HomeMy WebLinkAboutPermit Mechanical 1999-6-10
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
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SPRINGFIELD
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JOB NUMB~R 94~ ;:>P-'
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225 Fifth Street
Springfield, Oregon 97477
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LOCATION OF PROPOSED WORK' 2/ <'"'6
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10 ~'7'&!:>
ASSESSORS MAP'
LOT'
BLOCK:
OWNER: ~AJ,e Y- I) /} ,J "..d J<..J
ADDRESS' /). IS-o /,() u rA :::T d:7,.,:5?
CITY:'':;',''''' P "'"l 'r .c/-e../d STAT'" c:J /2
DESCRIBE WORK' ,4 o.D fI>6::;....p ;Ji/ Fr'>J1?
NEW
REMODEL
r
ADDITION""-- DEMOLISH
OTHER
TAX LOT'
SUBDIVISION'
PHONE: .24 h - </--S::R ~
ZIP:
'97L(z7
ADDRESS
CONST.
CONTRACTOR .
EXPIRES ,'" PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL' :)arn....,..,. J~-I/;;C?
/
ELECTRICAl'
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER'
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
~L
~"
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONllARY 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 bo
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches arB
excavated.
o Masonry - Stee,l location, bond
beams, groutlng.~
D Foundation - After forms are
erected but prior to concrete
placemont.
D Undorground Plumbing - Prior
to filling trench.
!
O Underlloor Plumbing/Mechanical
- Prior to Insulallon or decking.
D Post and Beam + Prior to floor
Insulallon or, decking.
'.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Slorm Sewer - Prior to filling
trench. .
O Water Line - Prior to filling
trench. .
o Rough Plumbing - Prior to
cover. ~.
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 Insulallon - Prior to
cover. _'
D Drywall - Prior to taping.
o Wood Stovo - After InstaUallon.
o Insert - After fireplace approvel
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Drlvewav - After
excavation Is complete, forms
and sub-base material In place.
o Fence - \iVhen cOfl1pleted.
o Street Trees - Whun all required
trees are planted.
o Final Plumbing - When all
plumbing work Is complete.
, ,
D Final Electrical - When all
'---' rctrlcSI work Is complete.
czJ !:,~al Mechanical - When all
mec~~n!Cal 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 ~et;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 - After aU required
Inspecllons are approved and
porches, skirting, decks, and
ventlng have been Installod.
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1-" "\....... 1'. {\
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Lot-"{aces
"
Lot. sQ. Itg.
<.
L.ot coverage
Topography
Total height
BUILDING PER~IT 'I,
ITEM SO. FT.
Main
Garage
Carporl
Total Value
Building Permit Fee
State Surcharge
Total Fee
L~t'~yP'"
Interior
Corner
Panhandle ','
Cul.de-sac
\
;; '~
X $/ SO. FT.
(A)
"
i
.. THE PROPO~'ED WORK IN THE _
HISTORICAL DISTRICT, OR ON
THE HISTORiCAL REGISTER?
If yes, this Bpplfeatlon must be signed
and approved. by the Historical
. Coordinator prior to permit Issuance.
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Setbacks.
I PL. HSE I GAR ACe' I
I N I
Is'" I
W
----
E
VALUE
'.
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
FIxtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
FurnacQ
Exhaust Hood
Vent Fan
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permll
N'
FT.
FT.
FT.
N'
(B)
(C)
~
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
'.
FEE
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APPROVEP'
BuiLDIN'G VALiYE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition lhalthe said
constructlon shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Dovelopment Code, regulating the construction and use of
oulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date 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 carofully examined
the completed applicatIon and do hereby certify that all
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 perlalnlng to the work described
herein, and thai NO OCCUPANCY will be made of any
structure without permission of lhe Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all r~qulred 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'~74Z
Slgnatur~ If ~
Date
?-?o- 9f
VALIDATION:
RECEIPT NUMBER ? ~"9:2
DATE PAID ~__.a~<9f!.
AMOUNT RECEIVED ~ 2e>
RECEIVED BY ~....-'l~
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