HomeMy WebLinkAboutPermit Mechanical 1998-6-5
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olfice: 726.3759
LOCATION OF PROPOSED WORK: _
ASSESSORS MAP: /7 /? 2
LOT:
OWNER:
ADDRESS:
CITY:
DESCRIBE WORK:
NEW
REMODEL
ADDITION
OTHER
CONTRACTOR'S NAME
GENERAL'
i,,'
SPRINGFIELD .....
.
9 ~1?~lL
.,
JOB NUMBER
,
t(Yi
;;9% J q,I/W~.J (!;b,
225 Fifth Street
Springfield. Oregon 97477
TAX LOT:
Qo/O~
, -
BLOCK:
SUBDIVISION:
-.
PHONE: _
1tj-JJ-/17/
ZIP: t/1tf7i
DEMOLISH
ADDRESS
CONST.
CONTRACTOR /I
PHONE
EXPlliES .~
PLUMBING: Z
MECHANICAL'f!omjMi.J/OrlH5/ brJ.~
ELECTRICAL:
QUAD AREA:
/I OF BLDGS:
OCCY GROUP:
/I OF STORIES:
WATER HEATER:
()fJ!t6IJ
b-d7-9J
~Q?
- OFFICE USE -
LAND USE:_
FLOOD PLAIN:
/I OF UNITS:
CONSTR. TYPE:
ZONING CODE:
It OF BDRMS:
HEAT SOURCE:
RANGE:
SECONDAFlY HEAT: _____.
SQUARE FOOTAGE: '___'__'__
To request an Inspection. you must call 726.3769. Tills Is a 24 hour recording. Alllnspeclions 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 worl< dny.
D Temporary Electric
D Site Inspection - To be made
after excavation. but prior to
seltlng forms.
D
Underslnb Plumbingl Electricall
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
o Masonry - Steel location. bond
beams. groullng.
D Foundntlon - After (orms are
erected but prior to concrete
. placement.
o
Underground Plumbing - Prior
to filling trench.
o
UnderfJoor Plumbing I Mechanical
- Prior to Insulation or decl<ing.
o
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 (1lling
tronel1.
o Water Line - Prior to (illing
trench. .
o
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
o Final Plumbing - When all
plumbing worl< Is complet.e.
I2::r:Final Elect~C;\1 - Wilen all
eleclrical worl< is complete.
(
~ Final Mechanical - When all
P mechanical worl< 'Is complete.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain perrnanent
electrical power.
D
o
Finnl Building - When all
required Inspections have been
approved and building is
compleled.
~
Fireplace - Prior to (acing
materials and framing Insp.
o
o
Framing - Prior to cover.
o Ot.her
Wall/C'elling Insulation - ,prior to
cover.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Wood Stove - A(ter InstallaHon.
o Insert - After fireplace approval
and Installation o( unit.
o Blocking lInd Set.Up - Wilen all
blocl<in~lls complete.
o
o
Plumbing Conncctions - When
tlOme hns been connected to
waler antI sewer.
Curbcut & Appro(Jch - After
(orms are erecled bul prior to
placement Q( concrete.
o Sidewalk & Drivcw:tV - After
excavnlion Is complete. [orms
ancl SUI).bi)SCl materl,,1 In place.
o
EleclriclIl COllnection - When
blocldnl). set.up. and plumbing
Inspections Iwve been approved
nntltl1c. tl0lT10 is connocted 10
tile service panel.
o
Fence - Wilen completed.
o
Finnl - Afler all required
Inspections arc approved and
porches. sl<ining, dccl<s, and
venting have been Installed. : .
o
,
~:;treot Trecs - Wilen all required
trees are planted.
i~")\. ~;.""..',
.'
Lol faces
Lol Type
Lot s'q. ftg.
.
Interior'
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.cJe-sac
BUILDING PERMIT
ITEM
SQ. FT.
X $/SO. Fr. =
Main
Garage
Carport
Tolal Value
Building Permit Fee
State Surcharge
Total Fcc
(A)
, .... ~ ,
,. \
l' ' ~, " .
\ tHE 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.
.,
Setbacl<s
I P.l. I HSE GAR ACC
N
S
W
._--~_. ._- ----
E
APPROVED:
VALUE
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 tile 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 provision::; of said ordinances.
Plan Check Fee:
Date Paid:
Recei pi Number'
Received By:
- ...--.-. ._-,-~--.-._-
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
Nn
Sanitary S!'lwer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert I Fireplace 'Unit
Dryer Vent
Mechanical Permi t
Issuance
State Surcharge
/7J~/1f
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
ft
Demolition
~tate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
Systems Development Charge is due on all undeveloped
properlies within tho City Iimils which arc being improved.
ADDITIONAL COMMENTS
FEE
\
)5"~
(- I
_Lt:rd-.::J
J2tJ
,
??..~O
(
By signature, I stale and agree, that I h~ve carefully examined
tile completed application and do hereby certify that all
Information hereon i:.; true ancl correct, and I further certify
thai any and all work performed shall be done. in accordanco
with the Ordinancu:.; oflhe Cily of Springfield, and the Laws
of the SlClle of Oregon pertaining to the worl< described
herein, LInd lllal NO OCCUPANCY will be made of any
struclure withoul permission of the Building Safety Division.
I further certi fy Hlal only contractors and employees who
arc in compliancc'with ORS 701.055 will be used on this
project.
01
I further agree 10 ensure that all required Inspections are
requested at the er lime, that each address Is readable
~.
from the sire . tll the permit card Is located at the front
of the prop rty, d Ihe approved set of plans will remain
on the sit. at I times during construction.
. 'rf)
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Signature _
Date
h-S ~q1
VALIDATION:
RECEIPT NUMBER
?o/5'F
0/J-/~~
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, /-(' - - I
DATE PAID
..26,' :l. 0
AMOUNT RECEIVED
RECEIVED BY