HomeMy WebLinkAboutPermit Mechanical 1994-11-3
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726-3759
.
LOCATION OF PROPOSED WORK' it3 (
ASSESSORS MAP' 17-p'2,~""3 ">, =<""::5
LOT'
-",4 C K <'a/7;Gr7
BLOCK'
OWNER' uJnl...Ac/r- I /J'h.t'r
ADDRE~<:' I.f -;;, / L.4c,e' <.t'J4P'/7
5'1/ t't::t7
CITY'
DESCRIBE WORt<.
r.
NEW REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAl' /-h::fevt:rr If 5~
ELECTRICAl'
(?'F<
QUAD AREA-
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:
~/J,17
STAT'" '
6Jr--
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JOB NUMBER
97"'/6'7/
225 Fifth Street
Springfield, Oregon 97477
Coo/,
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OS-?~=- N
.. TAX LOT:
SUBDIVISION:
PHONE:
7Lf7 17~r:,
ZIP:
97'-' ?
/h?o A'//-J r"d
ADDITION X DEMOLISH
"cr/sT//79
.5~5rl5n7
OTHER
ADDRESS'
CONST.
CONTRACTOR'
PHONE
Nth gtJ J?n..-A1' _
.t;".<;,"Mi :L.
EXPIRES
J.h6Nc.
,
7</e; ?~7/
7<// 22:1(;.
- OFFICE USE -
LAND USE:
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
FLOOO 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 belore 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
D SUe 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
.beams, grouting.
o Foundation - After forms are
erected.but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
-.Prlor 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.
o Water L1no - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough MechanIcal ~ 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
cove~ !
o Drywall - Prior to taping.
o Wood Stove - After I~stallatlon.
o Insert - After fireplace approvlll
and Installation of unit.
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.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbIng work is complete.
.. ,
D Final Electrical - V\l.hen all
electrical work Is complete. Co
rn Final Mechanical - When all
mechanical 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 - Whe/l all
blocking Is complete.
o PlumbIng Connections - When
home has been connected to '
water and sewer.
o Electrical Connection - When
blocking, set.up, and plun;Jblng
Inspections have beon approved
and the home is connected to
the service panel.
o Final - After al/ required
Inspections are approved and
porches, sklrttng, decks, and
ventIng have been installed.
,..
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total ~eight
. ~"\:~ "';"':':' \' .(" ',I : ;:..i~':~.t{~f
Lot ~y.
Interior
~S THE PROPOSED WORK IN THE _ '
'''HISTORICAL DISTRICT, OR ON .
THE HISTORICAL REGISTER?
tf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I 'PL.
IN
Is
Iw
IE
Setbacks.
HSE GAR' ACe' I
I
I
I
I
Corner
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT. ~ VALUE
Main
Ga(age
Carporl
Total Val ue
Building Permit Fee
State Surcharge
Total Fcc
'.
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
.
Residential Bath(s)
SanItary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
Wood Stove/Insert/Fireplace Unit
Oryer Vent
(B)
FEE
N'
FT.
FT.
FT.
(C)
N'
Mechanical Permit ~$' /$'~
lssuahce ? /t!?-
State :Surcharge r "?",, :~
Total Permit (D) 26.2-
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical) 26. ::?=
(A, B, C, D, and E Combined)
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'
Date Pa!d:
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 appilcatlon and do hereby certify that ail
Information hereon Is true and correct, and I further certify
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 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 compilance 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 pormlt card Is located at the front
of the property, and the approved set of plans will remain
on the Sl~ ~es during ~~Ctl~
Slgnature'--fY 7 '/T /
Dat~ ,II / ~ / q rf
VALIDATION:
RECEIPT NUMBER /..,.? ~.:::;;
DATE PAID //<:S~7''Y
AMOUNT RECEIVEn 7&. <.co
RECEIVED BY ~--: ':"~~~_~
v ~~ - ,.
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