HomeMy WebLinkAboutPermit Mechanical 1997-10-23
SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
JOB NUMBER ~?Zcs:y~
Inspections: 726.3769
Office: 726-3759
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: --:Z' 7~ ~'!" ~ t:E.0
ASSESSORS MAP: /'/70-' ''2~ -"3~
TAX LOT: ~~~.
LOT:
BLOCK:
SUBDIVISION:
OWNER: /~H# . Ih::>c:9.~ PHONE: ,? 7"'7,,-=%"/9"
ADDRESS: ~~5 ~~-~4
CITY' ~.J*~_ STATE: . ~,.A ... ZIP' 7/~~>
DESCRIBE WORK: . ~.;:~~~ ~ ~/~,?~ ~~-::,/!7Ci~~?"'~
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR #
CONTRACTOR.'S NAME
GENERAL'
.PLUMBING:
MECHANICAL:,~ ~y~
ELECTRICAl'
ADDRESS'
EXPIRES .,,", PHONE
- -':!. ~ 7~,.'? .. ~.Ap-.
1~~~-~~ ~?7~~-/5~
';,"'~".....'.""-'J~.i:"'''''~::''-''''-l
- OFFICE USE ..,..
QUAD AREA:
LAND USE:
FLOOD PLAIN:
ZONING CODE:
# OF BDRMS:
# OF BLDGS:
# OF UNITS'
OCCY GROUP:
# OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
SECONDARY HEAT:
SQUARE FOOTAGE:
WATER HEATER:
RANGE:
To request an Inspection, you must cal/ 726-3769. This Is a 24 hour recording. AI/Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a.m. wI/I be made the fol/owlng work d~iy.
. .
REQU IRED INS PECTIO NS
D Temporary Electric
(0 Rough Mechanical - Prior to
Y~~~h~
D Rough Electrical -:: Prior to
cover.
D Final Plumbing - When all
plumbing work Is complete.
. . .
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Final Electrical ..,.. When all
e'lectrical work Is complete.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
IU Final Mechanical - When all
/ ~hanical w~;;mPlete.
D Fi~ing - When all
required Inspections have been
approved and building is
completed. .
r71 Other ~~~~WC~-.
j,A-1 ,/7 --' ;./c;'f'
o Electrical Service - Must be
approved to obtain permanent
electrical poweh~
o Footing - After trenches are ~O'(\
excavated. D FI~Lm:~~ P~I~\ facing
:~Is ~\1laming Insp.
o Mason", - Steel locallon.J'"nd ~ ,?,<-<r.~ ~O<r.
beams, grouting. 01.\C~' ~ f?>V\ ~~~rlor to cover.
D Foundation - Afte~or~,,'il~ ~ ~ ~~~~ ,
erected but prior to ,~'gre~1..~ ~~WI/ceiling Insulation _ Prior to
placement. ,~~v "i.~~ ~"Ikr.
~\J . t."~~\J ~\.~
o Underground PIUmbingeP~loIt\<)"~ Drywall _ Prior to taping.
to filling trench. ~'\ \'O...U
D Underlloor Plumbing/Mechanical
-.Prior to insulation or decking.
MOBILE HOME INSPECTIONS
D Wood Stove - After Installation.
D Blocking and Set-Up - When all
blocking Is complete.
D Post and Beam - P~lor to floor
Insulation or decking.. ">,
D Insert - After fireplace approvl'"
and Instal/atlon of unit.
o Floor Insulation - Prior. to
decking.
D Plumbing Connections - When
home has been connected to
water and sewer.
. D 'Curbcut & Approach - After
. forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
D 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 - P.rlor to filling
trench. ,.f:
'; , ~
o Water Line - Pilor to Ji.!Jing
trench.
o 'Fence. - When completed.
D Final - After all required
. Inspections are appro'ved and
porches, skirting, decks, and
venting have been Installed.
D Rough elumbir~g ~ .~rlor to
cover. '- "'c..',,
D..Street Trees..,.. When all required
. trees are planted. '
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Panhandle ';
Topography
Total height
Cul-de-sac
;~) III
BUILDING PERr3JIT
ITEM SO. FT.
"
'-~,
X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PER~T
Furnace q/f-:)
~"I,C4U"'; HV<ld /j" ff#- y~ .
NO
Vent Fan
Wood StovellnsertlFlreplace Unit
Dryer Vent
~4?~~
~/tY.
y:j
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
>.
",,' .
.. \ ::,;~i~:~:.;:;{~X ~ .
Setbacks .
I P.l. I HSE I GAR I ACe' I
IN
S
W
E
VALUE
"
FEE
dIIG. ,II?
3.~~
2,.-e>
/CS"': ~
, ~
/t:? _ilP
:P;:-
1 ~
-:7 t!ft.. "::2 P
\ 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:
.,.t.. '., 'I.
BUILDING \MLtJE, 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 db 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 e.~,s.ure' that all required inspections are
requested at the proper t1t;JJe, that each address Is readable
..~
from the street, that the permit card Is located at the front
of the property. and the approved se f pi ns will remain
on the site at all t'mes r ng n.
Signature
Date ~ - ~ 1 - 97' /
VALIDATION:
RECEIPT NUMBER
DATE PAID
2?8;/g
/~~3~-::>
~6. ~e:>
~/
AMOUNT RECEIVED
RECEIVED BY