HomeMy WebLinkAboutPermit Mechanical 1996-1-22
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
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SPRINGFIELD
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JOB NUMBER
225 Flflh Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK:
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ADDRESS' '2~2.""3 - ~RA? ~ ~
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DESCRIBE WORK: ,.w~~ ~..1C"::; ;9~_7 ~v~ 7?~~~/~'~A?
ASSESSORS MAP:
LOT'
OWNER:
CITY'
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL~~';
ELECTRICAl'
BLOCK'
STATE:_~~ ,
DEMOLISH
OTHER
TAX LOT' /:')/2~
SUBDIVISION:
~'
PHONF'
726 - 3"B-::r~
ZIP'
"'7'77' /-7
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ADDRESS
CONST,
CONTRACTOR'
PHONE
EXPIRES
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C/b:$', "?'"'~
- OFFICE USE -
QUAD ARE..' LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS' ZONING CODE:_
OCOY GROUP' CONSTR. TYPE: . OF BDRMS:
I
. OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' 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
D Site Inspection - To be mado
after excavation, but prior to
setttflQ forms.
D Underslab PlumblnglElectrlcalf
MechanIcal - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting,
D 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.
o F_I~or Insul.~t1ory - Prior to .
decking, "-
, ': .
o Sanitary Sewer-~ Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover,
,
REQUIRED INSPECTIONS
!Kl Rough M~anlcal - Prior to
cover. C?~
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power,
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wallle'alllng Insulation - Prior to
cover. .-:.
D Drywall - Prior to laplng, ,
. ....-
D Wood Slovo - After Installation.
D Insert - After fireplace Bpprov~1
and Installation of unit.
"
D Curbcut & Approach - Aller
forms are erected but prIor to
placemont of concro,te.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in placc,
o Fence - When completed.
D Street Treos - When all required
trees Bre planted.
D
Final Plumbing - When 011
plumbing wprk is complet.c.
D Final Electrical - When all
electrical work is complete.
"
~ Final Mechanical - WIlcn all
m$);1 work is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
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MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up. Llnd plumbing
Inspections have been approved
and the home Is connected to
the servIce panel.
D Final - After all required
InspectIons are approved and
porches, skirting, decks, and
ventlng have been Installed.
Lot faces
Lot TY.
Interior
Lol sq, ftg,
Lot coverage
Corner
Topography
Panhandle
Total helghl
Cul-do.sac
BUILDING PERMIT
'..'ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
Total Value
BullcJing Permit Foe
State Surcharge
Total Fcc
(A)
I P.L.
IN
Is
W
..L
VALUE
"
SYSTEMS, DEVELOPMENT CHARGE (SDC)
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/'//~f' -, .?5~
T -V~
;?6
P.
_~, A:::;>
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenlial Bath(s)
N'
Sanitary S~wcr
Water
FT.
FT,
Storm Sower
FT.
Mobile Home
Plumbing Permit'
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace tf/0E
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
~
, State Surcharge
..Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
.Cur.bcut
. Demolition
ft
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excludlng.electrlcal)
(A, 8, C, 0, and E Combined)
"
FEE
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.,' 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
HSE GAR Accl
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APPROVE['I'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is gr.anted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by Ihe City ,of Springfield, including the
Developmen"t'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 Fcc:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
, Systems bevelol?,menl Charge Is due'on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
8y signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and J further. certify
that any and all work performed shall be done In accordance
with the Ordinances 01 the Clly of Springfield, and the Laws
of the Stale of Oregon perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure wllhout permission of the Building Safety Division.
J 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 lime, that each address 15 readable
from the street, that the permit card Is located at the front
of the property, Il{Id the approved set 01 plans will remain
on the site at all times during construction,
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Date / - --. ~ q /'
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VALIDATION:
RECEIPT NUMBER ::2.::::v3.::=>
DATE PAIr' /~ 22-"'%
AMOUNT RECEIVED yc;;;;,::;>c:=o-
RECEIVED 8Y A--~
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