HomeMy WebLinkAboutPermit Mechanical 1996-10-9
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP:
LOT:
c.,
SPRINGFIELD
BLOCK:
ADDRESS:
CITY:
/74?
.
S/?rY
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~4?~A/! ( /~~~~ /tft/OPAJS
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OWNER:
DESCRIBE WORK:
CA<
NEW
REMODEL
CONTRACTqR'S NAME
GENERAl'
)
STATE:
O;:p
"P"Z-IA7 / ),A-t??- " ~ ~
I '- 1
ADDITION DEMOLISH
OTHER
~
JOB NUMBER
/G/3ro ~
225 Fifth Street
Springfield. Oregon 97477
~
TAX LOT' / CJ / C1~
SUBDIVISION:
PHONE:
7~7 -c44o
( /
ZIP'
~7~77
ADDRESS
CONST.
CONTRACTOR It
PHONE
PLUMBING:
MECHANICAL~~ / 4~~ 4 e>o ~47I(J
,
ELECTRICAL:
QUAD AREA:
It OF BLDGS:
OCCY GROUP:
It OF STORIES:
WATER HEATER:
_~ 5(,,8 ?.
- OFFICE USE -
LAND USE: _
It OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
RANGE:
EXPIRES
o/26~? ?~ - 7h77
FLOOD PLAIN:
ZONING CODE:
It OF BDRMS:
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,
D 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.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench, ,
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decldng,
o Floo~ Insulation - Prior t~'
decking. , '
o Sanitary Sewer -' Prior to filling
trench,
o Storm Sewer - Prior to filling
trench. .
", \,
\ '" ", (~,,',
o Water Line -:- p,~IO~.t9 (~llin9,
trench. ',\ . ",' , ".
. .' . \ \,
o Rough Plumo-ing,,~.Priorto
cover. " " ' ~. :--
, ,
REQUIRED INSPECTIONS
'1><1 Rough Mechanical - Prior to
""over.
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 Framing - Prior t~ co~~r.'.:
o Wail/Ceiling Insulatlo,~ ....,.~rlor to
cover. -
'."~~~,\
\
D Drywall - Prior t~}aplng:
D Wood Stove - After Installation,
D Insert--;-, After fireplace approvtll
and Installallon of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
o Sidewalk & Drivewav - After
excavation is complete, forms
and sub-base material in place,
o Fence - When completed.
o Street Trees - Whe.n all required
trees are planted, < '
D
Final Plumbing - When all
plumbing work is complete,
D Final Electrical - When all
electrical worl< is complete,
1'\;7( Final Mechanical - When all
~mechanical worl< is complete,
o Final Building - When all
required Inspections have been
approved and building is
completed,
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MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocl<lng 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, skirting, decks, and
venting have been Installed,
Lot face,s .
Lot Type
. .:,
Lot :,;q, ftg:
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac, .:
,
BUILDING PERMIT
ITEM
SQ, FT.
X $/SQ, FT.
.
Main",
Garage
" ,
Carport,
<.
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
, . .: (~-: .
. ~ ,,:'.
I ,- '.
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~-, .
IS"\HE PROPOSED WORK iN THE,
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
'If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I PL. HSE GAR' ACC I
IN'
Is
E
,.._V:!.~. \
"- -',.. ". '. -"~""'. )..~. .......
'APPROV~D:-'
VALUE
.. .~ \'-... .,.....:..
"
BUILDING VAUJE, PLAN CHECK
AND BUILDING PERMIT
',.\' 'This per,mit i::; granted on theexpre:,s con,dition that the said
: construction'sheW, in all respects;'conform to the Ordinance
"adopted~ by the, City ',of Springfield, Including the
D~velopment C'ode, regulating the'construction and use of
buildings, and may be suspende~ or revoked at any time
upon violation of any provisions 0"1. said ordinances.
Plan Ch(~ck Fee'
"'" \ '..
~ -'"
Date Paid: '
Receipt Number:
Received By:
Plans Reviewed By
Date
System~ Developmer)t./9tlCir'g,e is-sJu.e,.oh 'all undeveloped
properties within the City limits which are being improved.
" ~,SYSTEM$ DEVELO,PMENT CH,AR.GE (SDC) ":--;~
',.\..... ".__\.~ "1"-~'" '::~""-. - '--'
, , (B)
PLUMBING PERMIT
ITEM
Fixtures
Resid.ential Bath(s)
NO
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
,Furnace
Exhaust Hood
"
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
-~~ ~~
Mec.hani'c~I'" Permi t"~ j
$/,u
'.- } ',:....,.
Issuance
j":
. ~ t '.'
State Surcharge ,7 s-r-IIS
Total Permit (D)
IV1ISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
-/20-0
o?~
./ ~ ,
/S,tJ?J
/0 /~ 0
j,U)
_~,26
2-0,2.-0
ADDITIONAL COMMENTS
By slQnature, I state and agree, that I have carefully examined
the completed application and do hereby certl fy 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 s: ayall times dur:n~ cO~l,~
~natureG~DYL0-- fC, ,
\0 .q -Yep
Date
VALIDATION:
2-3 {/7
/~1~~
AMOUNT RECEIVED .2U t-~
/~~
RECEIPT NUMBER
DATE PAID
RECEIVED BY