HomeMy WebLinkAboutPermit Mechanical 1994-4-15
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD "
LOCATION OF PROPOSED WORI"_m 5986
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ASSESSORS MAP'
LOT.
OWNER:
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Kalmj",
BLOCK.
ADDRESS:
5986 Kalmia,
Springfield
Springfield, OR 97478
STATF.
OR
CITY'
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.-
JOB NUMBER q4fJ51 f)
225 Fiflh Street
Springfield, Oregon 97477
TAX LOT:. (')~('f")
SUBDIVISION:
PHONE:
74~ 492(1
ZIp.
97478
NEW
REMODEL
ADDITION
Install heat DumD (add to existina heatina RVRtp.m~
DESCRIBE WORK:
CONTRACTOR'S NAME
GENERA' '
DEMOLISH
OTHER
ADDRESS
CON ST.
CONTRACTOR d
EXPIRES
PHONE
PLUMBING'
MECHANICAL: rnmTn"" ~l.ow...Heati.ng_855_W-.-~i~~:?
ELECTRICA' .
nn4Rn
R/?7/q4
, .
14? -81 n1
- OFFICE USE -
QUAD AREA: LAND USF' FLOOD PLAIN:
P OF BLDGS: d OF UNITS' ZONING CODE:_
OCCY GROUp. CONSTR. TYPE: d OF BDRMS:
p OF STORIES. 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 same working day. Inspections requested after 7:00 a.m. will be made the following work day.
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(~ovef.
D Rough Electrical - Prior to
cover.
o Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/ElectricalJ
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o
Masonry.. - Steel location, bond
beams,.grouting.
o
Foundation - 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 - Prlor 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.
o Water line - Prior to filling
trench.
o Rough Plumbing - 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 Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
.0 Wood Stove - After installatlon.
o Insert - After fireplace approval
and installation of ur:it.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
D Fence - When completed.
D Street Tr~es - \I\Ihen all required
trees arE:.' planted.
o
Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When at!
electrical work is complete.
dFinal Mechanical - When all
~echanical 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 - 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
inspections have been approved
and the home is connected to
the service panel.
o Final - Arter all required
inspections are approved and
porches, skIrting, decks, and
venting have been installed.
Lot" faces
Lot Type .
.
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.
Lot sq. Itg.
Interior
Setbacks
, ,
P.L HSE GAR ACC
Lot coverage
Corner
N
Topography
Total height
Panhandle
S
--
E
W
----
APPROVEr>'
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
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 StovellnsertlFlreplacc Unit
Dryer Vent
Mechanical Permit
isCS,CO
to ,CO
"0
N'S . rrs
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)01<~ ..1}.5
(A, B, C, 0, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shalf, 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'
Dalo 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
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 cerlify
that any and all work performed shall be done in accordance
wittl 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 QRS 701.055 will be used on this
proiect.
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 approved set of plans will remain
on the site at all times during construction.
Signature ~.~. (l/7/1LzJ
. II ~-
Date () tJ -1.'7 -4fj
VALlDATtON: .\ i\ ~ n
RECEIPT NU4R _. b~) \ - I
DATE PAID . f...'i'Cff
AMOUNT R~ ~'.?-~
RECEIVED .(~-