HomeMy WebLinkAboutPermit Mechanical 1993-8-10
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
LOCATION OF PROPOSED WORt<'
ASSESSORS MAP:
LOT'
OWNER'
ADDRESS:
CITY:
DESCRIBE WORK:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA' '
.
SPRINGFIELD
BLOCK'
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DEMOLISH OTHER
STATE:
.
JOB NUMBER ~I
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
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PHON'"
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ZIP:
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ADDRESS
CONST,
CONTRACTOR'
EXPIRES
PHONE
PLUMBING'
MECHANICAL:~" 6ay-!lr.... /PE-'tJ,
ELECTRICA" {J'/).~II'o;j;.lSJJfe.
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?oS~S
Id/93
31/(j-..)~J
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR, TYPE: . OF BDRMS'
. OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SQUARE FOOTAGE:
To request an inspection, you must call 726-3769. This Is a 24 hOllr 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 Underslab Plumbing/Electricall
Mechanical - Prior to cover.
o Footing - After trenches arc
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o Underlloor PlumbinglMcchanical
_ Prior to insulation or decking.
o Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trenctl.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
~ough Mcchanical - Prior to
cover.
~OU9h Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - PrIor to facing
materials and framing Insp.
D Framing - Prior to cover.
o WalllCeiling Insulation - Prior 10
cover.
o Drywall - Prior :0 taping.
o Wood Stove - After installation.
D Insert - After fireplace approval
and installation of unit.
o
Curbout & Approach - Afler
form:; arc erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
o Fence - When ccmpleled.
o Street Trees - VoJhen all required
:rces me nl,mlecl.
~nal Plumbln9 - When all
plumbing work Is complete.
~inal Electrical - When all
. electrical work Is complete.
o Final Mechanical - 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 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, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - Alter all required
inspections me approved and
porches, skirting, decks, ~lnd
ventIng have been installed.
....
Lot faces
Lot Type
Lot sq, ltg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.dc-sac
BUILDING PERMIT
ITEM
SO, FT.
X $/SO. FT,
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential 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
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrical)
(A, B, C, D, and E Combined)
.
I IS THE PROPOSED 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.
Setbacks
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APPROVED'
VALUE
FEE
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25,/~
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopled by the Cily 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:
Receipl 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
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By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify Ihat all
information hereon is true and correct, and I further certify
lhat any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the Stale of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division,
I further certify that only contractors and employees who
arc in compliance with CRS 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.
Signatu~~ ~~
Dalo 91,0IOJ?'
VALIDATION:.
RECEIPT NUMBER
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY