HomeMy WebLinkAboutPermit Mechanical 1992-2-3
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT:
-.
SPRINGFIELD ".
BLOCK'
M~I~)5
l~sr
OWNER' f:)rr A/' J
ADDRESS' - 1'36 '3
~ftd
CITY:
DESCRIBE WORK'
1jo-. ""
~~
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' .
PLUMBING:
MECHANICAl'
ELECTRICA' .
STATF'
O~
.
JOB NUMBER
qz,o 107
ADDITION
DEMOLISH
OTHER
225 Flflh Slreel
Spring ficici, Oreoon 97477
TAX LOT:
SUBDIVISION'
f) ?.,~ () '2-
pHON~'
74- G, -363:)
ZIP:
17'1-77
ADDRESS
CONST,
CONTRACTOR'
PHONE
EXPIRES
- OFFICE USE -
OUAD AREA' LAND USF' FLOOD PLAIN'
. OF BLDGS' . OF UNITS' ZONING CODE:
OCCY GROUP: CONSTR. TYPE: . OF BDRMS:
I . 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.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Undcrslab PlumbinglElectricalJ
'Mechanical - Prior to cover.
o
Footing - After trenches are
excavated.
o
Masonry - Sleel roeation, bond
beams, grouting.
o Foundation - After forms arc
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: \ .
- - -- - - - \ ' , ~
Prior to
o Floor Insulation -
decking.
... ~ .
,
-"
o
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench.
o
Water Line - PrIor to filling
trcnc~.
o Rough Plumbing - Prior t~
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prior to facing
materials and framlng.lnsp,
o
Framing - Prior to cover,
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After installation.
Q Insert - After fireplace approval
. " and installation of unit.
,.
W Curbcut & Approach - Afler
-- r. 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 311
plumbing work Is complete.
o Final Electrical - When all
electrical work is complete,
o Final Mechanical - When all
mechanical work is complete.
o Final Building - Wilen all
required Inspections have been
approved and building is
completed.
'.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Wilen all
blocking Is complete,
o Plumbing Connections - When
home has been connected 10
waler and sewer.
o Electrical Connection - When
blocking, set-up. and plumbing
inspections have been ;'lpproved
and Ihe home is connected to
the service ponel.
o
Final - After all required
Inspections are approved and
P9rchos, skirting, decl<s, and
venting have been inslalled.
Lot fiJCUS
LotTY.
Lot sq. fig,
Interior
Lot coverage
Corner
TopograpllY
Panhandle
Total helgl11
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT, X $/SO. FT,
Main
Garage
Carpor!
Total Value
Building Permit Fee
Stale Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
SiJn i lary Sewer FT.
Water FT
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surclmrgc
Total Ctlarge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertl Fireplace Unit
Dryer Vent
~Y'_"'- L~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
Curbcut
II
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, 0, and E Combined)
I P.L
IN
Setbacks
._ IS THE PROPOSED WORI< IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
,?oordinator prior to permit issuance.
HSE GAR Accl
I
2-___1
IE
W
----
APPROVED:
VALUE
FEE
1;::'_00
i6.6b
,n .6/)
':1h
2J7,7 IS
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permi! is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by tile City of Springfield, including the
Development Code, regulating the consl,ruction and use of
buildings, and may be suspended or revoked ilt any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipl Number.
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within ttlO City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stale 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 certlry
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and Ihe Laws
of the State of Oregon perlaining to the work (Iescribed
herein, and 1I1al NO OCCUPANCY will be made of any
structure without permission of the Building Safely Division.
I further certify tlwt only contractors and employees who
are In compliance Witll ORS 701.055 will be used on ttlis
project.
I further agree 10 ensure that all required Inspections arc
requested at the proper lime. that each address is readable
from the street, that the permit card is located at the front
of the property n thit'lfap: v d set of plans will remain
on the site at II ti _e ~n.
Signature 1J, -
Date',
7~ -' ; -~ :7
VALIDATION:
RECEIPT NUMBER ~ c.p C:>
Z -3-CJL
AMOUNT RECEiVED 2-6-7 t')
~
DATE PAID
RECEIVED BY