HomeMy WebLinkAboutPermit Mechanical 1996-1-16
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT:
.
SPRINGFIELD
BLOCt<'
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ADORE""" \'~~ ----......'\()S\ \ l ~
CITY:, ~~ \} l\
DESCRIBE WORK: ~\:') \ i-.A\Q
NEW - REMO~E~i.... \ - ADDITION
OWNER:
CONTRACTOR'S NAME
GENERA' '
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.
.
Q\olI'Jd)
JOB NUMBER
225 Fifth Street
Sprlnglleld, Oregon 97477
SUBDIVISION:
PHONE: \4\0 . ffiRl n
('t""
STATF' WJ(( j ZIP: en4 -II
) ) C\Cl.b \ f\[j) it) c1C\.b \J..M J' ~W J.
~MOLlSH OTHER '- \
-'
ADDRESS
CONST,
CONTRACTOR'
PHONE
:~c::~~1IDN~~ rn_~'~ui ?it
ELECTRICA' ' ~
QUAD AREA'
. OF BLDGS'
OCOY GROUP:
I
. OF STORIES'
WATER HEATER:
~
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE: _
EXPIRES
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE: ,____
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, All Inspections requested before 7:00 a,/n, wIll be
made the same working day, Inspections requested after 7:00 a.m. will be made the followIng work day.
REQUIRED INSPECTIONS
"~U9h MechanIcal - Prior to
LJLJ ~~ver.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Elaclrlcal1
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Sleel location, bond
beams, groutIng.
D Foundatfon - After forms are
erected but prior to concrete
placement.
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.
D Rough Plumbing - Prior to
cover.
D.Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover. .
o Drywall - Prior to taping,
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation Of unit.
o Curbcut & Approach - After
forms are erected bllt prior to
placement of concre~te.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub.base materIal In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing worl< Is complete.
, ,
D Final Electrical - When all
electrical work is complete.
r-n F'~chanlcal - When all
~;~~"~i~al work Is complete.
o Final Building - When all
required Inspections have been
approved and bUlld:Iwn Is
completed.
, ..fjff I'J
~hcr d -v '
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
vcntlng have been installce!.
I
Lol TY.
Lot faces
Lot sq, ltg,
Inlerior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-dc.sac
BUILDING PERMIT
ITEM
SO, FT,
X $/SO, FT,
Main
Garage
Carport
Tolal Value
Building Permit Fee
Slate Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
Drxe~ Xeot./ . _ LJ, \1.0 J\l.n c.{)
C\M \.U\Qf11\l)lLlfVJ)JtL~ -,S,_
Mechanical Jermit I IS, Ul)
lO.OO
d)[~
(B)
PLUMBING PERMIT
ITEM
Fixtures
ResidenUal Balh(s)
N'
Sanitary S~wcr
Water
FT.
Storm Sower
FT,
FT,
Mobile Home
Plumbing Permit"
Stato Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertJ Fireplace Unit
Issuanco
'State Surctlarge
""\ 3lV
..Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
.Cu~bcul
Demolition
It
State Surcharge
I PL,
IN
is
Iw
IE
VALUE
"
FEE
Total Miscellaneous Permits IE)
TOTAL AMOUNT DUE (excluding.electrical) c5l1.o~
(A, B, C, D, and E Combined) ,
.'
.....\
, :'(;i \,~
.' 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.
Setbacks
HSE GAR ACC
APPROVED:
BUILDING VALUE, 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:
Datc Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Developmenl Charge is due on all undeveloped
properties within 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 Ordinancus of the City of Springfield, and Ihe Laws
of the State of Oregon pertainIng to the work described
herein, and that NO OCCUPANCY will be made .01 any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance wllh ORS 701,055 will be used on this
project.
I further agree 10 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 roperty. 8Jld the approved set of plans will remain
on t Ie at -all l~nfS d~ng construction.
ro#~
t-/~-~~
D te
VALIDATION:
RECEIPT NUMBER 2n 0 7 ~
DATE PAID I. I (/7' C{ CtJ )
AMOUNT RECE~ED i c;{)( 0 . ::JL
RECEIVED BY - W~,'
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