HomeMy WebLinkAboutPermit Mechanical 1992-4-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ollice: 726.3759
.
.
JOB NUMBER
CWf)s5\'
225 Fifth Street
Springfield, Oregon 97477
( J"'f-06
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ADDRES~<:;~/~ m ~~JJ1Jl1 r~A:rE'" ~b- ~
CITY _ \~! ) ZIP: ~7-1l7
DESCRIBE WOR~( vi Q nT -Pi ffi{J
NEW REMODEL ADDITION DEMOLISH OTHER
CONTRACTorrs NAME
GENERAl'
PLUMBING: ^ . () \
MEGHANICAL: 11.-<<111_10-'", A- J ~cSU-J
W.U_/fV r .
V
ELECTRICAl'
ADDRESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
r;3H2J0. \?st7~lfl
rYJ4it6) I n,l/I I,~
- lLkJ~klf-~:M
- OFFICE USE -
OUAD AREA' LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF UNITS: ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STOHIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG~' SQUAHE 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.
f I Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/Electricall
Mechanical - Prior to cover.
o Footing ~ After trenches are
excavated.
o
Mas'onry - 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 Plumbing/Mechanical
_ Prior to insulation or decking.
o Post and Beam - Prior to floor.
insulation or decking.
~ . . '.
o Floor Insulation -- Prior to
decking.
o Sanitary Scwcr - Prior to filling
trench.
o Storm Scwer - Prior to filling
trench.
o Watcr Line - Prlor.to filling
trench. . .
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
matertals and framing Insp.
o Framing - Prior to cover.
!
o Wail/Ceiling Insulat.lon ....:. Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After I~~tallation.
I
o Insert - After fireplace approval
and installation of unit.
D
~urbcut & Approach - Arter
forms are erected but prlor to
placement of concreto.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When cO~Pleted..
o Street Trees - When all required
trees are planted. ,
o
Final Plumbing - When nil
plumbing worl{ is complete.
D Final Elcctrical - When all
electrical work is complete.
ctJ
Final Mechanical - When all
mechanical work Is complete.
o
Final Building - Wtlen all
required Inspections have been
approved and building is
completed,
o Other
MOBILE HOME INSPECTIONS
o Blocking and Scl.UI) - Wilen nil
blocking is complete.
o Plumbing Connections - When
tlome tlas been connected 10
water and sewer.
o
Electrical Conneclion - When
blocking, set.up, anel plumbing
Inspections have been approved
and the home is connecteu to
the service panel.
o Final - After all required
inspectlons are approved and
porches, skirting, decks, and
venting have been installed.
"
Lot Typ. Setbacks
Interior ~HSE GAR ACC
Corner N
Panhandle ~-
Cul.de.sac W
.S 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 permil iSSllancc.
Lot faces
Lot sq. Itg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fcc
Slale Surr.harnc
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
,
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Waler
Storm Sewer
FT.
Mobile Home
Plumbing Permit
Slale Surcharge
Tolal Char~Jc
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Sloveflll~;erl/FircJJlacc Unil
Dryer Vent
Mechanical Penni I
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Curbeul
It
Demolition
Slale SUlchnrne
IE
VALUE
--_----!.
FEE
1 . Of)
lB.
().QU
. __ . ')CS
QI:') . j l~
Total Miscellaneous Permits (E) __,____
TOTAL AMOUNT DUE (excluding electrlcal,-{G.'J"'5
(A, B, C, 0, and E Combined)
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 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 Ctlcck Fee:
Date Paid:
Receipt Number"
Received By:
Plans Reviewed Oy
Dale
Systems Dcvcloprllcnl Cllmgc is duc on all undeveloped
properties within tile City limits which arc being improved.
ADDITIONAL COMMENTS
By slgnature,l state CIne! agree. that I have carefully examined
the completed application and do hereby certify thai all
information hereon is true amJ correcl, and I further certify
thnt any nnd all work pcrlorrned shall be done in f1GGold<lnGf~
wilh lhe Ordinances of Ihe City of Springfield. ;lIld Ihe Law~;
of lhe Stale of Orenon perlaining 10 the work described
herein, and Ihal NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I furlher certify lhal only contractors and employees who
are In compliance with QRS 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 '11 remain
on the site at allffi os during construction.
/- /
Signature _ ./ /h
Date y-Ii r/
VALIDATION:
L/235?
t.t'-~-'72-
AMOUNT RECEIV"" Z"S:"'/S-
~.;---
RECEIPT NUMOEf~
DATE PAID
RECEIVED BY
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