HomeMy WebLinkAboutPermit Mechanical 1994-5-25
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOT:
OWNER:
ifardtl-r;~ do (
/II"} \" I6M.JMr,'.{t'-
9!r~ J ;j/~U
~r-h.do-
ADDRESS:
CITY:
.
SPRINGFIELD
BLOCK'
STATE:
{),~
--I~(t.-~
{/ DEMOLISH
NEW
REMODEL
acto
tI
ADDITION
DESCRIBE WORK'
CONTRACTOR'S NAME
GENERAL'
PLUMBING:
MECHANICAL: 6d..f), 1>>(;
ELECTRICA' ' /
1ft.......
(/
OUAD AREA'
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER'
OTHER
.
C44{Y~l
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:C>ld--lW
SUBDIVISION:
PHONE: ?~-f'lSl
,.
ZIP:
9 'l '17 7
ADDRESS
CONST,
CONTRACTOR'
EXPiRES
PHONE
1/;;'07 tv -s/] &; ,
-J(J )'Lh-
bu- ~N
3 </<f -..:J f( j/J
- OFFICE USE -
LAND USF'
. OF UNITS:
CONSTA. TYPE:
HEAT SOURCE:
RANGE: ___
FLOOD PLAIN'
ZONING CODE'
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you must call 726.3769. This is a 24 hour recording. A!1lns;Jections requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made tne fol:owing work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Eleclricall
Mechanical - Prior to covel.
o Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o
Foundation - After forms arc
erected but prior to concrete
placement.
o
Underground Plumbing - Prier
iC filling tr~;1ch.
o
Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or decking.
o
Floor Insulation - Prior to
decki ng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
D Water Line -. Prior to filling
trench.
o
Rough Plumbing ~~ Prier 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.
D Wall/Ceiling Insulation - Prior to
cover.
n
,--,
Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - After fireplace approval
and in$tal1ation of unit.
o Curbcut & Approach - After
forms arc erected but prior to
placement of concrete.
D
Sidewalk & Drivc\\IClY - After
excavation is complete, forms
and sub-base material in place.
o
Fence - When completed.
o Sheat Tre~s - V'./I.cn ~Il r;;!qutred
trees [lrt) p!<,u1ted.
o Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work is complete.
-rt/( Final Mechanical - When all
1AI 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 approvcd
and the home is connected to
the servIce panel.
o Final - After all required
inspections arc approved and
porches, skirting, decks, and
venting have been Installed.
Topography
Total height
Panhandle
Setbacks
I P,L, HSEIGAR ACC I
N I I
-- I
S
.
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.
Lot faces
.
Lot Type
Lot sq, ltg,
Interior
Lot coverage
Corner
Cul.dc.sac
W
E
- --..---.. -----
APPROVE['\'
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
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.
Garage
Carport
Plan Check Fce:
Date Paid:
Total Value
Receipt Nurnuer"
Building Permit Fee
Received By:
State Surcharge
Total Fee
(A)
Plnns Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential 8ath(s)
N'
Sanitary Sewer
FT,
Water
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
Aurnace
Exhaust Hood
MECHANICAL PERMIT
(~t'U11
(i; (p..;JCJ
Issuance
{... AO VS ~
,~ -l0~
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify thaI 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 Slate of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safely Division.
I further certify that only contractors and employees who
arc in compliance with ORS 701.055 will be used on thls
project.
Ven t Fan
N'
Wood StovellnsertlFireplace Unit
Dryer Vent
Mechanical Permit
State Surcharge
Total Permit
(D)
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, thai 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.
Signature~4 a,;(
OS-' .,::l3- Y''T
Date
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
~~
VALIDATION: () 0 I ~
RECEIPT NUMBER \ Jj\ l(.1J
DATE PAID _ ~,9-7(,. 'L... '
AMOUNT RE~ ~~ n. A I:l.lj od.()
RECEIVED BY t= ~
State Surcharge
Total Miscellaneous Permits (E)