HomeMy WebLinkAboutPermit Mechanical 1995-12-4
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT'
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SPRINGFIELD
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BLOCK:
OWNER:
ADDRESS:
CITY:
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7?9 S. 7C30
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DESCRIBE WORK:
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NEW
REMODEL
ELECTRICAL:
STATE:
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DEMOLISH
OTHER
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
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ADDITION
SUBDIVISION:
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ZIP: <J?~/t$
ADDRESS
CONST.
CONTRACTOR #
EXPIRES '.::'> PHONE
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CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL: 4;l/bV r U~ /4~ J!:Nb rAltJJ;d /13/'0 N,/j~ ~A
( -~ 0-
- OFFICE USE -
QUAD 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: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769, This Is a 24 hour recording, All Inspections requested before 7:00 a.in, will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
..
o Site Inspection - To be made
after excavation, but prior to
setting forn:s,
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
D 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.
D Post and Beam - Prior to floor
Insulation or decking.
,
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., .
'D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
1~~Rough Mechanical - Prior to
Jr ,,",cover.
o Rough Electrical - Prior to
cover.
o 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 Wall/Ceiling Insulation - Prior to
cove~ '
D Drywall - Prior to taping. --
o Wood Stovo - After I~stallatlon.
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.
D Street Trees - When all requl,red
trees are planted. "
.....~
D Final Plumbing - When all
plumbing work Is complet,e.
o Final Electrical - When all
electrical work Is complete,
~Flnal Mechanical - When all
~mechanlcal wor1< Is complete.
o Final Building - When all
required Inspections have been.
approved and building Is
completed,
~ Other 2~ ~
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MOBILE HOME INSPECTIONS
o 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 Type Setbacks
Interior I P.L HSE GAR ACC
IN
Corner
Is
Panhandle
Iw
Cul-de-sac
IE
Lci't faces
Lot sq. ftg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
. '
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary S!3wer
Water
FT,
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
~A5 U.o~ / jA~$
Mechanical Permit
Issuance
State Surcharge I 7 j T ' ~ .J
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
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.2 Tt;fE PROPOSED WORK iN 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:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is gr<;1nted on the express condition that the said
construction sh'all, in all respects, conform to the Ordinance
adopted by the City of Springfielfl, including the
Development Code, regulating the constructi@n 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 Numbcr'
Received By:
Plans Reviewed By
Date
Sy~tems Development Charge is due on 'all undeveloped
.. properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I statc 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.
/1,lgnature f!o'*-.- ..J. ~o-v/
Date
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VALIDATION:
RECEIPT NUMBER
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY