HomeMy WebLinkAboutPermit Mechanical 1996-10-25
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
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LOT'
NEW
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REMODEL
CONTRACTOR'S NAME
GENERAL'
PLUMBING'
MECHANICA' .
ELECTRICAL'
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SPRINGFIELD
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JOB NUMBER
225 Fi fth Street
Springfield, Oregon 97477
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ADDITION
STATF'
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DEMOLISH
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SUBDIVISION'
PHONE:~7 - Z ?,qC;
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ZIP:
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES ~. PHONE
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.".\. \
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D Wall/e"elllng Insulation --:tPrl~r to
cover. . \ . "
o Drywall - Prior to tapiii'g. . ,\
D Wood Slovo - After Installation.
D Insert - After fireplace approvftl
and Installation of unit.
D Curbcut & A'pproach - After
forms. afC erected but prior to
placement of concrete.
D Sidewalk & Driveway - 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. ~.,
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[-97
L/ros. 31m
OWNER: jJa. VJ!l ~ I1/V<~^/
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DESCRIBE WORK: IYlC'1;. /1
e.s.
70. <R,-,."., <,"U,
- 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: _ SOUARE FOOTAGE:
To roquest 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 rOQuested atter 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
mROU9h Mochanlcal - Prior to
r cover.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical I
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
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Boam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sower - Prior 10 fllting
trench.
o $Iorm Sewer - Prior to filling
trench.
D Water Line - "P~I~)( to fiIl1n.g'
trench.
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D Rough Plumbing."":" PrIor to
cover. . _ ,,_.
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'. ,
D
Final Plumbing - When all
plumbing wc;>rl< Is complet,c.
0" Final Electrical - When all
electrical work is complete.
~Flnal Mechanical - Whon all
~hanlcal work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
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" MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Wilen nIl
blocking Is complete.
D
Plumbing Connections - When
home has been connected to
waler and sewer.
D Electrical Connection - When
blocking, sel-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D
Final - After all required
Inspections arc approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
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Lot sq. ftg:' ~
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lot Type
Interior
Lot coverage
Corner
Topography
Total height
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IN
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Setbacks.
I HSE I GAR I Acc'l
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Panhandle
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Cul-de-sac " ,..l W
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IS THE PROPOSED WORK IN THE.
....HISTORICAl DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application musl be signed
and approved by the Historical
Coordinator prior to permit Issuance.
'.
BUILDING PERMIT
ITEM SO. FT.
X $/SO. FT.
Main
. .
Garage
Carport
Total Value
Bulldlng Permi t Fee
State Surcharge
Total Fee
(A)
VALUE
'.
,
. APPROVED'
BUILDING VAUjE, PLAN CHECK
AND BUILDING PERMIT
This permit ls granted on the:express condition 'that the said
construction 'shall, In ~1I res,pects, conform to the Ordinance
adopled. 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 (SDC)' ....,
Systems Development Charge ls due on all undeveloped
properties within the City limits which are being Improved.
(B)
PLUMBING PERMIT
ITEM FEE
Fixtures
Residential Bath(s) N'
Sanitary S~wer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
TOlal Charge (C)
MECHANICAL PERMIT
Furnaco
,
Exhaust Hood .---
Vent Fan N'
Wood Stovellnserl/ Fireplace Unit
Dryer Vent
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Mechanical Permit
Issuance
State Surcharge
Total Permit
,7J-f,';..r
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
II
Curbcut
II
Demolition
Slate Surcharge
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) c:;: l}-O
/O,'e<:>
1.2...0
~L.o
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) 4 .2,.0
(A, B, C, 0, and E Combined)
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 the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the 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 agree to ensuro 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 properly, and the approved set of plans will remain
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Date 10 ~ ?- ~~ r:
VALIDATION:
RECEIPT NUMBER
2- 3~11
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY _