HomeMy WebLinkAboutPermit Mechanical 1997-6-24
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, RESiDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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SPRINGFIELD
'LOCATI~N OF PROPOSED WORK: 2l~ 2-S-
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ASSESSORS MAP: 17{). ,
LOT:
OWNER'
ADDRESS:
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S.o~
CITY:
DESCRiBE WORI<: '?=-ASt-ct U
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
ELECTRiCAl' ,
M4. ,<< N \'\~
QUAD AREA:
# OF BLDGS:
t'-i . .:i')/
,. -. ,,~
OCCY GROUP:
# OF STORIES:
WATER HEATER:
,.
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D Tem~orary Electric
D SlIe Inspection - To be mado
after excavation, but prior to
, setting forms.
o ~riderslilb Plumbing/ Electrical/
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.
D Underground Plumbing - Prior
. to filling trench,
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking,
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1701'71.
,JOB NUMBER
225 Fifth Street
SprIngfield, Oregon 97477
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TAX LOT: J {? .3 D / ,
ZIP: Cf, y 7.J
Wet-T (" (" t\-e.;\t" ("" / f~ b T
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OTHER N (.w G:,a..~ S ~ r V\'c e
BLOCK:
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STATE:
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ADDITION
DEMOLIsH
SUBDIVISION:
PHONE:
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,ADDRESS
CONST.
CONTRACTOR #
PHONE
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EXPIRES
C <f 1 ~ 1 (,{l.{lt: '\
~S- i't6' :
1 'J, f"z;J '4.. 7
Lfl 160l'i~4L!! 'SD~
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- OFFI?E USE 7": ,
LAND .USE:-,-
.. i .,~... 0 F"d NITS:
,,> CONSTR, TYPE:
HEAT SOURCE:
RANG E: __
D, Rough Electrlcol - Prior' to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to fac.lng
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stovo- After Installation.
O Post and Beam '~ Prior to ,floor ." '
Insulation or"decklng, . ,\ , ~, ..'1"; ,,:.0 Insert- After fireplace approvl1l
," .", '..1- . '.. '''' '~,,' " and Installation of unit.
D Floor Insulation - Prior to \ - .J'"
decking. '
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 aiter 7:00, a.m. will be made the following work day.
REQUIRED INSPECTIONS
f' " '",,,,.,.., ,
,/t1l' Rough Mech~nlclJl -, Prl~:>r t~
u;s...z cover. i
, ~'.
,
D Sanitary Sewer - Prior to filling
trench. '
D Storm Sewer - Prior to filling
trench. '. :
o Water L1no - Prior to filling
, trench.
o Rough Plumbing - Prior to
cover.
o Curbcut 8. Approach ~ After
, forms are erected but prior to
placemont of concrete,
D Sidewalk & DrlveW3\' - After
, excavation Is complete, forms
and sub.base material In place,
'0 Fence - Wt1On,completed,
D Street Trees - When all required
trees are planted.
FLOOD PLAIN:
ZONING CODE:
II OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
D
Final Plumbing - When all
plumbing W9rl< Is complet,e.
. ..\
D FInal Electrlcol,- When all'''1;,,:(
electrical work Is complete. .
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MFlnal Mechnnlcal - When all ,:~
, ~mechanlcal work Is complete. ..'.-
D Final Building - When all '
'required Inspections have been
approved and building Is
. completed. '
J, Other @tt1 ~0fU5
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MOEHLE HOME INSPECTIONS
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o Blocking and Set.Up - When all
blocking Is complete. " "
D 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 faces
Lot Type
Lot sq, ftg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
_ Cul.de-sac
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.THE PROPOSED WORK IN ~;HE ' ,.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed'
and approved by the Historical
Coordinator prior to p~rmlt Issuance.
Setbacks
P.L. HSE GAR ACC
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. APPROVED:
f
B'UILDING PERMIT
ITEM SO, FT. X $/SO. FT. ';= VALUE
Main
Garage
Carport
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- \
"J ~. :"'~ ,-. ; ~;'t\
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Total Value ,
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Building Permit Fee
State Surcharge
:/
.: _. ;,'
Total Fee
(A)
"
-.l
-,. -.
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~,7~~Y?TEIYI~ ,DEVELOPMENT CHARGE (SDC)
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~i: (-; "" \;',: ~~. '(8) , .
PLUMBIN:q'PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary S~wer FT,
Water FT.
Storm Sewer FT.
I ~.. Mobile Home
I"'
I'
,
Plumbing Permit
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
.' -:
Furnace
Exhaust Hood'
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit'
Dryer Vent '
lLlili^-
Mechanical Permit
Issuance
State Surcharge -I 3 to a~ MVV{i~
Total Permit ,(D) ,
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
'.
State ~urcharge
Sidewalk
1\
1\
Curbcut
Demolition, '
{:
.~ . 1
State Surchargl3 '" ,.
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Total Miscellaneous' Per'mlts' i!I,~ ; (E)'
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TOTA~ 'AMOUNT DUE (excluding electrical)
(A, B, C, Dt and E Combined)
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FEE
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)12. rro
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BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
ThIs permit Is granted on the express COfldltlon that the said
construction shall,ln,all respects, conform to the Ordinance
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ad,opted by' fh6 City, of Sprlngll,eld, Including the
, Developmeni Code,Jr.egulallng lhe~cbnslructlon and use of
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buildings, and may be suspended or r/evoked pt any lime
upon violation of any provisions of sa.ld:ord)nances.
Plan Check Fee:
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:Date Paid: -
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Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge Is duo on all undeveloped
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'. pr,op~~,~\I~S'':'f.~.th,ln 1110 CltY.l!n;llts,.~~Jph'il{e being Improved.
ADDITIONAL COMMENTS
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If ca3~.cJO
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By sIgnature, I state and agree, that I have carefully examined
the completed application and do hereby cerllfy that all
Informallon hereon Is true and correct, and I further cerllfy
that any and all work performed shall be done In accordance
with the Ordlnancos of the City of Springfield, and the Laws
of the State of Oregon pertaining to tho work de~crlbed
herein. and that NO OCCUPANCY,lN,lII be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compllanco with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper lime, 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 site at all times during construcllon.
Slgn"",e ~ ~
Date 6 -?;'( ?(,l
VALIDATION: 2
RECEIPT NUMBER " & J~ 7
DATE PAID' /:; -,J.. c.; r-97
AMOUNT RECEIVED :1-0 :;zn
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RECEIVED BY
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