HomeMy WebLinkAboutPermit Mechanical 1992-11-4
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
SPRINGFIELD
..
JOB NUMBER
92/S :s~
I
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: 2. / '1 ><<-
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TAX LOT:
L/kn:)
ASSESSORS MAP'
LOT:
BLOCK:
OWNER: .1)I"IIf'("IA-h-V D~Q..~( (1)
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ADDRESS:' -2.'\:?-. ~. r ~-:t-e.....n. V"\ \..0.. _X-
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STATE:
DR-
DESCRIBE WORK'
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ADDITION
p\. p.L- ~ hQRJ:-e.r
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL:
DEMOLISH OTHER
SUBDIVISION:
, PHONE:
~- ;.SDB ,'I-
ZIP:
q 7 t/77
ADDRESS
CONST.
CONTRACTOR /I
EXPIRES
PHONE
PLUMBING:
MECHANICAL' SP)~v\ I f)jUP GJI6.S d-q785\~lllo\.fl Ut II ~J 70YD,
ELECTRICAL'
QUAD AREA:
/I OF BLDGS:
OCCY GROUP:
II OF STORIES'
WATER HEATER:
- OFFICE USE -
LAND USE:
II OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
RANGE:
rI...1$
.
\?V{=751Y i
FLOOD PLAIN:
ZONING CODE:
/I OF BDRMS:'
SECONDARY HEAT:
SQUARE FOOTAGE:
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
I I Temporary Electric
I I Sile Inspection - To be made
after excavation, but prior to
setting forms,
D
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover,
D 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,
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking,
o Post and Beam - Prior to floor
Insulation or decklnn,
o Floor Insulation - Prior to
decking, .
o Sanitary Sewer - Prior to filling
trench,
o Storm Sewer - Prior to filling
trench, '
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover,
E><:t Rough Mechanical - Prior to
. cover,
o Rough Electrical - Prior to
cover,
D Electrical Service - Must be
approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp,
o Framing - Prior to cover,
o Wail/Ceiling Insulation - Prior to
cover, '
o Drywall - Prior to taping.
D Wood Stove - After l~stallat'lon.
D Insert - After fireplace approval
and installation of unit,
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o 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.
o Final Plumbing - When all
plumbing work Is complete.
o Final Electrical - When all
electrical work is complete,
.D<r Final Mechanical - When all
. mechanical work Is complete,
o Final Building - When all
requlrl;ldlnspectlons have been
approved and building Is
completed.
~'Other ~AS LJ~E:.
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete,
d).
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. .
r-4 ., .. .. .'t.,,, .,.;
U' Flnal,"-:l\fter-all,reql.llred .'. ...
.. "nspe'ctlonMare.'a'pp,roved . a'nd
. "po~ches; skfrtfF{g;'1'ae'6ksiana'
'venting have been, Installed. .'
Lot faces
Lot . ~'(,ftg:
Lot coverage.
Topography
Total height
, Lot Type,
'IrHerlor'
'.t-;...
c~rner
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)
S
Iw
IE
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT,
Water FT.
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
4A:r L/A..Jc-
Mechanical Permit
Issuance
State Surcharge
Total Permit'
(C)
/"1 ~ A.) .
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
FEE
~~
2-~"':>
/~o-O
/ tJ 6-f)
?S"
?S7,r
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) -2- ~ 7r
-
(A, B, C, 0, and E Combined)
Setbacks
HSE ,GAR ACC
II
l, ;', THE PROPOSED WORI< IN THE
"i!"l"ISTo.RIGAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes"thls ap'pllcatlon must be signed
and approved by the Historical
Coordinator prior to permit issuance,
APPROVED'
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 Checl< 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 construction,
>G;gnalur;;(~\-IJ----' - \12, \.
/ Date Jd-' Lf- fP-
VALIDATION:
~~?4-
/I-~ -'I L
?,), 7 r
~
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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