HomeMy WebLinkAboutPermit Mechanical 1994-4-7
OWNER:-J!L c;/Vm ,~A;J cI
ADDRESS: ~/...!:>- C:> .l-llfiY'-11 5' T 51 Ace ,p 2 I )
CITy:_5rff'Jj{Jf f-/cL- ~ STATE: e>J?e
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DESCRIBE WORK: 1't7 ~ l~'_ ^~L ~,1~l_~ 1 \, I J A/l fb.IfV-..l'l"dh'r/V1 0,'_
NEW REMODEL ADDITION X- ~OLlSH
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726-3759
ASSESSORS MAP'
LOT:
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
.
SPRINGFIELD
.5'1
BLOCK'
OTHER
. .
J'OB NUMBER~ OLfId1_
225 Fifth Street
Springfield, Oregon 97477
5'/:)1'1 Ge-
I
-:it.J/3
04 L/ ()(J
TAX LOT'
SUBDIVISION'
, PHONE:
7t(7-J.'IS/
ZIP:
97'117
I
L' Wed f+L.,..(l2
ADDRESS
CONST,
CONTRACTOR #
PHONE
MECHANICAL:
I
COMm~rCIAL
Ail?
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C" ''t I~ D ('II<;-' en WI.... ."" 37r." "'1;)0 Jql..{
o '
L..j 101 -LtfO!
ELECTRICA' '
EXPIRES
'- OFFICE USE - .-
QUAD AREA' LAND USE: FLOOD PLAIN: 1b
# OF BLDGS: # OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR, TYPE: # OF BDRMS: ~
'"
# OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' AANr-a:::. 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
o Site Inspection - To be made
after excavation, but prIor to
settIng forms.
o Underslab Plumbing/Electrical/
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.
D Underground Plumbing - PrIor
to filling trench,
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
insulation or decking,
D Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. . .
O Water Line - Prior to filling
trench. ' "-
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
, 0 Rough Mechanloal - Prior to
cove~ '
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtai n permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover. .
o Drywall - Prior to taping,
o Wood Stove - Alter l~stallatlon.
o Insert - After fireplace approval
and Installation of unit.
o Curbout & Approaoh - After
. forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and 5:ub.base material In place.
D Fence - When completed.
o Street Trees - When 'all required"
trees are planted. ,
o Final Plumbing - When all
plumbing work Is complet,e.
o Final Electrical - When all
electrical work Is complete.
~al Meohanlcal - 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 Blooklng 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, set-up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
o Final - Alter all required
inspections are 'approved and
, porches, skirtln'g, decks, and
venting have been,installed,
Lot faces
Lot Type .
InterIor
Lot sq, ltg,
Lot coverage
Corner
Topography
Total hel ght
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
~THE PROPOS~D WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
: I
Setbacks
I P.L HSE GAR ACC I
IN
Is
Iw
IE
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT,
Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplaoe Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
IC"QO
In no
I~
d<: ,/~
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
i
i
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 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 carefully 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 Ordlnanoes 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
struoture 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,
Signature
: I
Date
'-1- J -Cjt-{
VALIDATION:
19/qq
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c\G),
RECEIPT NUMBER
DATE PAI['\
AMOUNT RECEIVEP
RECEIVED BY
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