HomeMy WebLinkAboutPermit Mechanical 1992-10-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
LOT:
OWNER'
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ADDRESS:
CITY'
.
SPRINGFIELD
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JOB NUMBER 32 J L..f 3 LJ_
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
(")11(')0
SUBDIVISION:
PHONE:
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ZIP: l'7 J. '71
DESCRIBE WORt<.
NEW REMODEL.--/
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OTHER
ADOITION
CONTRACTOR'S NAME
CENERA' .
DEMOLISH
ADDRESS
CONST.
CONTRACTOR #
EXPIRES
PHONE
PI.UMBING:
MECHANICAL: (i~<<lt-)lA' t:\OW ~eo1'M ~55 \,0, IS-t8lclQ.r&.. ~'lt1D;)' 004/p0
,
ELECTRICAl.
~b.'7/93 3q,;l-g,oJ
- OFFICE USE -
QUAD AREA: _5 LAND USF. FLOOD PLAIN.
1/ OF SLOGS- # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BORMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
selling forms.
D
Underslab Plumbing/Electricall
Mechanical - Prior to cover.
D Footing - After trenches are
excavaled.
D
Masonry - Sleel location, bond
beams, grouting,
D Foundi:ltion - Afler forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing/Mechanical
- Prior 10 Insulation or deckinG.
D Post and Beam - Prior to floor
Insulation or decking,
D Floor Insulation - Prior to
decking.
D
Sanitary Sewer - Prior to filling
trenctl.
D Storm Sewer - Prior to filling
trench.
D Water line - Prior to filling
trench,
D Rough Plumbing - Prior to
cover,
REQUIRED INSPECTIONS
[Z] Rough Mechanical - Prior to
cover. .
D Rough Electrical - Prior 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/Ceiling Insulnt,ion - Prior to
cover. :
o Drywall - Prior to laping.
I
D Wood Stove - Afte,r installation.
,
D Insert - After fireplace approval
and Installation of unit.
D
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub.base mater,lal In place.
D Fence - When completed.
,
D Street Trees - Wtl(~n all required
trees are planted. :
D
Final Plumbing - When all
plumbIng work Is complete.
o Final Electrical - When all
electrical work is complete.
[d"Final Mechanical - When all
mechanical work Is complete.
D Final Building - Wilen all
required inspections have been
approved and building is
cornplete(l.
DOlher ~.JJ~
MOBILE HOME INSPECTIONS
D Blocking and Sel-Up - When all
blockIng is complete. .
D Plumbing Connections - Wilen
home has been connected to
water and sewer.
D
Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home is connected 10
the service panel.
D
Final - After nIl required
Inspections are approved and
porctlcs, skirting, decks, and
venting have been installed.
Lot faces Lot Type. Setbacks .S THE PROPOSED WORK IN THE
I P,L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
Lol sq. ltg. Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corne r Is 1 If yes, this application must be signed
and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Tolal height Cul-de-sac i
~~-~ APPROVED:
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT.
VALUE
Main
Garage
Carport
Tolal Value
Building Permit Fee
Stale Surcharge
Tolal Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) ,
,
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Balh(s) NO
Sanitary Sewer FT.
Waler FT.
Storm Sewer FT.
Mobile Horne
Plumbing Permit
Slate Surcharge
Tolal Charnc
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertJFlreplace Unit
Dryer Vent
Mechanical Permit
TY\.AtYV
Ie:; nO
/(),OO
Ie:::
.as~
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
lt
Curbcut
II
Demolillon
Slate Surcharge
Total Miscellaneous Permits (E)
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 that the said
construction shall, in all respects, conform to the Ordinance
ado pled by the Clly 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 Fec'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Developlncnt Charge is due on all undeveloped
properties within the City limits which arc 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 wllho~t permission of the Building Safety Division.
I further certify Ihat only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensurc that all required inspections arc
rOQuested at the proper time. that each address is readable
(rom the street, that the permit card is located at the (ronl
of the properly, and the approved set of plans wi remain'
on tho site ~t all til S during construction.
Slgnature)< .:A....
\
Date I 4'
VALIDATION:
RECEIPT NUMBER (.,.LjIP'i
DATE PAIl' 101 '::>"\&1";),
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AMOUNT RECEIVEO
RECEIVEO BY