HomeMy WebLinkAboutPermit Mechanical 1998-9-22
SPRINGFIELD
RESIDENTIAL
PERMIT APpLIcATION
~'-;""'" .
,JOB NUMBER c; f / / g S
Inspections: 726.3769
Office: 726.375g
225 Fi fth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: 5() I
/7023$""33
oft 0 7J
ASSESSORS MAP'
TAX LOT:
'..'
. '
i
BLOCK:
LOT:
SUBDIVISION:
0/1/60 t't:1 /V at;:? >'
t)r:lJot C?if~
5//~i:/Va t:1:i / A
, I
'1 If 7~ Sc"b)
OW!'lER:
PHONF'
,
ADDRESS:
CITY:
DI2
Cj 7- '1'] r;
0/1
STATE:
ZIP:
DESCRIBE WORK:
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR #
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
ADDRESS
EXPIRES '.~" PHONE
l)w)./p /(
MECHANICAL:
ELECTRICAL:
, . s you \0
ATTENTION:Oregon law reqUIre UtTty - OFFICE USE -
d ted by the Oregon I I ,
QUAtfj).H.~A!-,les a op _I ~"r r~'gs are set{lAljij'b USE: _ FLOOD PLAIN:
Notification Liemel. I IW~ hoAR 952-001- , NOTiCe.
# orr ~~62_001-0010throug h I&SqJyUNITS: · ,', ,iONING CODE:
n btain copies of t e'ru THIS PERMIT SHALL
occf}.Oe.<Acr~ may 0 t~.Jt~ telepho~@lNSTR. TYPE: EXPIREdf ~W€1P~
calhl1g the cen~l. {on Utility NotificatIon AUTHORIZED UNDER THI,~ P~O~AIT Jc'J..If.'\"t:
# OF n'[lrtlitief.)fgrthp. rea 4) HEAT SOURCE: ' , . "'S~<9Wl!)A~Y'lIIift:.AT:
~~nter is 1-800-332-234 . , l.;UMMENCEO OR IS ABANnON1=n r:r\O ,
WATER HEATeR: _ RANGE, _ .',I\{ '. 'Sou~~e: 'FOOTAGE,
.' 1'\" I tju /JA Y PERIOD, '
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,
REQUIRED INSPECTIONS
o Temporary Electric
D Rough Mechanical - Prior to
cover,
o F.lnal Plumbing - When all
plumbing worl< Is complete.
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Rough Electrical --,. Prior to
cover.
o Final Electrical - When all
electrical work is complete,
o Un~er:slab Plumbing/ Electrical/
Mechanical - Prior to cover.
o Final Mechanical - When all
mechanical work Is complete.
o Electrical Service - Must be
approved to obtaIn permanent
electrical power,
o Footing - After trenches are
excavated.
o Final Building - When all
required Inspections have been
approved and building is
completed.
o Framing - Prior to cover, /n lther 6/.1-') /h/le..
o Wail/Ceiling insulation - Prior tol/
cover.
o Fireplace -Prior to facing
materials and framing Insp.
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 Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
O Underfloor Plumbing/Mechanical '
- Prior to Insulation or decking. D Wood Stove - After Installallon.
~"
Post and Beam - Prior to floor
o Insulation or decking. . 0 Ins - After fireplace approval
") a InstallatIon of unit.
o Floor Insulation - Prior to
decking.
o Blocking and Set.Up - When all
blocking Is complete,
o Plumbing Connections - When
home has been connected to
water and sewer,
o Curbcut & Approach - After
forms are €)rected but prior to
placement of concrete,
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Sidewalk & Driveway - After
excavation Is complete, forms
and'sub.base material In place,
D Storm Sewer - PrIor to filling
trench. '
o Fence - When completed.
o Water LIne - Prior to filling
trench. ,
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
D Rough Plumbing - Prior to
cover, ,
o Street Trees - When all required
trees are planted,
Lot faces
Lot Type'
Lot sq, ltg.
Interior
Lot coverage
Corner
Topography
Total height
y:
Panhandle '
Cul-de-sac
>'
'7
BUILDING PERMIT
ITEM SQ, FT.
'.',
I'
'*'
X $/SQ, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
Setbacks
'HSE'GAR'ACCI
I
I
--j
I P.L.
N
S
w
E
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary S!3wer
Water
FT.
FT.
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hoorl
Vent Fan NO
'WOOd Sto~lrePlace Unit
Dryer Vent
Ok? fAjJ~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
q ')-z?
2.0/...0'
/ C;-" tJ..)
10. ()o
Lf s Lif.
2. t,. ?.lJ
.~ (:.;
,.j.":'\.
'''...'' ;
\
IS THE PROPOSED WORK tN 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.
APPROVED:
" ~. ," 'l!
BUILDING V~LtiE, 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
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 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 site at all times during uctlon.
---.
/)
Slgnatqre ~--- ." /_-
Date 0/ ~
/ I
VALIDATION:
()lliff
9/;2]lf8, .
26. i.O !/
/lfl tJaf
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY