HomeMy WebLinkAboutPermit Mechanical 1996-6-18
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORI<"
ASSESSORS MAP: /~t') 2
LOT:
.
SPRINGFIELD
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00
4eo/
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BLOCK'
OWNER:-1-.lII?:;=r/- D~,t veL ~ )
ADDR~""" 4-&0/ cJA,~~ A'~,
CITY: 'l..Rr~~(C::-r~. STATE:
DESCRIBE WORK: ~
7;P~r:-<
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL:_~ /, IJ~ r
PLUMBING' L: h lit,. ~
MECHANICAl' L:::;' /.,.; s
ELECTRICAl'
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JOB NUMBER
9?' /'") ~/3
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225 Fifth Street
Springfield. Oregon 97477
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TAX LOT'
SUBDIVISION:
~ 2. 5 t!7Z)
PHONE:
7~ - -f7"?'1
ZIP:
977'-7~
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DEMOLISH OTHER
ADDITION
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t' .,
CONST,
ADDRESS 91.,,,... CONTRACTOR'
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EXPIRES PHONE
/t'-t'9~:L-C<;>9-ra2
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- OFFICE USE - -~
QUAD AREI" ,.~AND USE:_ -- FLOOD PLAIN:
· OF BLDGS: . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769, This Is a 24 hour recording. All Inspections requesled 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.
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
O Footing - After trenches are
excavated.
O Masonry - Steel location, bond
beems, grouting.
O Foundetlon - 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 Sanllary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water LIne - Prior to filling
trench. .
19r Rough Plumbing - Prior to
~cover. _
REQUIRED INSPECTIONS
-r==:;c( Rough Mechanical - Prior to
~.
~RoU9h Electrical - PrIor to
~er.
o ElectrIcal ServIce - Must be
. approved to obtain permanent
electrlcaf power.
o Fireplace - Prior to facing
materials and framing Insp.
~ramlng - Prior to cover.
I:5<r Wail/Ceiling Insulation - 'prior to
,/ ~ver.
~ryWall - Prior tO,taplng,
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unll.
O Curbcut & Approach - After
forms are erected but prIor to
placement of concrete.
O Sidewalk & Driveway - Alter
excavation Is complete, forms
and sub-base material In place,
o Fence - When completed.
o Street Treos - Wh~n all ,required
trees Bre planted.
~Flnal Plumbing - When all
~umblng worl< Is complete.
~Flnal Electrical - When all
~Iectrical work Is complete.
'f;7f Final Mechanical - When all
~echanical work Is complete.
'f;;;7( Final Building - When all
~equlred Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set,Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
waler and sewer,
o Electrical Connection - Wh'en
, blocking, set.up. and plumbing
Inspections 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.
Lol faces
Lot TY.
Lot sq, ftg,
Interior
Lot coverage
Cornor
Topography
Total height
Panhandle
Cul.de.sac
',:
. IS THE PROPOSED WORK IN THE
'''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setb,cks
I PL. HSE GAR ACC
IN
/S
\W
IE
BUILDING PERMIT
ITEM SQ, FT, X $/SO, FT _ VALUE
Main
Garage
Carport
~ "0x~r
Total Val uc
Building Permi t Fee
State Surcharge 9. ~> -r 5.7'7
'Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
2..
Residential Bath(s)
N'
Sanitary S~wer
Water
FT
Storm Sewer
FT.
FT
Mobile Home
Plumbing Permit
State Surcharge
/. -t- .,,~
(C)
Total Charge
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
I
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
.#?,r~
Issuance
State Surcharge I
7..)"1'-, -iF
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
"
Demolition
State Surchargll
.
.Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
'.
..
Y~~-'h)
..- /
Ir3.~
,
7/1 & -;if-'
FEE
'? /.) t:>oD
/.~
:2/.6(7
4- .)0
:?,.tHJ
/s-~
LO,~
1,.20
2h2,D
25/~ .2.1
APPROVED: .
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted o"n the express condition that the said
construction shall, In" all respects, conform to the Ordinance
ado pled . 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
Dale
Syslems Development Charge Is due on all undeveloped
properties within tile City limits which are being Improved,
ADDITIONAL COMMENTS
.Jff7J/~~14 ;PW4?1^"J,/= Ilj/
p..u~
By signature, I stale and agree, Ihat I have carefully examined
Ihe compleled application and do hereby certify that all
Information hereon Is true and correct, and I further cerllfy
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, and Ihat NO OCCUPANCY will be, made of any
structure without permission ot 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 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 lhe front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Slgna~~~
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Date r. - /%'-7....-
.J<.
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
2. 2.:::J~ ~
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