HomeMy WebLinkAboutPermit Mechanical 1991-9-20
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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LOCATION OF PROPOSED WORK:
.ASSESSORS MAP:
LOT'
OWNER:
ADDRF"'''''
CITY:
DESCRIBE WORK'
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' '
PLUMBING'
MECHANICAL:
ELECTRICAl'
.
SPRINGFIELD
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ADDITION
DEMOLISH
OTHER
.
JOB NUMBER ---.9 ) I 100
225 Fifth Street
Springfield, Orogon 97477
TAX LOT:
SUBDIVISION-
(') /....I '-I DO
PHONE:
/ ';;lfo -7-:JS:3
ZIP:
ADDRESS
CONST,
CONTRACTOR'
PHONE
EXPIRES
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~s..c:; 'w. /51.$./"31 _ "'6,,,
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.:... OFFICE USE -
QUAD AREA' ' LAND USF' FLOOD PLAIN-
. OF BLDGS: . OF'UNITS' ZONING CODE:
OCCY GROUP: CONSTR, TYP'" . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER- RANGE: SQUARE FOOTAGE:
To roquost an Inspection, you must call 726-3769. This Is a 24 hour rocording. All inspections requested bofore 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.
'I
Ii
II
I
o
Underslab Plumbingl Electrical!
Mechanical - Prior to cover.
o Footing -.After trenches are
excavated.
o
Masonry - Steel location, bond
beaf'!ls, grouting:
D Foundation - After forms are
. erected but prior to concrete
placement.
I
o
Underground Plumbing - Prior
to filling tronch.
o
Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
o
Post and Beam - Prior "to floor
Insulation' or decking. "
o Floor Insulation - Prior to
docking.
o Sanitary Sewer - Prior to filling
trench.
O Storm Sewer - Prior to filling
trench.
o Wetor L1no - Prior to filling
trench.
"
I,
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 - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover. ~
o Drywall - Prior to ta'ping.
o Wood S~ove - After insta.J1J~ti~n.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to"
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-I?ase material In place.
o Fence - When completed.
o Street T~~es - Wrien"all required
trees are planted. ,
o Finel Plumbing - Whon all
~um~ngwo~lscom~Ma
[2(J" Final Electrical - When all'
~rical work i~omprete. .
+'..t.vvni-l "l<e~L.{i ..-e.,Q
lZ 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 SOI.Up - Whon all
blocking is complote.
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 all required
Inspections are approved and
", .porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot Type .
Lot sq. ftg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
BUILDING PERMIT
tTEM so, FT. X $/SO. FT.
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
. 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
HSE GAR ACC I
I
I P.L.
IN
Is
Iw
IE
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldontlal Bath(s)
N'
Sanitary Sewer
FT.
FT.
FT.
Water
Storm Sewer
Mobllo Homo
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
>>()iJ
Q~
MeChanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobllo Homo
State Issuance
Stato Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eloctrical)
(A, B, C, D, and E Combined) '.
FEE
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APPROVED'
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
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 Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
horein, and that NO OCCUPANCY will be mado 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 f plans will r main
on the site at all,tlmeAfu~g co ructlon.
Signature:" -W
/'1--lo !J/
Date....
VALIDATION:
RECEIPT NUMBER
DATE PAIr>
2.\3"'1
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AMOUNT RECEIV"n,
RECEIVED BY