HomeMy WebLinkAboutPermit Mechanical 1998-4-21
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: / (od ~
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ASSESSORS MAP'
LOT'
OWNER'
ADDRESS'
CITY'
DESCRIBE WORK'
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA' .
PLUMBING'
MECHANICAl'
ELECTRICAl'
/tr:/tl.V6f ~P~I't(; to.
QUAD AREI"
"
. OF BLDGS:
OCCY GROUP'
· OF STORIES'
WATER HEATER"
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
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 Boam - Prior to floor
Insulation or decking.
D Floor Insulation - PrIor to
deckl ng.
D 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.
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BLOCK-
,
9)(7) If 7 ()
JOB NUMBER
225 Fifth Street
Springfield, ore~
TAX LOT: ~
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SUBDIVISION'
. PHON~'
7 <{f# - 5'~ ss
STATF' .
(!)~E6-0tJ
ZIP'
'i 7 <.(..77
(!) F h E4T- /J) (,.) n(,a
DEMOLISH
OTHER
ADDRESS'
CON ST.
CONTRACTOR .
EXPIRES '=' PHONE
(1-0 e.s /V(/fJc6c-I <N"....,
EtJ6-6Vc (!)tf' 97'1tJ3
REQUIRED INSPECTIONS
D R~ugh M~chanlcal - Prior to
cover.
D Rough Electrical - Prlor'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 Wall/C'elllng Insulation - Prior to
cover.'
D Drywall - Prl.or to taping,
D Wood Stovo - After I~stallatlon.
D Inser. - After fireplace approvlll
and Installation of unit. .
D Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation ,Is .complete, forms
and"sub-base material In place.
D Fence.-- When completed.
D Street Trees - When all required.
trees are planted. . .
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RANGE: '. ~~. NO,!,
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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. ".Y11l be made the following work day.
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
D FInal Plumbtng - When all
plumbing work Is complet.e.
D Final Electrical - When all
electrical work Is complete.
~nal Mechantcal - When all
mechanical work Is complete.
D Final BUilding - When all
required Inspections have been
approved and building I.
completed.
DOthor
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
bl~cklng Is complet,e.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
btocklng. set.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 faces
Lot sq. ftg.
Lot coverage
Topography
Total height
BUILDING PERMIT "1
ITEM SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
"",',:1'
. l ' ,
Lotlyp
Interior
Corner
.
Panhandle'
Cul-de'sac
(-:
".il .t
X $/SO. FT. a
Setbacks .
I
I. IS THEPROPOSED WORK IN THE.
'--HISTORICAL DISTRICT, OR ON
THE HISTORtCAL REGtSTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
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I P.L. HSE GAR Acc'l
IN I
S I
W I
IE I
VALUE
"
(Al
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S!3wer
Water
Storm Sewer
Mobile Home
Plumbing Perml!
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
FT.
FT.
FT.
(C)
Dryer Vent
Wood StovellnsertfFlreplace Untl
N'
Mechanical Perml!
Issuance
Stale Surcharge
Total Perml!
Mobtle Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
fl
ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Perml!s (E)
FEE
.,:;"
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\';"'
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.'~'
"
#/51
.$-/0_
_7c;-+.~
1L2r..~
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0,' and E Combined)
APPROVEP'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition thai the sold
constructlon shall, In all resp~cts, conform to the Ordinance
adopted by the Clty.of Springfield, Including the
Development Code, regulatlng the construction and use of .
buildings, and may be suspended or revoked at" any time
upon violation of any Prc:lVlslons of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge Is duo on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carefully examined
the completed application and dO,hereby certify that all
Information hereon Is true and cor~ect, and I further certify
that any and all work performed shall be done In accordance
with the Ordlnanc~s of the City of Springfield, and the Laws
of the State of Oregon pertaining to tho work described
herein, end that NO OCCUPANCY will be made of any
structure without permission of the Building Sefety Division,
I furth.er certify that only contractors and employees who
are In compliance with ORS 701.055 wilt be used on this
project.
I further agree to ensure that all required Inspectlons are.
requested at the proper time; that oach address Is readable
Irom the street, that the permit card Is located at tha front
01 the property, and the approved set of plans will remain
on the site p;_~~:~ d'P~":;'-"'truc~03' /or1.-.
~Ignature N--dVVI.-Y .~ (;1J~ ZO~
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VALIDATION:
RECEIPT NUMBER d7f'73
,J.f-;)r' '71
AMOUNT RECEIVEr, JJ:2&. ~
<K~
DATE PAt",
RECEIVED BY