HomeMy WebLinkAboutPermit Mechanical 1992-8-27 (2)
OWNER t Y&A! 'l?-Bl~('MJ /
ADDRESS _2...5') 2- ' IV-L '7- 7 t:/
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726-3759
LOT-
CITY:
DESCRIBE WORK:
NEW
REMODEL
ADDITION
.
SPRINGFIELD
.
qZ!l qJLJ
BLOCK'
JOB NUMBER
225 Fifth Street
Springfield, Oreaon 97477
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TAX LOT:
SUBDIVISION:
PHONE:
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STAT'"
DEMOLISH
OTHER
EXPIRES
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PHONE
CaNST,
CONTRACTOR'JjAME ADDiSS to CONTRACTOR #
CENERAL __ _ ULff-_-l/gJlJJ!@ty,-,-__,_ ~61Jc~~ 60f.36
I'LUMBING6er)Jf!!~~ChS9'~ ,-----
MECHANICAL _6-1tL~7g-t!IJLf}
ELECTRICAL: __' (J/lc.4'~ l'.tfrC{~..d
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- OFFICE USE -
OUAD 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: RANGF' SOUARE FOOTAGE:
To request an inspection, you must c~1l 726.3769. This Is a 24 hour recording. All InspectIons requested before 7:00 a.m. will be
made the same working clay. Inspections requested after 7:00 a.m. will be made the following work day.
D Tcmpornry 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.
D
Undcrlloor Plumbing/Mechanical
_ Prior to Insulatlon or decking.
o
Post and Beam - Prior to floor
insulation or decl~lng.
o Floor Insulation - Prior to
decking.
I~ Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trencll.
o Water line - Prior to filling
trench,
I'tJ Rough Plumbing - Prior to
'--f"'e(wcr.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~t:()ver.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power,
D Fireplace - Prior to faelna
materials and framing Insp.
iXf Frmnino - Prior to cover.
o Wall/Ceiling Insulation - PrIor to
Gover.
~ Drywall - Prior to taping.
D 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.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
D Fence - When completed.
o Street Trees - When all required
trees arc planted.
~ Final Plumbing - When all
~PIUmblng worl~ is complct.e.
o Final Electrical - When all
electrical work is complete.
Nl Final Mechanical - When all
~ mechanical work is complete.
~ Final Building - When all
required Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Sel'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 approvecl
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.
Interior
Lot sq, fig,
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
Total Value
Building Permil Fcc
Slate Surcharge
Total Fee
(AI
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
3
Fixtures
Residential Balh(s)
N'
Sanitary Sewer
FT,
Water
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Fireplace Unit
Dryer Vent
Mechanical Perml t
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
fI
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
.'S THE PROPOSED WORI{ IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by ttlO Historical
Coordinator prior 10 permit issuance.
Setbacks
, I'
P,L, HSE GAR ACC
~------
S
Y'Y-___
E
VALUE
3_0::0
..1R_~
L'13
FEE
:y),OO
3),00
J ..so
3 ( , so
IS.OO
--1 S ,00
-I-IJ .00
Ie;
2.5 4 75
if? (t? "l
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is wanted on the express CO/lc.tilion 1I1al the said
construction slwll, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Dovelopmenl Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of <lny provisions of said Oldinanccs.
Plan Check Fcc: .
Date Paid:
Receipt Number:
Received By:
.f=>inns.-R'(;:.;i.cwccJ-By----.-.----
Date
Systems Development Charge is due on all undeveloped
properties within the City limils which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully ex?mincd
the completed application and do hereby certify that all
information Ilereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of tile City of Springlield, and Ule Laws
of the Slate of Oregon pertaining to the work described
~1Crein, and that NO OCCUPANCY will -be made of any
structure wittlout permission of the Building Safety Division.
I further certi fy thaI only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure U1at all uired inspl clions are
. requested al the proper time, t teach add res is readable
from the street, that the perm t card is locate at the front
of tll0 proper ,and the appr ved set of pia s wilt remain
c;lne Sll JaIl lillle::; durin constructlo.
Signal I I
~
Dale~~ - ~I ") '7___
VALIDATION:
RECEIPT NUMBER (;;61.{7
DATE PAID "iJ - 2..7 - 97
AMOUNT RECEIVED q?, G 2-
r;~
RECEIVED ElY