HomeMy WebLinkAboutPermit Mechanical 1994-11-18
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPqg,o WOR~ ~, l
ASSESSORS MAp. \ Iffi'J ~ \ ..
OWNER\ ~~(\~- \,\\J)~t.
ADDRE~ :~ -~~~)\.,~ ~J(.'"
CITY- 0~l ~- . ST~:.l
DESCRIB~ WORK: \ lJl..LX\ ~ -( .IDJ.> \Nl1 ~ b
NEW I) REMODEL ADDITION ~EMOLISH OTHER
T
CON/RAc:roR.S NAME
LOT:
GENERAl.
PLUMBING. ;\ \
MECHANICAl ~)O .~ V
ELECTRICAL:
BLOCK.
-,
.
JOB NUMBER ~4
IlJlp
TAX .LOT.
SUBDIVISION.
PHONE:~'\~)
REQUIRED INSPECTIONS
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 facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulntlon - Prior to
cover.
o Drywall - Prior to taping.
o Wood Slove - After Installation.
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 - Aller
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all required
tre~s are planted.
U.~I'
ZIP:
ADDRESS
CONST.
CONTRACTOR #
PHONE
EXPIRES
- OFFICE USE -
QUAD AREA- LAND USE: FLOOD PLAIN.
# OF BLDGS: # OF UNIT~. ZONING CODE:
OCCY GROUp. CONSTR. TYPE: . OF BDRMS.
# OF STORIES: HEAT SOURCE: SECONDARY HEAT: 6,
.
WATER HEATER: RANGE: SQUARE FOOTAGE:
To requesl 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.
o
Final Plumbing - When all
plumbing w9rk Is complet,e.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setllng forms.
o Undersleb Plumblng/Electrlcal/
MechanIcal - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
,beams. groutl ng.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground PlumbIng - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
-.Prlor to Insulation or deckln~.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
D
Final Electrical - When all
electrical work Is complete.
o Final MechanIcal - When all
mechanical work Is complete.
o Final BUilding - When all
required Inspections have been
approved and building Is
completed.-
~o""~~
MOBILE HOME INSPECTIONS
o Blocking and Set.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
porchos, skirtIng, decks, and
venting have been Installed.
Lot faces
i
lot TYP.
lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM
so. FT.
X $/SO. FT. -
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
rn!\t ,,~rb
~anical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
. - ',t~ .\~ .~~'
_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
Coordinator prior to permit issuance.
Setbacks
, HSE ' GAR' ACC I
I
I PL.
IN
Is
Iw
IE
VALUE
.,
FEE
(~.CQ
(7) PU
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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 Clty.ol 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:
Dale 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 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
herein, and thai 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 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 prop ty, and the approved set of plans will remain
o the t ~~t~Jlrw~s~~:I:~
-"''"''1 'JI,-
\~17.
DATE PAID ' / t'tffYLf
AMOUNT REC~ (\ 'II/J-Of )
RECEIVED BY~ 1UJIl )~-
VALIDATION:
RECEIPT NUMBER
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