HomeMy WebLinkAboutPermit Mechanical 1997-1-21
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
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JOB NUMBER
'9~/Y'3
225 Fifth Street
Springfield, Oregon 97477
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LOCATION OF PROPOSED WORK:....26 '"5 ~ ~~~ ~?1~
ASSESSORS MAP: /:)~::J-. <~. S/4'"
OWNER:--#/,? r-2-v~
ADDRESS: '2.t;; _~ ~&:- /~.~
-5~r:'?)?_
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LOT'
CITY'
BLOCK'
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STAT'"
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TAX LOT: ~<;-'~
SUBDIVISION'
PHONF'
77"." -~ c;.r/9
ZIP'
9/$'?:::>
DESCRIBE WORK: ~'f"rA'L~ _~- r~~~::"'-:;, /~/'"'~:~~ r ~~~ ~
NEW REMODEL ADDITION DEMOliSH OTHER
ADDRESS
CONST,
CONTRACTOR'
EXPIRES ',"7> PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL;4~/'~ ~.~ _~..~ '_~~ ~~~ ?A5 2~,4P~:; .~'f-"~ ~
ELECTRICAl'
- 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 be
made the same working day. Inspections requested after 7:00 a.m. will bo made tho following work day.
D Temporary ElectrIc
D Site Inspection - To be made
after excavatlon, but prior to
setting forms.
D Underslab Plumblng/Electrlcall
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 Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Senltary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water LIne - Prior to filling
trench.
D Rough Plumbing - Prior to
cover. .
REQUIRED INSPECTIONS
lKl Rough Mechanical - Prior to
~&?
o 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/Celll"g Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvlSI
and Installation of unit.
D Curbcut & Approach - After
forms are erected bllt prior to
placement of concrete.
D Sidewalk & Drlvewav - After
excavation Is complete. forms
and sub-base material In place.
D Fence - When completed.
D Street Trees - Wh~n all required
trees are planted.
D Final Plumbing - When all
plumbing w9rl~ Is complet.e.
o Final Electrical - When all
electrical work Is complete.
fA71 Final Mechanical - When all
~ ;-~~I ~ ;mPlete,
D FInal Building - When all
required Inspections have been
approved and building is
completed.
[ZlOther ~ ,~C~'
MOBILE HOME INSPECTIONS
D Blocking and Set.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
LOI Type
.
Lot sq. flg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle'
Cul.de-sac
", ""
, .: v' ~j~ k~}t ;~~~ \
i ~THE PROPOSED WORK IN THE.
'..'HIST08ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I PL.
Setbacks '
HSE GAR ACC
N
S
Iw
IE'
BUILDING PERMIT 'i "
ITEM SO. FT, X $/SO. FT. - VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
ResldenUal Bath(s)
N'
Sanitary S~wer
Water
FT,
Storm Sewer
FT,
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
FEE
MECHANICAL PERMIT
I LdJ "~ ,r?",-,=,.-=-
Furnace Y/7 ,-"'~ , ~~
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Br,.r ':<>"t 4r7 /ijZ)"~
AfpC/AW'/~ e"~
MechanIcal Permit
Issuance
~!
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
/ "'). -
2.-
~.-
2Q',-
/tI',-
/.~-
,~
3/. ~&>
APPROVEP'
. ", . .,
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 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 tho City iimits which are being Improved.
ADDITIONAL COMMENTS
By signature, I stato and agree, that J have carefully 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 porformed shall be done In accordance
with the Ordinances of the City of Springfield, and the Laws
of the Slale of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agreo 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 will remain
on the site at all 1,lme~ dU"/9 construction.
Signature _<<I-~~
Datp l-d/-~7
VALIDATION:
RECEIPT NUMBER '2 Y? ~?
DATE PAID /' ::2 / ~ "7 ?
AMOUNT RECEIVED ?/,h~
r
RECEIVED BY
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