HomeMy WebLinkAboutPermit Mechanical 1994-8-31
RESIDENTIAL
PERMIT APPLICATION
Ins pectl ons:: 726-3769
Office: 726.3759
SPRINGFIELD
LOCATION OF PROPOSED WORK: /7 2 ~ ~A~{A4 C
ASSESSORS MAP: /"/ -<:::) '? '?-5"-::?/
OWNER: /kyc #~n~./Y'
, ,. J. ~ _ . _ ',_
ADDRESS~' ::~#~
5,~LZ;.
DESCRIBE WORK:/-:f;:. ~~(
REMODEL Y ADDITION
LOT:
CITY'
NEW
<~..
%/?'~ 7 ~?/ 7;;-
BLOCK:
STATE:
DEMOLISH
OTHER
~/
JOB NUMBER ., ~/:S- $_S:--
225 Fifth Street
Springfield, Oregon 97477
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I'
TAX LOT'
A:::7'3~/
SUBDIVISION:
.1
, PHONE:
"/ V~"'~/R:::>
ZIP'
9-::> ~ =='
~~....... -
.//~~,
CONST.
CONTRACTOR'S NAME , ADDRE~5".;?~R~;!:~gOR # EXPIRES ,PHONE
GENERAL: 7d~/~f'~~~~~~~~~ 97.~37~2~ 9~~16-5b7X
PLUMBING:
MECHANICAL:
ELECTRICAL:
- OFFICE USE -
QUAD AREA" LAND USE. FLOOD PLAIN:
# OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG E: 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 t~e following work day.
REQUIRED INSPECTIONS
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;
o 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.
'.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
rvl'Rough Plumbing - Prior to
~ cove~, ,
I\?I Rough Mechanical - Prior to
L,LlJ cover.
rn 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.
,
~ Framing - prlor:to,cover.
rJI, Wail/Ceiling InsJlatlon ~ Prior to
L.,.LJ cover..
I xl Drywall - Prior to!aplng.
o Wood Stove - After Installation.
D 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 m'aterial In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
'[Z]Flnal Plumbirig - When all
plumbing w(Hk Is complete.
I1i1 Final Electrical - Wflen all
Lp electrical work is complete. '
rn Final Mechanical - When all
mechanical work Is complete.
m Final Building - When all
7f-l required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Whep all
blocking Is complete.
o Plumbing Connections - When
home has been connected to '
water and sewer.
o Electrical Connection - When
blocking, set-up. and plu~bing
Inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been installed.
~
Lot faces
Lot Type
Lot sq, Itg.
Interior
Lot coverage
Corner
Topography
Total "eight
Panhandle
_ .,Cul-de-sac
BUILDING PERMIT'
ITEM
SQ. FT.
X $/SQ, FT.
Main
Gal<lge
Carport
#i5~~C-
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
(B)
PLUMBING PERMIT
ITEM
Fix~ures .:z
Residential Bath(~) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
Stat~. Surcharge
Total Charge
(C)
MECHANICAl. PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnser /Flreplace Unit
~~
Mechanical Permil
Issuahce
,/h/N"
State :Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge,
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneou:; Permits (E)
TOTAL AMOUNT 0 JE (excluding electrical)
(A, B, C, D, and E Combined) ,
, ,
:~
,j~) :(~p:;~it
IS THEPROPOSED WORK,tNTHE-
HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
, Coordinator prior to permit Issuance.
Setbacks '
I I .1
HSE GAR ACC'
I' I
p.L.
I.N ·
Is
Iw
IE
VALUE
"
2~~'~
FEE
2.0, 01>
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APPROVED:
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 construction and use of
buildings, and may be suspended 'or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
, Plans Reviewed By
Date
L~t7. -5"P
7,'153
." , ~J .., ~
"0.' 7.:" <.......
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L2'/. ?~
SYSTEMS DEVELOPMENT CHARGE (SDC)
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 Ordlnancl;lS 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 proper ,and the approved set of plans will remain
on the site t II tim~ j/,~1ccztructlon.
Signature \{}~
Date
VALIDATION:
RECEIPT NUMBER / $I ~;?::c.
8 -~ 1'. c;;J V
1?9. ~S--
/7~__
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/
DATE PAID
AMOUNT RECEIVED
RECEIVED BY