HomeMy WebLinkAboutPermit Mechanical 1992-3-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ollice: 726.3759
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LOCATION OF PROPOSED WORK: _ ) '00
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OWNER:
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CITY:
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DESCRIBE WORK'
NEW
REMODEL
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ADDITION
CONTRACTOR'S NAME
GENERA' '
BLOCI" _
STATE:
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OTHER
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JOB NUMBER ~".!;.' ~ .
225 Fifth Street C1 f)T\':2<:::;/"\
Springfield, Oregon 9}4'ir~
TAX LOT:
SUBDIVISION'
{Y)/{D
PHONF'
f9S-oCf'J-
ZIP:
9~
ADDRESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
PLUMBING'
MECHANICAL ..v.ft- F~l... /JuL;;
ELECTRICAl'
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- OFFICE USE -
OUAD 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 request an inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m, wIll be
maclc the same working day, Inspections requested atter 7:00 a.m. will be made the following work day.
o Temporary Electric
o S1Io Inspection - To be made
after excavation. but prior to
setting forms.
o Underslab Plumbing/Electrical I
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.
o
Underfloor PlumbingJ Mechanical
- Prior to insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to tilling
trencll.
o
Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
If'/1?ROU9h Mechanical ~ Prior to
r cover.
o Rough Electrical - 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 WallJCeiling Insulat,ion - Prior to
cover. .
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - Atter
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place.
o Fence - When cOrr'preted.
o Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing worl~ is complete.
D Final Electrical - When all
electrical work is complete.
~al Mechanical - When all
~~~~hanical work is complete.
o Final Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
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 have been installcd.
LOI faces
.
Lol Type '
Lol sq, fig,
Interior
LOI coverage
Corner
Topography
Panhandle
Total height
Cul.de.sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
Main
Garage
Carport
Total Value
Building Permi I Fec
State Surchargc
Total Fee
(A)
Setbacks
I PL 'HSE' GAR' ACC I
IN
Is
.S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
COQldinnlor prior to permil issuance.
E
W
----
APPROVED'
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential 8a01(s)
N"
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Horne
PI u mbi ng Perml t
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Yen I Fan
N"
Wood Stove/lnsertl Fireplace Unit
Dryer Vent
Mechanical Perini l
Issuance
Slate Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stato Surcharge
Sidewalk
fl
Curbcul
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, D. and E Combined)
FEE
(f).QJ
i!)o()
.75
&~l;S
AJ':) -J.l)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condilion 1t1iltthc said
construction shall, in all respects. conform to the Ordinance
adopted by the City of Springfleld. including the
Developmcnt 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 the City limits which are being improved.
ADDITIONAL COMMENTS
By signature. I state and agree, that I have carefully examined
the completed application and do hereby certify thai 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 Ihe Laws
of the Statc of OI'CfJon pcrtaining to the wOII~ dcscribed
herein, and that NO OCCUPANCY will be made of any
slructure WitllOul permission of the Building Safety Division.
I further certify that only contractors and elllployees who
are in compliance with GRS 701.055 will bo used on tllis
project.
I further agree to ensure that all required inspeclions arc
requested at the proper time, that each address is readable
from the street, that tile permit card is located at the fronl
of the propert , and the approved set of plnns will remain
on the site at all times during constrIction.
S! ature tV ~~
0'0/ /7,J.{-9:;-
VALIDATION: ~f)--1
RECEIPT NU~ER ,.jJ I
DATE PAlf'O ,;Jh . q;
AMOUNT RECtrcY~. ~ "'\
RECEIVED BY r m )
1 ______