HomeMy WebLinkAboutPermit Mechanical 1996-5-21
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP:
LOT'
OWNER'
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CITY:
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BLOCK'
STATE:
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DESCRIBE WORK: r::;"
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ADDITION DEMOLISH
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OTHER
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NEW
REMODEL
CONTRACTOR'S NAME
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JOB .NUMBER
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225 Fi Ilh Street
Sprlnglleld, Oregon 97477
.
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. TAX LOT: 6~~6";!;)
SUBDiVISION'
PHON~'
ZIP:
9?~?7
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES -. PHONE
GENERAl'
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ELECTRICAl'
QUAD AREA-
. OF BLDGS'
OCCY GROUP'
· OF STORIES:
WATER HEATER:
/0 (,0 r;, '1
- OFFICE USE -
LAND USF'
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
I"'....v ~7 7<t'CI_S-9o)'
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,
FLOOD PLA'IN: ~ .
ZONING CODE:
. OF BDRMS: ~
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspecllon, you must call 726-3769. This Is a 24 hour recording. Alllnspecllons requesled belore 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 Inspoctlon - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
MechanIcal - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel locallon, bond
,beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Undarlloor 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 Sewer - Prior to filling
trench.. \
o Storm Sel.\(~r - Prior 10 filling
trench.
o Waler Line - Prior to filling
trench. .
o Rough Plumbing - Prior to .
cover.
REQUIRED INSPECTIONS
'f:::7f Rough Mechanical - Prior to
~cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtaIn permanent
electrical power.
o Fireplace - Prior tq facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Calling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood. Stovo - After Installation.
o Insert - After fireplace approvlll
and Installation of unit.
o Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, forms
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 w9rl< Is complet.e.
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final BUilding - When all
required Inspections have been
approved and bUilding I.
completed.
~Other ~A< ,~/-4/.,1~
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
waler and sewer.
o Electrical Connection - When
blocking, sel.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - Aftar all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
.
Lot Type
Lol sq. fig.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle'
Cul-de.sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
Tolal Value
Building Permit Fee
State Surcharge
Total Fec
(A)
I p.L. 1
IN
Is
Iw
LL-__~
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary s~wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
PlumbIng PermIt
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace .
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace UnIt
..Dryer VeRt ~ )A.JS~
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MechanIcal Permit
Issuance
State Surcharge
Total Permit
,7J'T/-I..r
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
SIdewalk
fI
Curbcut
fI
Demolition
Slate Surchalge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrical)
(A, B, C, D, and E Combined)
FEE
-;to :>0
5.n:J
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"S THE PROPOSED WORK IN TH~ .
....HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by th'e Historical
Coordinator prior to permit Issuance.
I.
Setbacks
HSE GAR'ACcl
1
I}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 Cily.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:
Dale 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 compleled 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 Clly of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thai 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 localed at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
. ~ignature ~-,,:L//-/~...;:=-
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Date
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VALIDATION:
2/ C. 2--/
'Y2 JC 5'/..
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AMOUNT RECEIVED ~P.
/f'~
RECEIPT NUMBER
. DATE PAin
RECEIVED BY