HomeMy WebLinkAboutPermit Mechanical 1996-11-5
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olllce: 726.3759
.,
SPRINGFIELD
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LOT'
I .
OWNER' -HiJ././I. !
CITY: ~Y'I
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DESCRIBE WORK: IAtl1aJi-Gf
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
BLOCK'
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STATE: -'1l2..
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ADDITION
DEMOLISH
OTHER
.
9b/OOC;-
JOB NUMBER
225 Filth Street
Sprlnglleld, Oregon 97477
TAX LOT'
SUBDIVISION'
() C-(7C7n
PHON'"
ZIP: q7L/77
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES ., PHONE
MECHANICAL:
ELECTRICAL'
Lo,ry1./ i3ra~A
(
- 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: RANGF' SQUARE FOOTAGE:
To rOQuest 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
D Site Inspection - To be made
after excavation, but prIor to
setting forms.
D Under,lab Plumblng/Electrical1
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D
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 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 fltllng
trench.
D
Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
UIRED INSPECTIONS
- Prior to
D Rough Electrical - Prior to
cover.
D 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/C'elllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Inserl - After fireplace approv41
and Installation of unit.
D
Curbcut & Approach - After
forms are erected but prior to
placement of concreto.
D SidewalK & Drlvew3\' - After
excavation Is complete, forms
and sub.base material In place.
o Fence - \Nhen completed.
D Stroot Treos - When all required
trees are planted.
D
Final Plumbing - When all
plumbing w.;:>rl< is complel.e.
D Final Electrical - When all
electrical work Is complete.
~Inal Mechanical - When all
v ~ mechanical worK Is complete.
D Final Building - When all
required Inspections have boen
approved and building is
completed.
DOthor
MOBILE HOME INSPECTIONS
D BlocKing and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home l'las 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 - Aller all required
inspections are .approved and
porches, skirting, decks, and
venting have been Installed.
Lot Type. . " .~ .: :::~: ;)~ ~.~:~ \~'
~, t . '.
I Lot faces Setbacks.
Lot sQ. Itg. Interior PL. IHSE GAR ACC I
Lot coverage Corner N I I
Is I I
Topography Panhandle .
Iw I I
Total height Cul-de.sac
L___LJ
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
Main
Garago
"
Carport
Total Value
Building Permit Fee
Stale Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
Moblfo Home
Plumbtng Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
/.I11\(h
j C;; (JO
Mechanical Permit
Issuance
W.OD
-t 3% C+y MIMi n-F~ . i. JJ7
(D) 2/t? . J 0
State Surcharge
Total Permit
MISCELLANEOUS PERMITS
Moblfe Home
State Issuance
Stalo Surcharge
Sidewalk
It
Curbcul
ft
Demolition
State Surcharge
Total Mlscelfaneous Permits (E)
.2. & .ck?
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
.
IS THE PROPOSED WORK iN THE.
....HiSTORiCAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this applfcatlon 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 that the said
construction shall, In all respects, conform to the Ordinance
adopted DY the City of Springfield, Including the
Development Code, regulating the constructIon and use of
bulldJngs, 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 are being Improved.
ADDITIONAL COMMENTS
By signature, I state and 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 tho City of Springfield, and lhe Laws
of the State of Oregon pertaining to the work described
heroin. and that NO OCCUPANCY wI/I be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
aro 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 wI/I remain
on the site at a:t'l/~ng const.~n. ()
Slgna~urp. ./ ~~ ~(~
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Date /1- ~- f? c
I . ~ .,
VALIDATION:
RECEIPT NUMBER 2q71/
DATE PAID (/vQ: 9,0
AMOUNT REC~'~ED :? t, ,Q/J)
- .... ............
RECEIVED BY ,I.{:-