HomeMy WebLinkAboutPermit Mechanical 1992-7-21
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726,3769
Olliee: 726,3759
lOCATION OF pnOPOSED wont<' \ D~ ~
;SSESSORS MAP J)<oo.oLa.a4-
130.6' N.4,t /4.55
ADDnESS: /O.3~ A0'rizt-f''1
CITY S,/4'//[iltico__
LOT:
OWNER'
DESCRIBE WORK'
/4574 t'{
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
BLOCK'
,
STATr'
oP1'c:.
F 4t'~ $7..("" tJ/'Y /
(,AS
;/l'47t"'/f
, DEMOLISH
OTHER
.
q() 1001
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
m'JJU
SUBDIVISION'
PHONF'
7C/7-S09C/
ZIP'
'17V77
ADDRESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
~;}o? 'J j,->.-7
MECHANICA"
{P/!tf'dJ'/IY
/It''>'f~,w,
ELECTRICA' '
QUAD AREA: l$~\\:(\ ./
. OF BLDGS: ___,
OCCY Gnoup: ,u ____
. OF STORIES:
WATEn HEATER:
70S"1(S;-
17--7/-9'J-
3Y$/2y;/
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE: ___
HEAT SOURCE:
RANGE'
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspectlon, 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. lnspccllons rcqucs!ed after 7:00 a.m, will be made the following work day,
r I TClIlpormy Elcclrlc
D Sile Inspection - To be made
nfler excavation, Inll prior to
selling fOfms.
D
Undcrslab Plumbingl Electricall
Mechanical - Prior to cover,
D
Footing - After trenches are
excavated,
D
Masonry - Steel location, bond
beams, grouting,
[ 1 Foundation - Afler forms <He
crcclcll bul prior 10 concrete
placement.
D
Underground Plumbing - Prior
10 filling trench.
D
Underlloor Plumbing/Mechanical
_ Prior 10 Insulation or deckln!],
r 1 Posl and Beam - Prior 10 floor
Insulation or decldno,
D Floor Insulation - Prior to
decking,
D
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - Prior to filling
trench.
D Water line - Prior to lilling
trench,
o Rou{Jh Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
(r7T1 Rough Mechanical - Prior to
~ cover,
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp.
Cl Framing - Prior to cover.
r I WallJ Ceiling Insuli1tion - Prlor to
cover.
D Drywall - Prior to taping,
CI Wood Stove - After Irwtallatlon.
D Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms arc erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place,
D Fence - When completed,
D Street Trees - When all required
trees arc planted,
D
Final Plumbing - Wi,en all
plumbing worl< Is complcl,e,
D Final Electrical - Wilen all
electrical work Is complete,
D
Final Mechanical - When all
mechanical work Is complete,
o
Final Building - When all
required Inspections have been
approved and building Is
completed,
DOthor
MOBILE HOME INSPECTIONS
D Blocking and Set. Up - When all
blocking Is complele,
D Plumbing Connections - When
home has been connected to
water and sewer,
D Electrical Connection - When
blocking, set-up, and plumbing
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 TYP.
Interior
Lot sq, flg,
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
Main
Garage
Carport
Total Value
Building Permit Fcc
State Surcharge
Total Fce
(A)
Setbacks
P.L. HSE GAR ACC
. IS THE PROPOSED WORK IN THE
,- HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
N
~---
W
----
If yes, this application must be signed
and npprovcd by the Historical
Coordinator prior to permit issuance,
~~~,_._--_.
APPROVED:
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
N'
SanItary Sewer
FT.
Water
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
Slate Surcharge
Total Charge
(e)
MECHANICAL PERMIT
furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
fl
Demolition
Slate Surcharge
FEE
f,S .o~
/D.OU
&~:g
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (eXCluding electrical) .--<J...'l, '2"1
(A, B, C, D, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Ttlis permit is granted on Il1e express con,dition lIwt Il1e saki
construction shall, in all respects, conform to the Oldinancc
adopted by the Cily of Springfield. including the
Devcloprllcnt Code, fCHulating the construction anclusQ of
bullclings, and may be suspended or revoked ill any time
upon violation of any provisions of said ordinances,
Plan Cllcck Fcc:
Dale Paid:
Receipt Number:
Received By:
Plans Reviewed By
Dale
Systems Development Cllargc is due on ~lll undeveloped
properties within tile City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have cnrcfully cx?-mined
the completed application ,and do hereby certify that all
Information hereon is true and correct, and I fUrl her certify
ttlat any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and Ole Laws
of the Stale of Orenon pertaining to lhe work described
herein, ami that NO OCCUPANCY will 'be made of any
struclure willlOUI permission of the Building Safety Division,
I furl her certify that only contractors and employees who
me In compliance with ORS -'01.055 will be used on this
project.
I further agree to ensure lIlat all required inspl~clions arc
requested at the proper time, that each address is readable
from the strec~, at tlle permit card is located at the front
of the proper! a d the fJ:roved set of plans will remain
::~:::u:~o a~~esfJ;: 7:;J;___
Date 7 - 7-- / - '1 'J- '/7/
"
VALIDATION: t=:! ~
RECEIPT NUM[JER ,,' )CoW
If ( '{
DATE PAID "1 '('7... ,
AMOUNT fIECEI~ED _R......<; .l~
RECEIVED BY '(=>J{(j 'f}:.7'