HomeMy WebLinkAboutPermit Mechanical 1992-6-4
I
! RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: 1t.4tJ'0 1-11 IAII/1
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ASSESSORS MAP:
LOT'
OWNER'
ADDRESS'
CITY'
BLOCK'
STATF'
01\
-
~~B NUMBER ii?b 793
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
o I SOD
SUBDIVISION'
PHONE:
'l4'1~q,9g'
~'
ZIP'
'I 7'Y 7'1
DESCRIBE WORK:
11ll~"'P. u... bl\S FOf.,J\)A-e.e:.
~ 000 :b'ru,'s
OTHER"
NEW
REMODEL
CONTRACTOR'S NAME
ADDITION
DEMOLISH
ADDRESS
CONST,
CONTRACTOR #
EXPIRES
PHONE
GENERA' '
PLUMBING'
MECHANICAL: _C:~~O'-\- ~\o.,.) \\~i-.~ 'loSS \i), \>'" f,~
ELECTRICAl'
OUAD AREA:
. OF BLDGS'
OCCY GROUP'
. OF STORtES:
WATER HEATER'
oel(<-ll
- OFFICE USE -
LAND USF'
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
)
ftb.'1ft;a,.
.-'
_'1'1.~ - f I ~.L
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. 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.
o Temporary Electric
o Sito Inspection - To be made
tIfter CXCuvHlion, but prior to
setting forms.
o Underslab Plumbing/Eleclricall
Mechanical - Prior to cover.
o Fooling - Atter trenches are
cxcavalCd.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - Atter torms are
erected but prior to concrete
pI acemcn l.
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
Sanllary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover. '
o Rough Electrical - Prior 10
.cover.
o Electrical Service - Must be
approved to obtaIn permanent
electrical power.
o Fireplace - Prior to taclng
materials and lramlng Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulailon - Prior to
cover. I
o Drywall - Prior to taping,
o Wood Stove - After Installation.
o Insert....;. After lire place approval
and installation of unit.
o Curbcut & Approach - Alter
torms are erected but prior to
placement of concrete:
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place.
o Fence - When corrpleted.
I
,
o Street Trees - When- all required
trees are planted.
o
Final Plumbing - When all
plumbing work is complete.
o Final Electrical - When all
electrical Walk is comph..!,lc.
o Final Mechanical - Wilen all
mecllanlcal work Is complete.
o Final Building - Wilen all
required inspections have been
approved and building Is
completed.
DOlher
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking is complete.
o Plumbing Connections - When
home has been connected 10
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbIng
inspections have been 3pprovcd
and the home is conneclcd to
the service panel.
o Final - Atter all required
Inspections are approved and
porches, skirting, decks, and
venting have been Install eel.
Lot r.1ces
LOI sq, IIg,
Lot coverage
Topography
Total heigllt
BUILDING PERMIT
,s~. ~r.
ITEM
Main
Garage
"
. .
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
-
Lot Type I
Interior
Corner
Panhandle
Cui-de-sac
X $/SQ, FT,
. ,".
(A)
Selbacks
I PL. HSE GAR ACC
IN
_L...___
W
----
I E I I
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDCk"-:
(B)
PLUMBING PERMIT
ITEM
Fixtllles
Rcnidcntial B;]lh(s) NO
Sanitary Sewer FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
FT,
FT,
(C)
Dryer Vent
Wood Stovelln~.crtJFilCpli1cc Unll
N'
Mcclwrlicnl Permit
lsuuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
OIAto SLlrohnrgQ
Sidewalk
II
Curbcut
II
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
-l;JJ)~
IO,C)D
\/0
2YJ,10
?A.,t?
/
/
.> THE PROPOStfo WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coollllnator prior 10 permit issuance.
\
APPROVED:
~
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit ls gra,,,ted on the express condition that the said
construc'tio;; shall"in all.res6e'cts, conforin H) 'the Ordinance
adopled by .the 'S;jly' 01 ,Springfield, :including tile
Development Code, regulating ttie constr.uction and use of
buildings, and may be suspen9~d 9r. !~volt;cid at any time
upon violation of any provisions of said ordinances.
." Plan ~Check. FCQ:,
Dale Paid:
Receipt Number"
Received By:
Plans Reviewed By
Dale
-
.Systems bC~~IOpfnen)Cllarge. is.du,?on"..all undeveloped
properties within the City limits which <He being improved.
ADDITIONAL COMMENTS
By signature, I state and agrec, thai I have carefully examined
the completed application and do hereby certify lllat all
information hereon is true and correct, and I further certHy
that any and all work pedonned shall be done in nccordance
Wltll the Ordinances of the City of Sprinuficld. find lhe L:IW:.
of the Stnle of Ore~lon pertaining to the WOlI( dc:>clibcd
l1~rcin. and thnt NO OCCUPANCY will be rrl:Hle 01 :my
structure without perrlli~:~.ion of the Buildinu Safely Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on nlis
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 will remain
on the site at al')Jr':/ dUrl~g con. struct7n.
Signalllro. ~~,,~
Date eft'. {--j'- 9J.-
VALIDATION:
RECEIPT NUMBER L.{. q 0 OJ
b -~ 4 Z-
DATE PAID
AMOUNT RECEIVED __?::fJ:7!3
(0VV ,..
RECEIVED BY