HomeMy WebLinkAboutPermit Mechanical 1992-11-9
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT:
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OWNER:
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ADDRESS-
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CITY'
DESCRIBE WORK:
NEW
REMODEL __ ADDITION
CONTRACTOR'S NAME
CENERAL:
STATE:
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QGIG5S
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New
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JOB NUMBER
225 Flflh Stroet
Springfield, Oregon 97477
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DEMOLISH
OTHER
TAX LOT:
SUBDIVISION'
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ZIP:
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ADDRESS
CaNST.
CONTRACTOR'
EXPIRES
PHONE
REQUIRED INSPECTIONS
~ Rough Mechanical - PrIor to
~ cover.
o Rough Electrical - Prior 10
cover.
o Electrical Service - Must be
approved to obtaIn permanent
electrical power.
o Fireplace - PrIor to facing
materIals and framing Insp.
o Framino - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Slove - After Installation.
o Insert - After IIreplace approval
and Ir:-tslallatlon of unIt.
o Curbcut & Approach - After
forms are erected but prior to
placement of concreto.
o Sidewalk & Driveway - After
excavatIon Is complete, forms
and sub.base material In place.
o Fence - Wtlen completed.
o Street Trees - When all required
trees are planted.
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ELECTRICA' . ~. -.t-.s t:'" I -ect ( ,- Ca. 1
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'2./B 'rJ~
- OFFICE USE -
QUAD AREA: -f:) Q s c.., LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS' ZONING CODE:_
OCCY GnOup:_ CdNSTR. TYPE: ____ . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call ~/26.3769. .rhis is a 24 hour recording. All InspectIons requested before 7:00 a.m. will be
made the salTle working day. inspectlons requested after 7:00 a.m. will be made the following work day.
o Temporary Eloctrlc
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electricall
Mechanical - Prior to cover.
o Footing - After trenches arc
excavated.
o
Masonry - Steel location, bond
beams. grouting.
o
Foundation - After forms are
crected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Under'loor Plumblng/Mochanical
_ Prior to insulatlon or decking.
I-I Po~;I and Buom - PrIor 10 floor
- Insulation or decking.
o Floor Insulation - Prior to
dockIng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to lilling
trench.
o Water Line - Prior to filling
trench,
o Rough Plu!T1blno - Prior to
cover.
o
Final Plumbing - When all
plumbIng work Is complet.e.
o Final Electrical - When all
electrical work Is complete.
r&t1 Final Mechanical - When all
l mechanical work Is complete.
'.'
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
.;'
o Blocking and Set.Up - Whon all
blocking Is complete.
"
o Plumbing Connections - When
home has been connected to
water and sewer.
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o Electrical Connection - When
blocking, set-up, ami plumbing
Inspections have been approved
and the home is connected to
the service panel.
.,
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,
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o Final - Aller all required
Inspections are approved and
porches, skirting, decks, and
ventIng have been installed.
Lot faces
Lot Ty.
Interior
Lot sq. Itg.
Lot coverage
Corner
,[
Panhandle
Topography
Total height
Cul.de.sac
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT,
Main
Garage
Carport
Total Val ue
Building Permit Fee
Slate Surcharge
Total Fee
(A)
P.L. HSE GAR ACC
N
Is
Iw
~---
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Setbacks
VALUE
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
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/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
co
IS'D
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.IS THE PROPOSED WORK IN THE
-- HISTORICAL DiSTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this applicatIon must be signed
and approved by the HistorIcal
Coordinator prior to permit issuance.
APPROVED'
This permit is granted on the express condition 1I1at tho said
construction shall, in [Ill respects, conform to the Ordinance
adopted hy the City or Springfield, including tile
Dovelopment Code. regulating the construction <ll1d use 01
bulldinns, :lnd may b(~ suspended or rcvoked at any time
upon violntion or any provisions of said ordinn/lces.
Plan Chccl< Fcc:
Date Paid:
Receipt Numbcr.
Received By:
Plans Reviewed By
Date
Systems Development Chargc is due on all undevclopcd
propcrties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully cXflmined
the complcted application and do hereby corti fy thai 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, amJ that NO OCCUPANCY will "bc made of any
structure wllhout permission of the Building Safety Division.
I further certify that only contractors and cmployccs who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all fCquired inspections arc
requested at the propcr time, that each address Is readable
from the street, that the pcrmlt card Is located at the front
of the property, and the approved set of plans will remain
on the site al all lInh"s during construction.
Signature ..lltJ ,,";'.1 /I~
II-q~L .
Date
VALIDATION: I _~
RECEIPT NUMBER 11 . ~
DATE PAID ~ hi :-),
AMOUNT REC D' r!-L~.' f'-.-)
RECEIVED BY _ V-Yl_ J