HomeMy WebLinkAboutPermit Mechanical 1995-5-18
RESIDENTIAL.
PERMIT APPLICATION
.
SPRINGFIELD
.
JOB NUMBER ~.o~~B
Inspecllons: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK: :::? /:52; LA2u~~_ If<! <' /:..5"'"
ASSESSORS MAP: J7--6~ <:>-/~
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ADDRESS' 7/5'0 /.At:..J}Z'?,A?" F5<<2./~
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DESCRIBEWORV' ~/,p ~"P ~ ,f/.?:~
LOT:
OWNER:
CITY'
NEW
REMODEL
BLOCK'
STATE:
~.A>.
ADDITION
DEMOLISH
OTHER
225 Filth Slreet
Springfield, Oregon 97477
TAX LOT: ,..., 4/-7/ ~
, r
SUBDIVISION'
PHONF'
ZIP: C?,?&"/?> ?
-<: s.- ~..7~
-
ADDRESS
CON ST.
CONTRACTOR'
PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
LL. .J'. <;<'.b.-e>/~~
MECHANICAL:h0?l'7~ / ~......":~ ~::>~",
ELECTRICAl.
QUAD AREA:
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER:
EXPIRES
~< ..2...;at;.~">
, r
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE: _
~q"C~ :::>-:>
FLOOD PLAIN: /J..
ZONING CODE: _ ~__
. OF BDRMS: ;~
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769, This Is a 24 hour recording. Afllnspectlons requesled 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
Slto Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbingl Electricall
Mechanical - Prior to cover.
o Fo'oUng - After trenches are
excavated. , '
o Masonry - Steel locatlon, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
pI acemen t.
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,
,"", "..... ....
o Floor Insulation .'''""Prlor'to'
decking,
o
......,..
Prior to filling
Sanilary Sewer -
trench.
o
Storm Sewer - Prior to ftlling
trench.
o
Water Line - 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 - ~rlor to facing
materials and framing Insp.
o Framing - Prior t~ cover.
o Wail/Ceiling Insulation - Prior to
cover. .
o Drywall - Prior to taping.
o Wood Stovo - After Instal/allon.
o Insert - After fireplace approvlll
. '. '.. . and Installation of unit.
\. '\ "" ,
Q 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.
D Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing wc;>rk Is complet.c.
D Final Eleclrlcal - When all
electrical work Is complete.
GEl
Final Mechanical - When all
mechanical work Is complete.
o
Final Building - When all
required Inspections have been
approved and building Is
completed.
OOthe'
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking is complete.
o
Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel-up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - Aller all required
Inspections are approved and
porches, skirtIng, decks. and
venting have been Installed.
Lot faces
Lot sq. flg.
Lot coverage
Topography
Total height
Lol Type'.
Interior
Corner
Panhandle
Cul'de.sac~
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT.
MaIn
Garage
Carpor~t
Total Value
Building Permit Fee
State Surcharge
Total Fee
"
(A)
, .,
, . ,,~, ~
ie THE PROPOSED WORK IN THE.
HISTORICAL DISTRICT, OR ON
THE HtSTORICAL REGISTER?
If yes, this application must be signed
and approved by the.. Historical
Coordinator prior to permit Issuance,
':', .
Setbacks
HSE GAR ACC
I P.L.
IN
Is
Iw
IE
VALUE
"
SYSTEMSPl=VELOP!'v1ENT CHAR.GE (SDC).;
.,
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
.
(B)
N'
(C)
Dryer Vent
Wood Stove/lnsertlFlreplace Unit
N'
Mechanical Permit
Issuance
State Surcharge
Total Permit
FEE
//J/ij.
/&7.-
t~- :p.,
<~ . <0
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
/"5: -
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is.granted on the ox press condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City ,of Sprlnglleld, including the
Development Code, regulating the construction and use of
buildings, and may be s.uspended or revoked at any Ume
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 undevoloped
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 cerllfy 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 pertaining to the work described
herein, and lhat 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 compliance 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 permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all .times during construction.
SlgnalureW'/) L$'dff/
Date ~'P /( /~
VAliDATION:
/ ?c/:7.'5"'
?""/9 -5' S-
AMOUNT RECEIVEfl '2~ - <~
~~---
,r
RECEIPT NUMBER
DATE PAIr>
RECEIVED BY