HomeMy WebLinkAboutPermit Mechanical 1992-8-3
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED wOnK'
ASSESSORS MAP'
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LOT:
CITY:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
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.
SPRINGFIELD
Wit,.,
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JOB NUMBER
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BLOCK:
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DEMOLISH
OTHER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT'
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SUBDIVISION'
PHONE: .7:AC-~,;,;
ZIP'
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ADDRESS
CONST,
CONTRACTOR'
EXPIRES
PHONE
- OFFICE USE -
LAND USE:
N OF UNITS: _________
CONSTR, TYPE:
HEAT SOURCE: ___
RANGE:
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D 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.
GENERAL:
PLUMBING:
MECHANICAL: j1.a>e;.r, C:::;:z.:: p::z:> ~ t'~*;t5~i 7.7~2{, %;- 9s~-9'~;:;
ELECTRICA' '
OUAD AREA'
. OF BLOGS: ___ __
OCCY GROUP:__
N OF STORIES:...,
WATER HEATER:
FLOOD PLAIN'
ZONING CODE:__
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
.j"
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.
o Temporary Electric
I~ Site Inspection - To be made
after excavation, but prior to
seltin~ 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 me
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumblng/Mcchilnlcal
_ Prior to insulation or (Iecklng.
o
Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to fitling
trench.
o
Storm Sewer - Prior to filling
trench.
O Water Line - Prior to fllll!19
trench.
o Rough Plumbing - Prior to
cover. .
o
Framing - Prior to cover.
o Wall/Ceiling Insulntion - Prior to
cover.
o Drywall - Prior to taping.
D Wood Slove - Atter In:>tallatlon.
o Insert - After fireplace approval
and Installation of unit.
o 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.
o Fence - Wilen completed.
o Street Trees - When all required
trees arc planted.
"'
o Final Plumbing - When all
pl'umblng worl( Is complete.
D FInal Electrical - When all
electrical work Is complete.
rn
Final Mechanical - When all
mechanical work Is complete.
.'
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o 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.
.:1
o Electrical Connection - When
blocking, set-up, and plumbing
I nspections have been approved
and the home Is connected to
the service panel.
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o Final - After all required
Inspections are approved and
porches, sl<irting, decks, and
venting have been installed.
i
Lot faces
Lot Type-,
Interior
Lot sq, ltg,
Lot coverage
Corner
Topography
Panhandle
Total height Cul-de-sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
Setbacks
r- ------,
P.L. HSE GAR ACC I
I N I
I
S
, .3 THE I'ROPOSED 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 permil issuance.
W -
l-L- ___ == =
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
Water
FT,
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFireplace Unit
Dryer Vent
~,~C.//.NCE ,/;7~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Horne
State Issuance
State Surcharge
Sidewalk
lt
Curbcut
It
DemoO 1Ion
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
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APPROVED:
This permit is granted on the express condition U18t the said
conslrllcUon shall, in all rcspecls,'conform to thcOl(linance
mJoplcd by the City of Springfield, including tho
DOVClloplIlcnt Code, mqulalinn IIle construction and use of
lJlIffdin~g;, and may /)1) t;lIspencJcd or rcv()l~cd ,II any lime
upon violation of any provisions of said ordinances.
Plan Chccl< Fcc:
Dale Paid:
Receipt Number"
Received By:
Plans Hevlcwe(J By
Date
Systems Development Cllarge is due on all undeveloped
properties within the City limits whic~1 are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully ex~mined
the completed application and do hereby certify that all
Information hereon is true and correct, and 1 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 permitision of the Building Safety Division.
I furl her cerlify that only contractors and employees who
are in compliance with ORS 701.055 will be used on tllis
project.
I further agree to ensure that all requirecJ inspections are
requested at Ihe proper time, that each ad(Jress is readablc
from the street, that the permit card is locatcd al tile front
of the property, and tlw approved set of plan~; will rcmain
on the silo at all Ullles duril11 construction.
Slgl1ature$~
00.11'"
;? ,:'5 -/..2--
VAll DATION:
RECEIPT NUMBER .-s-??~
DATE PAIr> *1- :J~7
AMOUNT RECElvo:n 7"5:- 70s--
RECEIVED BY .....--:?.h__~ ~~
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