HomeMy WebLinkAboutPermit Mechanical 1997-9-15
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Orrlce: 726.3759
LOCATION OF PROPOSEO WORK'
ASSESSORS MAP: J70 -3 ~7
LOT'
OWNER:
ADORESS:
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OESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL:
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ELECTRICAl'
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ADDITION
OEMOLlSH
OTHER
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SU80IVISION'
PHONE: ----2'# -t"? ~7
ZIP' ?:?~??
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1:'/7: ;At~~
ADORESS
io
CON ST.
CONTRACTOR .
EXPIRES "~ PHONE
- OFFICE USE -
QUAD ARE'" LAND USF' FLOOO PLAIN'
. OF BLOGS' · 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
made the seme working day. Inspections requested after 7:00 a.m, will be made the following work day,
REQUIRED INSPECTIONS
o Temporary Electric
O Slto Inspection - To be mado
after excavation, but prior to
setting forms.
o Undarslab Plumblng/Electrlcall
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
. ,placemont.
o Underground Plumbing - Prior
to filling trench.
o Underlloor 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.
D Water Line - Prior to filling
trench. \ '. ~
o Rough Plumbing -'Prior to
cover. _ ..1 'I-
o Rough Mechanical -..:. Prior to
cover.
o Rough Electrical - Prior ~o
cover.
o Final Plumbing - When all
plumbing work Is complete.
, ,
o 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 Framing - Prior to cover. ~ J _ - .. ~
..181. Other _urf"". ~ '
o Wail/Ceiling Insulation - Prior to ~ S1~/c.f=
cover. .
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o InsGrt - After fireplace approv~1
and Installation of unit.
o Curbcut & Approach - Aftar
. - forms are crected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - V\I'hen cOfllpleted.
o Street Trees - ~he,! all required
trees are planted. .
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 approvOd
and the home Is connected 10
the service panel.
o Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
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.~ THE PROPOSED WORK IN THE.
.'..HISTOI;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
, Coordlnalor prior 10 permit Issuance,
Set becks
HSE GAR ACC
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Balh(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sower
FT.
Mobile Home
Plumbing Permll
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Slovellnserl/Flreplace Unll
Dryer Vent
~ / /LI~ ,:' r~ ,,g~
Mechanical Permit
,/#/1tI ,
Issuance
Slate Surcharge
Total Permit
, 7r r~l-r
(D)
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
Stalo Surcharge
Sidewalk
II
It
Curbcut
Demolition
Slale Surcharge
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
FEE
~~f)
/'5.N
/&.00
/.20
2.1:;:,2. 0
~
APPROVEP'
BUILDING VAUJE, PLAN CHECK
AND BUILDING PERMIT
This permit Is gran led on ihe express condition thallhe satd
construction shall. In all respecls, conform to Ihe Ordinance
adopted by the City .of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspende~ or revoked at any time
upon violation of any provisions of said ordinances,
Plan Check Fee'
Oale Paid:
Receipt Number'
Received By:
Plans Reviewed By
Oate
Systems Developmenl Charge Is due on all undeveloped
properties wllhln the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree. Ihat I have carofully examined
the completed appllcallon and do hereby cerlHy Ihat 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 Clly of Springfield, and lhe Laws
of the Slate of Oregon perlalnlng 10 the work described
herein, and thai NO OCCUPANCY will be made 01 any
struclure wlthoul permission of lhe Building Safely 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 ensuro thai all required Inspections are
requested at the proper time, that each address Is readable
from the street, that Ihe pormlt card Is located at the front
of tho property, and I approved set of plans will remain
on the eata tI eSdu~
Slgnalure Cl~/ /~
.. --=-/
't
Datp
11.Jyr .7
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
"