HomeMy WebLinkAboutPermit Mechanical 1998-11-10
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT:
OWNER:
ADDRESS:
CITY:
DESCRIBE WORK:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL'
PLUMBING:
MECHANICAL: 1)'\ 6. i.r<. k,d l \. ~
ELECTRICAL:
SPRINGFIELD
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/1 o3~315
BLOCK:
Of
STATE:
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JOB.NUMBER
225 Fifth Street
Sprlngfleld,Oregon97477
TAX LOT:
SUBDIVISION:
t/ J/OO
PHONE'
ZIP:
q 11.("16
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OTHER N r l\,\
DEMOLISH
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ADDRESS
CONST.
CONTRACTOR 1/
EXPIRES ,~ PHONE
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- OFFICE USE -
QUAD NQIICE: LAND USE: _. FLOOD PLAIN:
1/ OF BI~~eRMIT SHALL EXPIRE IF THE '1'<6~NtTS' . ZONI&Wiaw>~uirp.s "ou.~o
AIITI-I()AIZeO UNOER THIS PERMIT IS NOT ATTENTION.Oreg thQ Oregon Utility
OCCY (,,-1i6Uf:S": CONSTR. TYPE: ,..IhAlt:>ohO'Jllm:s' t' .+h
COMMENCED DR ISA6ANOONED FOR fOllOW ru es aUUl""- se rules alt; ~z t~l:
# OF STORIES: HEAT SOURCE: ('lntifiCation ceQ1@,[:~'hl~ 952-001-
, ^NY 1 BIH)J\ Y Pt;,;l1lUU. . -OAR 952-001':btj . . ~l~tthe rules oy
WAl ER HEATER: RANGE' I~U'dU. 'IoU ma~a~~PJ?tt<'e't.~\ephefI~
, Il'lf sr-,-,.pr (Note. ... ,;'-""
call1lj~ L.e 1 ' lillty I'IUUll"U""-'
To request an Inspection, you must call 726,3769. This Is a 24 hour recording. .I}1h\8eJilfStl~Qr~~e ~~ff4r.=oo a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be mI;\Ye the~h\~4611~k)- .
REQUIRED INSPECTIONS
D Temporary Electric
D 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.
D Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
_ Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Final Plumbing - When all
. . plumbing worl~ Is. complete.
D Final: Electrical - When all .
electrical work Is complete.
.~eCh.nlc., - When all
m anlcal work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
o F"mlng - P"o< 10 covec. @he,o;.,5 IlftL f,rT
o Wail/Ceiling Insulation - Prior to
cover.
o Fireplace - Prior to facing
materials and framing Insp.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation 01 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 - When completed.
o Street Trees - When all required
trees are planted.
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
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
Lot sq. flg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
. {
ITEM
SQ. FT.
X $/SQ, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
. _ i',.
. ',"~' .
.~) ,
Setbacks
I P.L. HSE GAR ACC I
IN
Is
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.
W
E
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
'Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
;: . ,'t,'.''{" f'
. J t I
Wood Stovellnsert/Flreplace Unit
Dryer Vent
CAS /n,/.f
Mechanical Permit
Issuance
State Surcharge
.;, ."...
--"
, ,
Total Permit
(D)
.' !'l ,,'
MISCELLANEOUS PERMITS
Mobile Home
..,'t'
L, .
State Issuance
, f",
r .':il':
1":~ .,
State Surcharge
Sidewalk
ft
Curbcut
ft
,..,. ..~...,,:,:, r; .
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding elec
(A, B, C, D, and E Combined)
FEE
, - ~;......" " ~
2C.u
( ,;"~'-7't 20
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APPROVED:
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BUILDING VALUE, 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
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By signature, I state and agree, that I have carefuliy examined
the completed~ppllca\19n and do here!:>Y.certlfy, trat .all
't' ... ~, . , . ~" . .
Information' h'ereon Is' true and correct, and I further certify-
that:a~y an'da,r'wo'rk perf~rn:ied'shall:6e done.ln"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. r
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I further agree to e'nsure that all' required i'nspecti6~s are
reques~ed at the proper time, that each ,address Is readable
from th.E:! street, that the permit card is;l?c,~ted<j~phe front
of the property, and the approved set of plans wr"1I remain
on the. site at a;F' mes during construction.
Signature ~ 'ltJ ^~~
- t?
. 11- , D--1B
Date
VALIDATION:
RECEIPT NUMBER
OJ2.03r
/(/''''/1'9
2' /1 Lei " /1
M I..J~
DATE PAID
AMOUNT RECEI'
RECEIVED BY