HomeMy WebLinkAboutPermit Mechanical 1995-10-11
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
ASSESSORS MAP'
LOCATION OF PROPOSED WORK: 2. 7/ 7
176)3 ~
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LOT.
OWNER.
ADDRESS:
CITY.
DESCRIBE WORK'
NEW ~ REMODEL
CONTRACTOR'S NAME
GENERAL: ;l-wi/'7 / ,Sl.,)
PLUMBING:
MECHANICAl.
ELECTRICAl.
BLOCK.
STATE: _/.?~
t'
.,.
fi-{l",
.
9S/Co~o
ADDITION
DEMOLISH
OTHER
JOB NUMBER
225 Flflh Slreet
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:
~/f 00
PHONE:
77<7- _?.;;;, ),3
ZIp.
*
ADDRESS
CONST.
CONTRACTOR'
crt::, ~ 2.
.yU'/~7 7~-7'-:-;77
REQUIRED INSPECTIONS
~ Rough Mochanlcal - Prior to
~cover.
K:;7( 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 ,?over.
o Wall/Cefllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fIreplace approve I
and Installation of unit.
o Curbcut & Approach - After
.forms are erected but prior to
placemont'of concrete.
o Sidewalk & Driveway - After
~xcavatlon Is completc, forms
and sub-base material In place.
o
Fence - When completed.
--f6~t') b?~
EXPIRES PHONE
'.
- OFFICE USE -
QUAD AREA: LAND US". FLOOD PLAIN:
. OF BLDGS: . OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BORMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER. RANGF. SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons 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 Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumblng/Electricall
Mechanical - Prior to cover.
o
Fooling - 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 tloor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior 10 filling
trench.
o
Storm Sewor - Prior to filling
trench.
o
Water line. - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
o
Street Treos - When all required
trees are planted.
o
Final Plumbing - When all
plumbIng w9rk Is complet.e.
~ Final Electrical - When all
electrical work Is complete.
~Inal Mechanical - When all
~ ~echanlcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building is
completed.
~Other &A:r;
4~.
L/&M'
"~V/I'"e-
MOBILE HOME INSPECTION~
o Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
tJ Electrical Connection - When
blockIng, set-up. and plumbing
. Inspecllons 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
.ventlng have been installed.
, . .' : '.:'~ . :...
Lot ~pe. q '. _S THE PROPOSED WORK IN THE,
Lot faces Setbacks
I P.L. , . , ACC I HISTORlqAL DISTRICT. OR ON
Lot sq. fig, Interior HSE GAR
IN I THE HISTORICAL REGISTER?
Lot coverage Cqrner Is I II yes, this application must be signed
Topography Panhandle and approved by the Hi~torlcal
Iw I Coordinator prior to permit Issuance.
Total height Cui-dc-sac
IE I APPROVED:
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT,
VALUE
Main
Garage
"
Carport
Total Value
Building Parmi t Fee
~tate Surcharge
Total Fee
(Al
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
/:)?/LJ,
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unil
Dryer Vent
.4~ ~f7L
.H4 .".;_
JC~
/ C; .<>-0
/ ,::U)
2.&; .2. '"
Mechanical Permit
Issuance
State Surcharge I 7 r.,.. / "I' J
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
State Surcharge
Total Miscellaneous Permits (E)
0J5 ZoO
TOTAL AMOUNT DUE (excluding electrical) '_
(A, B, C. 0, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thai the said
construction shali, 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 al any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number'
Received By:
Plans Reviewod By
Oate
Systems Development Charge Is due on all undeveloped
properties within thn 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
arc In compliance with ORS 701.055 will be used on this
project.
I further agree 10 ensure that all required Inspections are
requested at the proper time, thai each address Is readable
from the street. that the pormlt card Is located at the front
of the property. and the approved set of plans wlll remaIn
on the sIte (j~I~ times during constoc}'o~
~nature {!jJmJ1J[) , /YIJ.r1tU
Datp
VALIDATION:
RECEIPT NUMBER
DATE PAIl"
AMOUNT RECEIVED,
/"7 2C? 3
/;.y-?~r
'7 /'~ ,?-O
;#~
'~. 1
RECEIVED BY