT RECEIVED ' . ~~ 7-f!'>
RECEIVEO BY d~.;..~
.v/
RECEIPT NUMBER
DATE PAlO