HomeMy WebLinkAboutPermit Mechanical 1992-8-20
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
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SPRINGFIELD
LOCATION OF PROPOSED WORK: __~~"Z-c:::.#A",<j.e:>/VE/V
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OWNER: p./A:E fv? #' /L?:Jj(Y
ADDRESS:~~~
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ASSESSORS MAP:
LOT'
BLOCK:
CITY'
STAT'"
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DESCRIBE WORK: ~
NEW /REMODEL
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ADDITION
CONTRACTOR'S NAME
GENERA' .
DEMOLISH
OTHER
.-
JOB NUMBER 9:30SI;aC'
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
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PHONE:
'7Lr;:;;:-~?>
ZIP:
ADDRESS
CONST.
CONTRACTOR .
PHONE
PLUMA1NG: _ _ .._____.________________._______
MECHANICAL: -e:zVw:~,c/",
ELECTRICAl'
QUAD AREA:
. OF I3LDGS:_
OCCY GROUP:____.____.
. OF STORIES:
WATER HEArER'
- OFFICE USE -
LAND USE:
. OF UNITS: ___,__.__
CONSTR. TYPE: ____
HEAT SOURCE:
RANGE:
EXPIRES
*"
FLOOD 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 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.
D Temporary Electric
D Site Inspection - To be made
after Cxc<1v<1tion. but prior to
sctlino forms.
D
Undcrslab Plumbing/Electrical!
Mechanical - Prior to cover.
D
Footing - Afler trenches arc
excavated.
o
Masonry - Sleel location, bond
beams, grouting.
o
Foundation - After forms arc
erectcej but prIor to concrete
placement.
D
Underground Plumbing - Prior
to filling lrenctl.
D
Underfloor Plumbingl Mechanical
- Prior to Insulation or decking.
D
Post and Bcam - Prior to.floor
insulation or dccking.
D Floor Insulation - Prior to
decl<ing.
o
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
D
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
r-Yt Rough Mechanical - Prior to
'AI cover.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain pcrmancnt
electrical power.
o
Fircplace - Prior to facing
lIwlcrlals nnd framing Insp.
o
Framing - Prior to cover.
D WallJCeillng Insulntion - Prior to
cover. .
D Drywall - PrIor to taping.
D Wood. Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcul & 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 Fenco - When completed.
D Strcet Trces - When all required
trees are planted.
D
Final Plumbing - When all
plumbIng worl< Is complet.e.
D Final Electrical - When all
electrical work is complete.
~
Final Mechanical - Whcn all
mechanical work 15 complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
DO'hcr
MOBILE HOME INSPECTIONS
D Blocking and Set. Up - When all
blocking Is complete.
,
D Plumbing Connections - When
home has beon connected to
water and sewer.
"
D Elcctrical Connection - When
blocking, sel.up, and plumbing
Inspections have beon approved
and the home Is connected to
the service panel.
"
is'
o'
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
Corner
Topography
Totai height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
Stale Surcharge
Total Fee
(A)
,. THE PROPOSED WORK IN THE
"-'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes. this application must be signed
and approved by (he Historical
Coordinator prior to permit issuance.
Setbacks
P.l. HSE GAR ACC I
N
..L-___
W
IE
VALUE
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residenlial Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
PlumbIng Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO 0_
Wood Stove/Insert/Fireplace Unit
Dryer Vent
MechanIcal Permit
Issuance
State Surcharge
Total Permit
(D)
I
MISCELLANEOUS PERMITS
Mobile Homo
State Issuance
State Surchargo
Sidewalk
It
Curbcut
It
Demolition
State Surchargo
Totaf Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
/-<t:>P
A;CJ>r?
/c?, t%'
.7-;-
'7 t:;:? S-
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Ttlls permit is granted on the express condition tllat Ihe said
constructlon shall, In all respects, conform to tilC Ordinancc
adopted by the City of Springfield, including the
Developmenl Codc, 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 Fcc:
Date Paid:
Receipt Numbcr'
Received By:
----+-
Plans Reviewed By
Date
Systcmn Dcvelopment Charye is due on all undeveloped
propcrUcs within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, th'at 1 have carefully cx?mincd
the complcted application and do hercby cCrliry that all
Information 11ercon is true and correct, and I furthcr certify
thai any and all work performed shall be done in accordance
wilh the Ordini:UlCCS of the Cily of Springfield. and the Laws
of tllC State of Oregon pert<1inlng to the worl( described
herein, and that NO OCCUPANCY will 'b(J made of any
structure without permisSion of the Building Safety Division.
I furtl1er ccrlify tl1al only contractors and crnployccs who
are in compliance with ORS 701.055 will bc used on this
project.
I furtllcr agree to ensure that all required inspections arc
requeslcd at the proper time, that each addrcss is readable
from the street, that tile permit card is locnted at lhe front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Signature r~l v11 ~
Date r r ). (),/ q 2--
VALIDATiON:
RECEiPT NIJMnEFI___.5-~7"5
1<?-2.,::;.-? 2.
AMOUNT RECElv~n '257'5-
~~
DATE PAIl"
RECEIVED BY
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