HomeMy WebLinkAboutPermit Mechanical 2001-6-11
RESID~NTIAL
P!:RMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
ASSESSORS MAP:
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LOT:
OWNER:
'S ~ rf2
1\70ri.
c;: pH c(
\n~lA
ADDRESS'
CITY'
DESCRIBE WORK:
NEW
REMODEL ___ ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL: _01 \n (};ha1J):)
ELECTRICAl'
QUAD AREA:
. OF BLDGS:
OCCY GROUP:
. OF STORIES: ___
WATER HEATER:
.
SPRINGFIELD
.10...,
.
JOB NUMBER1l1'. OQSq 1- 0 I
225 Fifttl Street
Springfield, Oregon 97477
BLOCK:
____ TAX LOT:
SUBDIVISION:
110 ?,?;;, 'S Lf -;;;L
t3ut'('.L
AL A-
STATE:
DEMOLISH
OTHER
PHONE: __7!:L7 -3,~o..s--
ZIP: Q"7477
ADDRESS
CONST,
CONTRACTOR'
EXPIRES ::" PHONE
LIllO Ohprp/': 81--. -*0lS"'790 047-71./([5--
- OFFICE USE -
LAND USE:_._
. OF UNITS:
CONSTR. TYPE: __
HEAT SOURCE:
RANGE:.___
FLOOD I'LAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SQUARE', FOOTAGE: ,___
T()"r-:-qupst 2.r! insp':ctj")~j Y0L! n::Jsl o:::!l! 725 :J?129. Tt:t$ ~i;~..z4 ~.:;:..;r r..:.;o"i-d:i1g:A:i Jiis-p'c.::iion; I~U~$led uelO--;:C 7:00 a~m. wtll oe
made the sarne working day. In"spections 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.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
REQUIRED INSPECTIONS
rn Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrlcal power.
D Fireplace - Prior to facing
materlal~ and framing Insp.
o Framing - Prior to cover.
D Wall/C'olllng Insulation - PrIor to
cover.
o Drywall - Pr~or to taping.
D Final Plumbing - When all
plumbing worl< Is complete.
D Final Electrical - When all
electrical work Is complete.
~ Final Mechanical - When all
~ mechanical worl< 19 complete.
o Final Building - When all
required InspectIons have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
rI Underlloor Plumblng/Mechanlcal _ _' _ ~ -.-
--b.d--:=-Pilor-to-Insulatlonorcieckln-g. D Wood Slove - After Installation.
D Post and Beam - PrIor to floor
Insulation or decking.
El Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior !o filling
trench.
D SIDrm S.w.r - Prior 10 filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
o Insert - After flroplace approvel
and Installation of unit.
D
Curbcllt & Approach - After
forms are erected but prior to
placement of concrete,
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.bssl3 mAterltll In place.
D Fence - v\/hen cOi"lpleted.
D Street Trees - Wh~n alt required
trees are planted.
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
tlOme 1135 been connected to
water and sewer;
o Electrical Connection - When
blocking, set,up, and plu'!i'9ing
Inspections have been aFUU'Ove~H
and the home Is connected ~ ii
the service panel. ;:0 -t::z:
rr1 fT1 CO
0..#
CJ J:::lC-i'.
o Final - After all reg1Jlred~. c:: 0
Inspections are apP'iiiedrahc:r ':
porches, skirting, d eace 0
venting have been 198t: e.g.,) g
~ ~L"'~U1
~rr1c)OCD
I--L .. c:n....L 0
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
SQ. FT.
Main
Garage
Carport
Totol Value
Building Permil Fec
SI<.Jtc Surctlargc
Total Fce
.
Lot Type
Interior
Corner
Panhandle
Cul-de-sac
X $/SO. .FT.
(A)
Setbacks
1;;:-';";;;-~'r~A~~c4
-: ---- + I
------
.
IS THE PROPOSED WORK iN THE.
. HISTORICAL DISTRICT, OR ON.....,..
THE HISTORICAL REGISTER?
if yes, this application must be signed
and approved by the Historical
Coordinator I;'rior to permit issuance.
VI'
----.- ~--- --- ----
E
APPROVED,
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT'
"
This permit is granted on the express condition thaI 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 ravokod at any time
upon violation of any provisions of said ordlnancea,
Plan Check Fee;
Dale Paid:
Receipt Number:_____
Received 8y:
Plarts ReViewed Qy
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
Syst~ms Duvelopmcnt Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
~.~obilc Ho~c
Plumbing Permit
SU.lte Surcharge
Total Charge
MECHANICAL PERMIT
Furnace:
Exhaust Hood
Vent Fan
(B)
N'
FT
FT.
FT.
(C)
Wood Sto\lef\f\sertlFlrcp~ace UnIt
N"
(X(;nt r.0'\1\ rLJi oY1LV
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCElLANEOUS PERMITS
(D)
Slale Issuance
State Surcharge
Sidewaik
II
Curbcut
It
Demolition
~tatc Surctlarge
Tot;)1 Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C! 0, and E Combined)
ADDITIONAL COMMENTS
FEE
I
\/ (71{~r~if!-,~7{)'~
/
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 wor~ performed shall be dontS in accordance
with the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertaining to the work des(;ribed
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify ttlat only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree Lo ensure that all required inspections are
requested at the proper time, that each address is readable
from tile street, that the permit card is located at the front
of ttle property. and the approved set of plans will remain
::,:::"::~~l~U/L)
( 11)
VALIDATION:
RECEIPT NUMBER
DATE PAI[l
AMOUNT RECEIVED
RECEIVED BY ____.________