HomeMy WebLinkAboutPermit Mechanical 1992-6-4
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: ...lin 0<6 L.a.JlJJA ,Vl'-d ~ f...-...' :
ASSESSORS MAP' I! 0:::;' 6- :77 '7 ~
("bl'lR.('.,E. Lllt.E.~f>c:~Q,ER,.
\ \cC)"i, ~o...'W~'(-'\~o.o
~"'~~l~ .--
LOT'
OWNER:
ADDRESS:
CITY:
BLOCK'
STATF'
OR.
-
'~B NUMBER q lD 7o;?f
225 Fifth Street
Springfield. Oregon 97477
-uJ}) f?-,
.-.=-
o I '7 C5CJ
TAX LOT-
SUBDIVISION'
'*
PHONE: 1t.jfp';'51il.fj
ZIP: _'1 '1tj11
r
DESCRIBE WORK: _r-.tl~ l='~~ :I:~*,,-\\~Ol\ ~,t}OO~IU:S '+' ",1:1/Dn f)_it> e.ondl'hOIlYj*'Ga.;
.~~ IJ)..~ /t'l:."TE.~ "$'1,000 ts't,l.I.
NEW REMODEL ADDITION DEMOLISH OTHER
CONTRACTorrs NAME
GENERAl'
ADDRESS
CONST.
CONTRACTOR N
EXPIRES
PHONE
PLUMBING:
MECHANICAL:c.D~OI-;- f\Q.O \.l,~~. ~'<>'511).\.~ 6U.Co.'\Q40?.
ELECTRICA' .
OUAD AREA"
. OF BLDGS:
OCCY GROUP:
. OF STORtES:
WATER HEATER:
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
00 ll.lLO
lR/,;n/f~ ~lJ:JrYI())
FLOOD PLAIN'
ZONING CODE: _
N 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.rn; will be made the following work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
selling forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o
Masonry - 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 Scwer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench.
o Watcr Lino - Prior to filling
trench.
o Rough Plumbing - Prior to
cover. -
REQUIRED INSPECTIONS
o Rough Mcchanlcal - Prior to
cover. ,
o Rough Elcctrical - Prior to
cover.
C". \
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.
o Wall/Ceiling Insulation - Prior to
cover. '
o Drywall - Prior to ~aping.
o Wood Stove - Afte,r Installation.
o Insert - Aher lire place approval
and Installation of unit.
o Curbcut & Approach - Aller
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, lorms
and sub.base material in place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. '
o
Final Plumbing - When all
plumbing work is complete.
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work is complele.
o Final Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel-Up - Wilen 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 approved
and the home is connected to
the service panel.
o Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
. .
....
Lot fncas
Lot TYP"
Interior
Lot sq. fig.
Lot covorage
Corner
Topography
Tolal height
Panhandle
Cul-de".sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
G.lIayc
Carport
, .
.
- ,
.
Total Value
Building Permit Fcc
Slale Surctlargc
Total Fcc
(A)
Setbacks
'HSE GAR
I :L
Is
W
ACC I
I
I
.S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Hislorical
Coordinator prior to permit issuance.
_L-___
APPROVED'
VALUE
J
..
SYSTEMS DEVELOP.MENT CHARGE (SDC);.
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
N'
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
Slate Surcharge
Tolal CI1:II{1C
(C)
MECHANICAL PERMIT
Furnace f ..+C H"'I'T
Exhaust Hood
Vent Fan
N'
Wood StovellnscrtJFlreplace Unit
Dryer Vent
_~ /l&fiCl:?
v~ Lt';(JZ; -
Mechanical Permit
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Homo
Stale Issuance
Stale Surcharge
Sidewalk
fI
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C. D. and E Combined)
FEE
J &."0
,"?C-O
2<>-0
( <[ e-e-
ID.D
. ~C]
77 . '6C)
"?7S0
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit-is-grantedon the express condition that the said
construction sha'll, h; 'al" res-peets, conform to !tie Ordinance
adopted by tlJc City .of 9Prir:-gricl'd,.- ~n<:luding the
Dcvelopment Code, rcgulating the construction ;lI1d use 01
buildings, ilnd may bc suspended, qr r,Ovokqd ilt any time
upon violation of any provisions of shid ordinances,
, Plan,:.Chgckgcc:
..
. -of.
.. ".; ; , ~
Date Paid:
Receipt Numbcr
Rcceived By:
Plans Reviewed By
Dale
~. 'Systems Oevclopl~ent Charge- ~is due on all undevelopcd
properties withi;' the Cit~ limits ~hich ~re b~ing improvc(l.
ADDITIONAL COMMENTS
By signature, I state and agree, Ihat I have carefully examined
the completed application and do hereby certi fy that all
information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the OrdinanclJs of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
slructure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance wittl ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspections arc
requested at the proper lime, that each address Is readable
from the street, that the permlt card is located at the front
of the property, and lhc ilPPloved set of plans ill remain
on the sito ajitll tun s dUflng con ruction.
Signature V
/,'1/
Date b ~...I--
VALIDATION:
RECEIPT NUMBER Lfq 0 q
DATE PAID to -L( -1 Z.
AMOUNT RECEIVED 2-7. 't' '3
f'J. JVtv^^SJ.-
RECEIVED BY
,