HomeMy WebLinkAboutPermit Mechanical 1995-5-3
RESIDENTIAL
PERMIT APPLICATION
"'
SPRINGFIELD "
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED,Y'Ojl,lf' ?111~
ASSESSORS MJP: j 'b U '// 0 I.; /91
LOT: iJ- BLOCK:
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DESCRIBE WORK. ~5'I.(<< Q..AV' ~~
t-JEyj I/' REMODEL ADDITfoN DEMOLISH
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OWNER'
ADDRF.C:C:'
CITY'
,
/
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICA' .
ELECTRICA' .
g/VJ:l(j-/d(2tL~
~~
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STATE:
t91:
JOB NUMBER
q6lJt:iq1
OTHER
225 Fifth Street
Springfield. Oregon 97477
TAX LOT. LfI[.t)
SUBDIVISION: i!JJiLJft1t YAJrrI/,L;
PHONE:
/j;)..0 - 7,<;~/
ZIP:
971/..27
ADDRESS
CONST.
CONTRACTOR'
PHONE
l/;M 1 4/S-!!::
EXPI RES
'70.5-'1,)"
() ILL -7'.5 3t;VdSt~(
- 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 HEAT.ER' 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,m, will be
made the same working day. Inspections requested after 7:00 a.m. will be made the following work day.
D Temporary Electric
o Site Inspectlon"- To be made
after excavation, but prior to
settIng forms.
D Undersleb Plumblng/Electrlcall
Mechanical - Prior to coyer..
D Footing - After trenches are
excavated.
D Masonry - Steel locatlon, bond
,beams, grouting,
D Foundation - After torms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
, D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam - PrIor to floor
Insulation or deckIng.
D Floor Insulation - Prior to
decking.
D
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - PrIor to filling
trench.
D Waler Line - Prior to filling
trench.
D Rough Plumbing - Prior .to
cover.
REQUIRED INSPECTIONS
DRou9h Mechanical - Prior to
cover.
D 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:
D Wail/Ceiling Insuletion - Prior to
cover.
D Drywall - PrIor to taping.
D Wood Stove - Atter InstallatIon.
D Insert - Atter fIreplace approval
and InstallatIon o( unit.
D
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Drlvewa\, - After
excavation Is compictc, forms
and sub'~~se'materlal In place,
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D
Final Plumbing - When all
plumbing wQrk Is complet.e.
o Final Electrical - When all
electrical work Is com'plete.
g~echanlcal - When all
mechanical work Is complete,
o Final Building - When all
required InspectIons have been
approved and building Is
comple~d.
Q~ro;~:r bet.:;, ~
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, sklrllng, decks, and
venting have been Installed.
.;"':" ::
Lot facos
Lol TyPO
Lot sq. ftg.
Interior
Setbacks
I :L. i HSE GAR I ACC I
I S I I I I
Iw I I I I
LLLLJ
..5 THE PROPOSED WORK IN THE.
"'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes,thls application must be signed
and approved by Ihe Historical
CoordInator prior to permit Issuance.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT.
APPROVED:
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
Garage
"
This permit Is granted on the express condition that the said
constructron shall,' In all respects, conform to the Ordinance
adopted by the City.ol Springfield. Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tfme
upon violation of any provisions of said ordinances.
Carport
Plan Check Fee:
Total Value
Date Paid:
Building Permit Fee
Receipt Number:
State Surcharge
Received By;
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
S~stems Development Cha~ge Is d.ue on all undeveloped
properltes within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
FEE
ADDITIONAL COMMENTS
Fixtures
Residential Bath(s)
N'
.;Jk~ /fn4'<j 7!<L JelU>1f i.,
f
Sanitary Sewer
FT.
FT.
FT.
A ?TN :
Water
R~ CG.-,,-7i.
~ ~cV>"6~ -I~4~.y
9'.-2 ? ~,_ _ A~ (j
......=;:A.~_ tOR 9'?~o,>--
C/
Storm Sewer
Mobile Home
Plumbing Permit
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace 40'0,000 e,t( ~
C), '
- -
Exhaust Hood
Total Permit
(D)
.r-I'D
JV).
/0. rro
pru
!&,{3V-
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 01 Springfield, and the Laws
of the Slate of Oregon pertaining to tho work described
heroin, and that NO OCCUPANCY will be made of any
structure wIthout permission of Ihe 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.
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
---- -----
( Me~hanlcal perm0
Issuance
State Surcharge
I further agree to ensure that all re~ulred Inspections are
requested at the proper time, that each address Is readable
from the street, that the pormlt 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.
Signature ~dJttlNl1"
cJ5r /):'5 ~ 15
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Datp
Curbcut
fI
DemolitIon
State Surcharge
VALIDATION:
RECEIVED BY
--
RECEIPT NUMBER IJrrJf),/() s
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II
Total MlsceUaneous Perm"s (E)
DATE PAID
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and. E- Combined)
AMOUNT RECEIVED