HomeMy WebLinkAboutPermit Mechanical 1993-11-17
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT'
OWNER:
ADDRI=~~'
CITY'
DESCRIBE WORK: _.&14<
NEW ~EMODEL
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SPRINGFIELD
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BLOCK:
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
21 f9-71
PHONE:
'74'7- ~7'45
ZIP:
'5'74'77
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CONTRACTOR'S NAME
GENERAL: rm/t!?v/If) ~;.:
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PLUMBING:., ,;
MECHANICA' .
ELECTRICAl'
ADDITION
DEMOLISH
OTHER
ADDRESS
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CONST,
CONTRACTOR #
'77~dl
PHONE
7;;.r:, -, f Z2L
REQUIRED INSPECTIONS
'1\7f Rough Mechanical - Prior to JJ
~ cover, 4~ /.o~~T f W;- 'rJ.
o Rough Electrical - Prior to
cover.
D 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 Insulallon - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove ~ After l~stallat'lon.
o Insert - After fireplace approval
and Installatlon of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
. excavation Is complete, forms
and 8:ub-base material In place.
o Fence - Whe,n completed.
o Street Trees - When 'all required
trees are planted,
EXPIRES
U#ft~
- 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:
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 be made the following work day.
o Final Plumbing - When all
plumbing work IS complete.
o Final Electrical -_ When all
electrIcal work Is complete.
-c;;( Final Mechanical - When all
~echanlcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building is
completed.
J2g'Olher
6/(-$ t:./Ue
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical!
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grout! ng.
o Foundation - After forms are
- erected but,. prior to concrete
placemer"!t.
o Underground Plumbing - Prior
to filling trench.
" ,
'. '~~
o Underfloor Plumbing/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 filling
trench.
o Storm Sewer - Prior to filling
trench. .
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cove~ .
.'
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
porches, skirting, decks, and
venting have been Installed,
. Setbacks IC' THE PROPOSED WORK IN THE
Lot faces Lot Type
, Interior I P.L. HSE GAR ACC I '- HISTORICAL DISTRICT, OR ON
Lot sq, ftg, IN I THE HISTORICAL REGISTER?
Corner If yes, this application must be signed
Lot coverage Is I
and approved by the Historical
Topography Panhandle I,w Coordinator prior to permit "Issuance.
i
Total height Cuj.de.sac
IE .
APPROVED:
BUILDING PERMIT
ITEM SQ, F:T, ',X $/SQ, FT.
VALUE
,
Main
Garage
Carport
Total Val ue
Building Permit Fee
State SLircharge
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
Exhaust Hood
"
Vent Fan
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
6# IM'!'- ) 2.'~~
/U/V,
) C;.d'O
I (J, oD
.7.r
2.. c:Jr
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
7~5 ,75"
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 C~eck Fee:
Date Paid:
Receipt Number-
Received By:
, ,
,
Plans Reviewed By
Date
Systems Development Charge Is due on ;11 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 Ordlnanc~s of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure wIthout permission of the BuJ/dlng 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 t1me~ 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
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Date /~/;113/ I
VALIDATION:
RECEIPT NUMBER
DATE PAl!'
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AMOUNT RECEIVE!'
RECEIVED BY