HomeMy WebLinkAboutPermit Mechanical 1991-11-18
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RESIDENTIAL .,
PERMIT APPLICATION
SPRINGFIELD
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JOB NUMBER
Inspections: 726-3769
Office: 726-3759
225 Fifth Stleet
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: 616' 7
ASSESSORS MAP' I '~3'-~c;I'- /y
~ $"&' -lO
TAX LOT'
SUBDIVISION'
BLOCK'
LOT-
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OWNER:
ADDRESS'
STAT~'
CITY:
DESCRIBE WORK: ~k 10-,,-.;0-- ~~~ :~.........
NEW REMODEL Y ADDITION DEMOLISH OTHER
CONST.
ADDRESS ~~~ CONTRACTOR #
~;Z~ IN ~ ~_
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CONTRACTOR'S NAME
GENERAL:~""""~~~.,
7- . . . ..' -,;
P\-UMBING:
MECHANICAl'
ELECTRICAL' (~A'2:>4~J n~~
, ,
EXPIRES
PHONE
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- OFFICE USE -
LAND USF'
FLOOD PLAIN'
ZONING CODE:
QUAD AREA'
# OF BLDGS-
# OF UNITS:
CONSTR. TYPE:
OCCY GROUP:
# OF BDRMS'
# OF STORIES:
WATER HEATER:
HEAT SOURCE:
SECONDARY HEAT:
RANGE:
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.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Temporary Electric
D Final Plumbing - When all
plumbing work Is complete.
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Rough Electrical - Prior to
cover.
C!] Final Electrical - When all
erectrl~al work is complete.
[E] Final Mechanical - When all
mechanical work is complete.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D. Footing - After trenches are
excavated.
o Final Building - When all
required inspections have been
approved and building is
completed.
o Fireplace - Prior to facing
materials and framing Insp.
o
Masonry - Steel locatton, bond
beams, grouttng.
o Framing - Prior to cover.
o Other
o Foundation - After forms are
erected but prior to concrete
placement.
D Wall/Ceiling Insulation - Prior to
cover.
o Underground Plumbing - Prior
to filling trench.
D Drywall - Prior ~o ~aPlng.
MOBILE HOME INSPECTIONS
o
Underfloor Plumbing/ Mechanical
- Prior to Insulation or decking.
o Wood Stove - After installation.
o Blocking and Set.Up - When all
blocking Is complete.
D Post and B~am - Prior to floor
insulation or decking."
D Insert - After fireplace approval
and Installation of unit.
D Plumbing Connections - When
home has been connected to
water and sewer.
o Floor Insulation - Prior to
decking.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place.
o Storm Sewer - Prior to filling
trench.
o Fence - When completed.
o Water Une - Prior to 'filling
trench.
o Final - After all required
inspections are approved and
. porches, skirting, decks, and
venti ng have been installed.
o Street Trees - Whe"n all required
trees are planted. "
o Rough Plumbing - Prior tc?
cover.
Lot faces
Lot Type .
Lot sq. ltg, ~
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT.
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
'"
. 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.
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IN
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Setbacks
HSE GAR'ACCI
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VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
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Mechanical Pelmit /'IlIff.
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
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jl,PPROVED:
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 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.
Plan Check Fee'
Date Paid:
Receipt Number.
.Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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 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 State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 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~lathe ap~l:Jed set of plans will remain
on the site at ~es du~~con:r:"/? ~
SignatulP ..tlt1 ~.r7.u ......-
Date / (-I r - f /
VALIDATION:
RECEIPT NUMBER ~:" r~<
DATE PAID ..L/~/Iil-~ /
AMOUNT RECEIVED ./.:? $"&;>
RECEIVED BY /~~,
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