HomeMy WebLinkAboutPermit Mechanical 1997-6-6
RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726.3769
Office: 726.3759
SPRINGFIELD
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LOCATION OF PROPOSED WRRK: ';;( ~I ?'.')
ASSESSORS MAP: to,} t)~4.~
LOT: BLOCK:
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JOB NUMBER~,-"-' ~
225 Fifth Street
Springfield, Oregon 97477
DR.'SP+d Of)
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SUBDIVISION:
OWNER:
ADDRESS' '~l-I'(" 5"'
CITY' "P -f} rJ .
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c.nl'?/J A t...... DR
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DESCRIBE WORK:
(7 A S
STATE:
1'1/)'
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PHONE: 7 {"J /.
974"3
. ZIP: 9- -:> b/ 7,'7
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NEW
REMODEL \./ ADDITION
OTHER
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL:
ELECTRICAL:
5lE./9 5 r, ,Y1
QUAD AREA:
'i
# OF BLDGS:
9CCY GROUP:'
, ,
...to.,.
.
# OF STORIES:
WATER HEATER:'
o Temporary ElectrIc
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab PlumbIng I Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated,' ,
o Masonry - Steel location, bond
, beams, grouting.
o Foundation - After forms are
erected' but- prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
DEMOLISH
ADDRESS' .
CONST.
CONTRACTOR #
,~. PHONE
'"
EXPIRES
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3'/~-~t.1) b
- OFFICE USE -
LAND USF'
,
..,# 0": ,UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
To request an Inspection, you must call 726-3769, This 15'a24 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
fU' R~ugh Mech~nlcal ~PrJor to
cover,' ,
- .' . .
D Rou~h'Eh3ctrlcal -,. 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 Wail/Ceiling Insulatlcln ..:.:: ~!?rlor to
cover,'
o Drywall- Prl,or to taping:
O Underlloor Plumblng/i'JIechanlcal 0' , -
-,Prior to Insulation or decking. Wood Stovo - After Installation.
o Post and Beam - Prior to floor
Insulation or decking.
O Floor Insulation - Prlo( to'.'
decking. . /',! '. ,
, ..
0,
o Sanltal)' Sewer - Prior to flllln'g
trench.
o Storm Sewer - Prior to filling
trench. '
O Water Line - Prior. to filling
trench." , ,
r' ,
,
D Rough Plumbl~g '-, Prior to
cover. , .'
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o Insert - After fireplace approvlll
and Installation of unit.
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'.DCurbcut & Approach - After
, forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
, excavation Iscompiete, forms
and' sub-base material In place,
'0 Fence - When completed.
D Street Trees - When all required
, trees are planted. . ",' ,
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,FLOOD PLAIN:
ZONING CODE:
". OF BDRMS:
, SECONDARY HEAT:
SQUARE FOOTAGE:
o Final Plumbing - When all
'plumbing w9rk Is complet,e,
D Final Electrical ,...... When all
electrical work Is complete,
~Inal Mechanical - When all
~echanlcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed,
~Other:~4 f./.ue
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MOBILE HOME, INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complet,e.
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 hav~ been Installed.
l
. '
Lot faces
':
Lot sq. ftg,
Lot coverage
Topography
Total height
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Lot Type
-
, Interior'
, ,",.,.'- ,':., '".Jf:t"""",' ," /\"..
' 10 . , . '" ". ,'f' _. ~ ..~. I '.h ", 1....., ;." ...../ .
" '~'.. '.' ". .'. ,.,." , ,I . '" . _.'
'" ' '. it "t' 'I.,., I'):, I '''.1{,1' ~ ! i lilt., '
,',~~!> \;,::'i":,,, \." :~'c' ',:I,,:,:(')i/yn,;.":',.
. .' ""~' .,. .; ", 1 . " ': .. ,- \~""., .~ I!.. ,
\;" " Setbacks, '"
'P.L. I HSE I GAR'/ ACe'
N I I
S' , L I -,
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W I I
E I I
-
{
Panhandle "
)o~
(A)
Corner
-
Cul-de"sac
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Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
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BUILDING PER~IT;\t'J,;'d!~,
ITEM SQ, FT. X $/SQ, FT. '"
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
, Total Fee
~\,
!ft"
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'.' ',::"
VALUE.
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SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
,
FT.
FT,
FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
...
Wood Stovellnsert/Flreplace Unit
Dryer Vent
~//AlrU?/tr
Mechanical Permit jJ1/,() "
Issuance
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(D)
State Surcharge
Total Permit '
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 O'and E Combined). ,.' ,. '
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( IS THE.PROPOSED WORK tN 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.
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BUILDING' \P)\t(JE,P:LAN CHECK
ANt;> BUILDING PERMIT
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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 ,suspefl,ded or revoked at any time
upon ,ViOlation of any provisions of said ordinances.
, APPROVED:
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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 are being Improved.
FEE
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-J.S. 00
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1,2..0
'2~. 2.0
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ADDITIONAL COMMENTS
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By sIgnature, I stato an,d agree, that I have carofully 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 tho work described
here'ln, and that NO OCCUPANCY will be made of any
structure without permission of the BUlldl"g Safety Division.
I further certify that only contractors and employees who
are In compllanc~ with ORS 701,055 will be used on this,
project.
,
I further agree to ensure that all required Inspections are
requested at the p'roper time; that each address Is readable
from the street, that the pormlt card Is IOCBtod at the front
of the property, and the approved set of plans will remain
on the site at all times ding construction.
~atur
Date
1
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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