HomeMy WebLinkAboutPermit Mechanical 1995-6-6
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DESCRIBE Wo.RK: !.tl. (TA U A f-,O'llAJ
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
Lo.CATlo.N o.F PRo.Po.SED Wo.RK'
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ASSESSORS MAP'
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o.WNER:
ADDRF"'"
CITY:
NEW
REMo.DEL
Co.NTRACTo.R'S NAME
GENERAL'
.
SPRINGFIELD
751
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BLo.CK:
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Jo.B NUMBER
225 Fifth Street
Springfield, o.regon 97477
TAX Lo.T:
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SUBDIVISlo.N'
. PHo.NE: 7:J,.(p- 5"~ V- ~"'~?'3rO
STATE:
~;(:> GCc~ ZIP'
'77ff77
19 r:: MeA- f fJJ ~
ADDITlo.N
DEMo.LISH
o.THER
~<-fS~A4
/
ADDRESS
Co.NST.
Co.NTRACTo.R #
PHo.NE
PLUMBING'
MECHANICAL:~€V ~ fJll({e C:;;,
Sc.o ~.F-ld E/EC.,
ELECTRICAl'
EXPIRES
OLDIS- NLI~e~ t ~ Q
E" Ur;..G..JiE. Cf"7IJ.il\ ~(X)77' O-JI-t7'7l'6-16'.;l1
- OFFICE USE -
QUAD AREA: LAND USE: FLo.o.D PLAIN'
# o.F BLDGS' # o.F UNIT'" Zo.NING Co.DE:
o.CCY GRo.UP' Co.NSTR. TypF. # o.F BDRMS'
# o.F STo.RIES: HEAT So.URCE:' SECo.NDARY HEAT:
WATER HEATER' RANGE: SQUARE Fo.o.TAGE:
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.
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placeme0t.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation ?r decking.
..' .'
o Floo'r Insulation - Prlo~ to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Sto~m Sewer - Prior to filling
trench. '
D Water Line - Prior to fillIng
trench. '"
D Rough Plumblng.- Prior to
cover.
REQUIRED INSPECTIONS
l\::7( Rough Mechanical - Prior to
~cover. .
"K71' Rough Electrical - Prior to
)A.l cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulatlo~. - P~lor to
cover. .
D Drywall - Prior to taping.
o Wood Stove - After I~stallat'lon.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and 5;ub.base material In place.
o Fence - When completed.
D Street Trees - When 'all requlied:
trees are planted.' "- ,
D Final Plumbing - When all
plumbing work Is complet.e.
i"v( Final Electrlcel -, When all
~Iectrlcal work Is complete.
i'"vf' Final Mechanical - When all
~mechanlcal work Is complete.
D Final Building - When all
reQuired Inspections have been
approved and building Is
completed.
D~ther
MOBILE HOME INSPECTIONS
D Blocking and Set. Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer. .
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are 'approved and
. porches, sklrtln'g, decks. s'nd
venting have been,lnstalled.
-, --
, "
Lot faces "', -,~ Lot Type .
.~. . \, "-.. I P.L
Lot sq. ftg. Interior IN
Lot coverage Corner
Is
Topography Panhandle
I
Total hel ght Cul.de.sac 'Iw
'I E
Setbacks
HSE GAR'ACCI
I
I
I
I
ltlTHE PRo.Po.SED Wo.RK IN THE
"HISTORICAL DISTRICT, o.R o.N
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
...../. \..
I .
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT, = VALUE
...., ,.' . )
Main' - r ~l ". .~. ," ~... ...
Garage
"
Carport
, "
\ .~.. ;,
"
"
Total Value
Building Permit Fee
State Surcharge
Total Fee
,.' ....
L,' .
/.:.).
(A)
"-
!_ SYST.EMS ,DEVELOPMENT 'GH~~GE' (Spq
(B)
PLUMBING PERMIT
ITEM
Fixtures'
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
F;'lumblng Permit
State Surcharge
Total Charge
(C)
FEE
MECHANICAL PERMIT
Fu mace #b'tT ,4:""'"
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge , 7/' r ' --f'J-
Total Permit (D)
MiSCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
C;~
?
~"."v
/ c::. ~
/6> .-
/20
2/.,.,.2.-0
'I
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, .0, and E Combined)
. .A1l!
~, ~eT'l'
2-4:> ,2...0 .
APPRo.VED:'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
: :rhls,permlt Is gra~ted"f'n the express c,?n~ltl.on that the said
construction shall, In'all,respects, conform'lo'the o.rdlnance
adopted "by ',ihe,'City. '0(. Springfield, Including the
Development Code, regulaji'ng the construction and use of
buildings, and may be'susp~nded'or.rev9ked at any time
upon violation of any provisions of said o'rdinances.
, Plan Check' Fee:
, ".,
-.." . ...
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
- ,
.',: - System~ Development Charge.l.s:due;on all undeveloped
properties wlthln,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 o.rdlnances of the City of Springfield, and the Laws
of the State of o.regon pertaining to the work described
herein, and that NO. o.CCUPANCY 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 property, and the approved set of plans will remain
on the sl~e ~I ~1~es d.lf!J19 fbnstructlon. _ ~ ~
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Slgnatur //f,-_ .. Z~ ?' tY~J' '--'J.
Dato & -lQ - Z'S- .
VALlDATlo.N:
RECEIPT NUMBER
DATE PAID
AMo.UNT RECEIVED
RECEIVED BY
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