HomeMy WebLinkAboutPermit Mechanical 1995-3-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORI<"
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DESCRIBE WORK:
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NEW
REMODEL
CONTRACTOR'S NAME
GENERAl .
PLUMBIN'"
MECHANICA' .
ELECTRICA' .
O~_
ADDITION
DEMOLISH
OTHER
.
9 56274-
JOB NUMBER
225 Firth Street
Springfield, Oregon 97477
.SUBDIVISION'
PHONF'
ZIP:
97-J/hS'
ADDRESS'
CON ST.
CONTRACTOR'
PHONE
o Rough 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 'acing
materials and framing Insp.
o Framing - Prior: \0 cover.
o Wafl/Celllng InsJlatlon - Prior to
cover.. ,'.
D Drywafl - Prior to taping.
D Wood Stovo - A.f.~br I,;stallatlon,
o Insert - After fireplace approvlll .
and Installation of unit. .
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
O Sidewalk & Driveway - Arter
excavation Is' complalo. forms
and sub-base material In place.',
o Fence - When ~ompleted.
D Street Trees - When all required
trees are planted. ' .
EXPIRES
. 7- ,;;'1- f-s'"
;:>,;;~ - 7(",sr'
II..~~ (!]..
no -/{f
- 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: 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 bo
made the same working day. Inspections requested after 7:00 a.m. will be mad~. the followIng work day.
REQUIRED INSPECTIONS.
o Temporary Eloctrlc
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Fooling - Alter trenches are
excavated.
o Masonry - Steel location, bond
.beams, grouting.
D Foundation ~ After forms are
erected but prior to 'concrete
placement.
o Underground Plumbing - Prior
to 'II11ng trench.
D Underlloor Plumbing/Mechanical
-.Prlor to In,sulatlon or decking.
. D 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 filling
trench.
o Water line -'Prlor to filling
trench. .
o Rough Plumbing - Prior to
cover.
o Final Plumbing - When all
. plumbing work Is complete.
. .
D Final ElectrIcal - \lV.hen all
electrical work Is complete. c.
Jc;;{ Flna' Mechanical - When all
~ mechanical work Is complete.
D Final Building - When all
. required Inspections have been
approved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Whep all
blocking Is complete.
D Plumb"lng Connections - When
home has been connected to .
water and sewer.
.
o Electrlcsl Connection - When
blocking, set-up, and plu'1lblng
Inspecllons have been approved
and the home Is connected to
the servIce panel.
D Flnsl - Alter all required'
. Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
.~ .,'
Lot faces
Lot TY.
_ Interior
P.L.
Lot sq. Itg.
Lot coverage
N
Is
Iw
IE
Corner
Topography
Panhandle:
Total ~elght
Cul-de-sac
BUILDING PeRMIT
ITEM sa. FT. x SISO. FT. ~. VALUE
~aJn
Ga(age
"
Carport
Total Value
Building Permil Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) .
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
,
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
P1:' '/v I
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit.
Dryer Vent
Mechanical Permit
) 5' rtJ
/f),tJ-O
!.?--tJ
'7,.0 12.0
Issuahce
Slate'Surcharge I 7J- 1- 1-fJ
Total Permit (0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
II
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)" _2,,/; ,").,()
(A, B, C, D, and E Combined)
".."::'.;\i'~':
Setbacks.
HSE GAR' Accl
I
I
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.IS THE PROPOSED WORK.tN THE., .
"'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the HIBtorlcal
. Coordinator prior to permit Is$uance.
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 by the City .01 Springfield, Including the
Development Code, regulating the construction and use 01
buildings, and may be suspended or revoked al any time
upon violation of any provIsions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number'
Received By:
Plans Rovlewed By
Date
Systems Development Charge Is due on all undeveloped
properties within tho Clly limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certlly that all
Informatlon hereon Is true and correct, and I further certlfy
that any and all work performed shall be done In accordance
with the Ordlnancus of the City 01 Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made 01 any
structure without permission of the Building Safety Division.
I lurther certlly that only contractors and employees who
are 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 15 located at the front
of the property, and the approved set of plans will remain
on the site at all tlmes during construction.
~gnature 1LA.&v, . --?:.u.//~
Date
d -.;? -- ?-.5
VALIDATION:
RECEIPT NUMBER
DATE PAIf'
AMOUNT RECEIV""
RECEIVED BY
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