HomeMy WebLinkAboutPermit Mechanical 1997-12-29
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK' /2$1./
ASSESSORS MAP' \f)O~~c::..~
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LOT' , , . " BLOCK'
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DESCRIBE WORK: U ~~ S \ ~ I J\ nQ('(L.... a. \l\\)\ J\()\
NEW REMODEL (\, AD ~ON ' ' DEMOL~H ~ER
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OWNER'
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ADDRESS:
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STATF'
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CITY:
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JOB NUMBER Q ~ \ ~ lJJL
225 Fifth Slreet
Springfield, Oregon 97477
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SUBDIVISION'
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PHONE:
7Y7- O:z.S"'O
ZIP'
ADDRESS
CONST,
CONTRACTOR'
EXPIRES '" PHONE
'V077c - OFFICE USE -
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To request an Inspection, you must call 726.3769. This Is a 24 hour recof<i!lng. Alllnspecllons requested before 7:00 a.m. will be
made the same working day. Inspections requested after 7:00 8.m. will be made the following work day.
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL: ..ffi/7<l'" 1!--7/ /k...l'!.;;;;" Jf ~/"""
ELECTRICAl' . I
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'&YlrAI
QUAD AREA:
. OF BLDG~'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
.0 Temporary Electric
REQUIRED INSPECTIONS
~U9h MW:'dn:l"n ;r~rlor to
cover. ~~\~
D Rough Electrical - Prior to
cover.
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Eleclrlcal/
Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Footing - After trenches are
excavated.
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Sleel location, bond
beams, grouting.
o Framing - Prior to cover.
o Foundation - After forms are
erected but prior to concrete
placement.
o Wail/Ceiling Insulation - Prior to
cover.
o Underground Plumbing - Prior
to filling lrench.
o Drywall - Prior to taping.
o Underlloor Plumblng/Meehanleal
- Prior to Insulation or decking.
o Wood Stovo - After Installation.
D Post and Beam - Prior to floor
Insulation or decking.
o Insert - After fireplace approv41
and Installation of unit.
o Floor Insulation - Prior to
deckl ng.
o Curbcut & AI>proach - After
. forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - PrIor to mUng
trench.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub.base material In place.
o Water Line - PrIor 10 filling
trench.
o Fence ~ \Nhen conlpleted.
D Rough Plumbing - Prior to
cover.
D.Street Trees - When all required
trees are planted.
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FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
o Final Plumbln9 - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work Is complete.
~I Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed,
E:J 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, sel,up, and 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
venting have been Installed.'
, Lot~yP_ \-",
,'; .,
Lot faces
Lol SQ. Itg. Interior I PL
IN
Lot coverage Corner
Topography Panhandle \ Is
Iw
Total hel ghl Cul-de.sac IE
BUILDING PERMIT:"'}; '~
ITEM sa. FT. x $/so. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
(A)
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
N'
Sanitary S!3wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Perml t
Issuance
Slale Surcharge ,,3%
Tolal Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slate Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
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'nrv
+ {,'LO
J!.(O,QD
rJ(o.2J.U
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_S THE PROPOSED WORK'IN THE _
~"HISTOI'iICAL DISTRICT, OR ON '
THE HISTORICAL REGISTER7
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Selbacks .
HSE GAR ACe' I
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APPROVED'
BUILDING vAuk PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on lhe express condition lhallhe said
construction shall, In all respects, conform to the Ordinance
adopted by the Cllyof Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked al any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
I
Dale
Systems Development Charge Is due on all undeveloped
properties within tile City limits which are being Improved.
,
ADDITIONAL COMMENTS
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By signature, I slale and agree, lhall have carefully examined
lhe compleled application and do hereby certify lhat 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 lhe Laws
of the Slate of Oregonperlalnlng to the work described
herein, and lhal 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 lhe streel, lhat lhe permit card Is localed at the front
of the property. and the approved set of plans will remain
On the site at all times during constructlll". , ~
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, Ignature / L/d~.A7// ?7./../~
! Date /2 -;>q-4< {7
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VALIDATION: A. c::....
RECEIPT NUMBER rl... y;~~)
, i)' /
DATE PAID I ~ ' ,-;.. Lf . C( J
Aln, i):[)
RECEIVED BY