HomeMy WebLinkAboutPermit Mechanical 1994-9-23
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726.3769
Office: 726-3759
.
LOCATION OF PROPOSED WORK: \ 7,.4 <(-
ASSESSORS MAP: \1 03 ~ Z2-
Lor
BLOCK'
'.
.-
QL{'(41l
JOB NUMBER
22S Fifth Street
Springfield, Or
r...J-
TAX LOT'
SUBDIVISION:
, PHONE:
7?.J/J -0'1 {b
OWNER'
ADDRESS'
CITY'
L---t> (j ,tALI
I 7 ~0 V \ rJ
Sot;]
M 1 +cG..JI
1/1 lA., '\ C::j-
q7i.{77
L'j)Q i\A.<;'-:6. &tafil\V1 --r qiAS -h'Y'f 0 ~ ac.-€. -+- H--w ~ ,/
/I ,.
DESCRIBE WORK'
~v.. <;
o
NEW
REMODEL
PHONE
STATE:~
ADDITION
, DEMOLISH
OTHER
ZIP:
ADDRESS'
CONST,
CONTRACTOR'
CONTRACTOR'S NAME
GENERAl'
PLUMBIW"
MECHANICAL:~N\.Q.v1 r-aAA611S ~plj-iC/IlLp bliS' l-Lil~
ELECTRICAL:
771oz...1
EXPIRES
,W/3J!q4 qc;.t-I./Ur..
- OFFICE USE -
QUAD AREA' LAND US'" FLOOD PLAIN:
· OF BLDGS' · OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR, TYPE: · OF BDRMS'
· OF SlORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SQUARE FOOTAGE:
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 aame working day, Inspections requested alter 7:00 a,m, will be made the following work day,
D TemporarY Electric
D Site Inspection - To be mado
after excavation, but prIor to
setting forms.
D Underalab PlumbIng I Electrlcal/
'Mechanical - Prior to cover,
D Footing - After trenches are
excavated, ' :
D Maaonry - Steel location, bond
,beams, grouting,
D Foundation - Mier lorms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to /lllIng trench,
D Underlloor Plumblng/Mechanlcal
- Prior to Insulation or decking,
D Poat and Beam - Prior to 1I00r
Insulation or decking,
D Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench,
D Storm Sewer - Prior to filling
trench.
D Water LIne - Prior to filling
trench,
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
l<v1' Rough Mechanical --:. Prior to
~over.
D Rough -Electrical - PrIor to
cover.
o Elactrlcal Servloe - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to lacing
materials and framing Insp.
o FramIng - Prior to cover..
I
D Wall/Celllng InsJlatlon - Prior to
cover.
o Drywall - Prior to taping,
D Wood Stovo - After Installation,
,{I
O Insert..." After fireplace ap~rov.1
and Installation of unit,
O Curbcut & Appro~'~'h - After '
forms are erected bltt prior to
placement of concretb., -,
D Sidewalk & Driveway - After
excavation Is completo. forms
and sub.base material In-place.
D Fence - When completed.
','
D Street Trees - When all required
trees are planted. .
o Final Plumbing - When all
plumbing w9rk Is complet,e,
D Final Electrical - w.hen all
electrIcal work Is complete. C
~ Final Mechanical - When all
~echanlcal work Is complete.
D Final Building - When all
required Inspections have been
approvad and building Is
completed. '
~ Other C;~ 6", J r-
MOBIL!; HOME INSPECTIONS
D'BIOCkl~g and Set.Up - When all
blocking Is complete, ,
DPI~1T!61~g Connectlo~s - When
home. bas -been connected- to
water"-snd',s"ewer. '"., '
. ,..'-:.~'" .
, '
,
,,'
'. 0 Electrical C'oiinectlon - When
, blocking, set.up; and pluroblng
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
~'
Lot faces
Lot Type
Interior'
Lot sq, ftg,
Lot coverage~~
r<s'...,.'.,
Topograp~y:': ---:-
I 'j ,
Total height
;' ,"'1"
(,,'/
Bu'f~DIN'G PERMIT
-
ITEM SO, FT,
Corner
Panhandle
Cul.de,sac
/.
,
,
.
X $/so, FT, ~
Main
Ga(age
Carport
Total Value
Building Permit' Fee,
)3.tate:Surcharge
_ . . '". . Total F6e, .'
, ..
:..;;....
(A)
. '", "':'\1,~'
Setbacks,
HSE GAR ACe' I
. .~.
I
I 'P.L.
IN
Is
Iw
IE
VALUE
"
\
\,
SYSTEMS DEVELOprJJ'ENT CHARGE (SDCf
(B)
PLUMBING PERMIT,
ITEM
Fixtures
.
Residential Bath(s) N'
Sanitary Sewer FT,
, Wafer FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Venl Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
( ,/ r
/~ l!ZA f t..-tJ'/T ~
~~ /~
Mecha!llcal PermIt
lssuahce
State'Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
II
II
Curbcul
Demoiltlon
State Surcharge
FEE
.h1?MJ,
/ )"0(#
10,DO
. 'IT
, ;!J-
'? /:. :L. (Q
Total MIsceilaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) ~ 2.,0
(A, B, C, 0, and E Combined)
.S THE PROPOSED WORK,tN THE, '
'''HISTOI:lICAL DISTRICT, OR ON
....THE HISTORICAL REGISTER?
if yes, this appilcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance,'
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construcllon shail, In all respects, conform to the Ordinance
adopted by the City ,of Springfield, including the
Development Code, regulallng the construcllon 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 wliich are being Improved,
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefuily examined
the completed appilcallon and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work perrormed 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 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 pproved set of plans will remain
on the site at all tI e" dU~ construction.
~ature ~ A"-
t-;;3 -f~
Date'
VALIDATION:
RECEIPT NUMBER j l/? LI ~
c; >/....7 -1 ~
AMOUNT RECEIVEn '~~. "Zb
~
DATE PAin
RECEIVED BY