HomeMy WebLinkAboutPermit Mechanical 1995-11-6
RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726.3769
Orfice: 726.3759
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SPRINGFIELD .1.,1... ,
LOCATION OF PROPOSED WORK: _::2' C)7#
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ASSESSORS MAP: /7?!?-;;;'" 2. 5'~' /2
LOT:
BLOCK'
O~NER' "h/c~:~~~ 7:~;z?dz:::;;.A?
ADDRESS: Z~? V ?"'" /?7.P/'>7 7) ~~
~P.A'r /.;> .' .. ,. ST~T~'
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CITY:
DESCRIBE WORK:
NEW
REMODEL -K--
ADDITION
CONTRACTOR'S NAME
GENERA' '
PLUMBING:
MECHANICAy;{fI..;-::J1l-~~~
ELECTRICA' '
~A_
~ ^~?~eF..~2.'~? *.
DEMOLISH OTHER"
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PHONE
..
JOB NUMBER
95""/:?~~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
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PHON~'
7V6'-:?;///
ZIP'
9/C;/>~
ADDRESS
CONST,
CONTRACTOR'
EXPIRES
"" Y-~ '-<-r"'Y7'9.>/"".
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- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF UNtTS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE:_ SOUARE FOOTAGE: _
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspecttons requested before 7:00 a.m. wilt be
made the same work_~ng day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing' Electrical!
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, groutl,!g.
D 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 Boam - Prior to floor
Insulation or decking.
o Floor Insulallon - PrIor to
decking, ,
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
D ,Rough Plumbing - PrIor to
cover.
REQUIRED INSPECTIONS
[E] Rough Mechanical - PrIor to
cover.
D Rough Electrical - Prior to
CQver. "
o Electrical Service - Must be
approved to obtaIn permanent
clectrlcal power.
o FIreplace - Prior to facing
materials and framing Insp.
o FramIng - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
o Drywall - PrIor to taping.
o Wood Slave - After Installation.
o Insert - After fIreplace approvlSl
and Installation of unit.
o Curbcut & Approach - After
forms Bre erected but prior to
placement of poncrete.
o Sidewalk & Driveway - Alter
excavation Is compictc, forms
and sub.base materIal In place.
o
Fence - When completed,
D
Street Troes - When all requl red
trees are planted.
o
Final Plumbing - When all
plumbing w9rk Is complet.e.
D Final Electrical - When ail
electrlC,a! work Is complete.
eEl
Final Mechnnlcal - When all
mechanical worl( Is complete.
o
Final Building - When all
required Inspections have been
approved and building Is
completed.
[EJ Other &~/::!?'A/---::;
MOBILE HOME INSPECTIONS
o BlockIng and Sel.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
waler 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 faces
Lol Type.
Interior
Lot sq, fig,
Lot coverage
Corner
Topography
Panhandle
Total height
Cul-de-sac
BUILDING PERMIT
ITEM
SQ, FT"
X $/SQ, FT, ~
Main
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fcc
(A)
fls 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.
Setbacks
I P.L, I HSE GAR ACC
I N I
I S I
Iw I
lLL_~
VALUE
"
SYSTEMS DEVELOPMENT CHARGE'(SDC)
'(B)
PI'!% /_~ -
-
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7&:;. 2C>
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) "I'
Sanitary Sewer FT.
Water
FT,
FT,
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace ~LV~
Exhaust Hood
Vent Fan
"I'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
~.:; ~hY~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
'Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcul
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding ~lec\!l.cal)
'(A, B, C, D, and E Combined) ,
FEE
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APPROVED'
,"
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 I~~due on al/ undeveloped
pro-pertles within tho Cily limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I h~ve 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 Ihe City of Springfield, and the Law.
of tho Stato of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any'
structure without permission of the Building Safely Division.
I further certify that only contractors and employees who
arc In compliance with OAS 701.055 will be used on thIs
project.
I further agree to ensure thai all required lnspoclions 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, and the approved set of plans will remain
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Dato Wc,u. c,/ ' 99 S
VALIDATION:
RECEIPT NUMBER
/'7 ~A:
//-/.... . 9'>
DATE PAID
AMOUNT RECEIVEn .:2..k:. . :?C>
RECEIVED BY ~~...-?