HomeMy WebLinkAboutPermit Mechanical 1993-5-27
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Oliicc: 726'<1759
LOCATION OF PROPOSED WORK:
I~h 2..
LOT
ASSESSORS MAP:
OWNER'
ADDRESS:
CITY:
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SPRINGFIELD
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ADDITION
NEW
REMODEL
GENERA' .
CONTRACTOR'S NAME
PLUMBING:
MECHANICAl'
~~.
ELECTRICA' .
OTHER 'l
,
JOB NUMBER '9' 3L) 1:~ti
DEMOLISH
225 Fiflh Street
Springfield, Oregon 97477
TAX LOT-
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SUBDIVISION:
PHONf'
1~{.,..-5il)1
ZIP:
1'1.'f1t
OJU... ~ "t/A
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f A/C'.
ADDRESS
CON ST.
CONTRACTOR"
PHONE
!./~1
\,U,5th.
1 DS'-/j-
EXPIRES
J;;i..-n
'S<I-'f-.1.. '1'6 I
- OFFICE USE -
OUAD 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: RANG". 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. witt be
made the same working day. Inspections requested after 7:00 8.m. will be made the following work day.
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D Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
selting forms.
o
Underslab Ptumbing/Eleclricall
Mechanical - Prior to cover.
D
Fooling - After trenches arc
excavated.
o
Masonry - Steel location, bond
beams, fjrouling.
Foundation - After forms are
erectl:d but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
D
Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
D
Post and Bcom - Prior to floor
insul;ltion or decking.
D
Floor Insulation - Prior to.
decki ng.
o
Snnq,:uy Sewer - Prior to (illing
trencn.
o
Storm Sewer - Prior to filling
trench.
CI
Water Line'~' Prior-to fllting
trenc~.
o
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~ cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D
Fireplace - Prior to facIng
materials and framing Insp.
D
Framing - Prior to cover.
D Wall/ Ceiling Insulation - ,Prior to
cover.
o Drywall - Prior to taping.
'-:
D Wood Stove - Afte; installation.
D Insert - After fireplace approval
and installation of unit.
D
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.
D
Fence - When completed.
o
Street Trees - When all required
trees are planted.
D
Final Plumbing - When all
plumbing worl< is complet.e.
D
Final Electrical - When all
electrical work is complete.
~inal Mechanical - When all
~echanical work is complete.
o Final Building - When all
required Inspections have been
approved and building ;s
completed.
DOthcr
MOBILE HOME INSPECTIONS
o Blocking and SEd.Up - When all
blocking is complete.
D
Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
. blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot' faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul-de-sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fce
(A)
"'-
Setbacks
I P.L. HSE GAR ACC
IN
Is
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
(C),
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Ven t
Mecllanical Permit
Issuance
State Surcharge
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
?1I1/cJ ,
/S ,lrO
/0,00
,
,7.r
?:=) ,7s-
LC7.r
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTEfl?
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 granted on the express condition 1I1at 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 arc being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that! have carefully examined
the completed application and do hereby certify thaI all
Information hereon is tru.e and correct, and I further.certify
that any and all work performed shall be done in accordance
with the Ordinanc~s of the City of Springfield. and ~he Laws
of O,e St?te of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be mad; of any
structure without permission of the Building Safety Division.
I furl her certify that only contractors and employees who
arc In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspcctionr 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
~n the si~i~all}ineS during con81tructi n. .
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VAliDATION:
~&:, ("?,
DATE PAin r-?- 7 - 'l.J
2.......- ) r
AMOUNT RECEIVED _ ,J ~_
.~
RECEIPT NUMBER
RECEIVED BY