HomeMy WebLinkAboutPermit Mechanical 1998-1-23
RESIDENTIAL
PERMIT APPLICATION
+-
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORI<'
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ASSESSORS MAP:
LOT
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BLOCK'
OWNER:
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ADDRF'"''
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STATF' .
CITY'
DESCRIBE WORK:-:r Nl+", \ \ ttCd,'h-f. (()
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NEW
REMODEL
ADDITION
DEMOLISH
OTHER
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JOB NUMBER "7'.$S~~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
60..;2.c ~
PHONF'
ZIP'
q 71.f,S
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PHONE
CONTRACTOR'S NAME
GENERA' .
ADDRESS
CONST.
CONTRACTOR .
EXPIRES .,",
1-\ ('e:\ 1 ....L.
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-4 ""'I'8A~ e- OFFICE USE-:-
0'1; ~-94
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, 80 O.fl~s;"'''?~,,~-1'I7f;)~
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WATER HEATER' RANGE: . V<l(~ VJ:(; V,I>-'F-
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To request an Inspection, you must call 726-3769. This Is a 24 hour rec6rdlng. All Inspections fF~quested before 7:00 L:..m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
PLUMBING'
MECHANICAl' t"r\A (~k( \ \ 's
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o h "" .....c..
ELECTRICAl'
QUAD AREA:
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
REQUIRED INSPECTIONS
o Temporary ElectrIc
[EJ Rough Mechanlca~ - Prior to
Y~#&:5
o Rough Electrical - Prior to
cover.
O Site Inspection - To be made
after excavatton, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Footing - After trenches are
excavated.
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beam., grouting.
o Framing - Prior to cover.
o Foundation - After forms are
erected but- prior to concrete
placement.
o Wail/Ceiling Insula,lon - Prior to
cover.
o Underground Plumbing - Prior
to IIlIlng trench.
o Drywall - Prior to i~Plng.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stovo - Atter I~stallatlon.
o Post and Beam - Prior to floor
Insulation or decking.
o Insert - After fireplace approvel
and Installation of unit.
o Floor Insulation - Prior to
decking.
o Curbcut & Approach - After
. forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Sidewalk & Driveway - After
excavation Is compiete. forms
and sub-base material In place.
o Water Line - Prior to filling
trench,
o Fence - When completed.
o Rough Plumbing - Prior to
cover.
D Street Trees - When all required
trees are planted.
S,t fcl
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2-..5"' 7'16 /'~-Jz..~/<fB
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FLOOD PLAIN'
ZONING CODE:
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
o Final Plumbing - When all
plumbing work Is complete.
, .
D Final Electrical - When all
electrical work Is complete.
o Final Mechanlcat - When all
mechanical work Is complete.
o Final BUilding - When all
required Inspections have been
approved and building I.
completed.
~ Other 6"'AZ"5 C;:;AWC~
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
Inspeclions 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..
l~t ~ype. ~ , .
Lot faces
lot sq. ltg' Interior I P.L.
IN
Lot coverage Corner
; S
Topography Panhandle .
Total height Cul,de.sac W
IE
"1 '/1
BUILDING PERMIT
ITEM SQ, FT,
'~it
X $/SQ, FT, =
VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
State Surc~arge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
FIxtures
Residential Balh(s)
N'
Sanitary S~wer
Water
FT.
FT.
FT,
.,.:'
.~
Storm Sewer
,-
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Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
.Exl>a<. " "- - - 4'~/?'~~
-:> _ t:1 c:>
Vent Fan
N'
Wood Stove/lnserl/Flreplace Unit
Dryer Vent
~ .v~,>o<p ,~t~-?"CES" J ~. ~
Mechan;cal Permit 4 /c<;;;;, "f"j
:1/0. -
%~ ',?A
, :f:.) In . 70;-
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
.' .,:::..~r:.\K.:\l
.
( IS THEPROPOSED WORK tN THE.
'.'.HISTOI;lICAl DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks.
I t I 'I
HSE GAR ACC.
I
I
I
I
APPROVEf"
BUILDING VAuk 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 Check Fee'
Date 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
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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 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 pro pert , and the ap' roved set of plans will remain
on the site at Ising construction.
~nature ,
Date
VALIDATION:
RECEIPT NUMBER d 8'<;S '2,
/-~3- c;{
AMOUNT RECEIVED $
=-1:1, )
,
DATE PAID
RECEIVED BY