HomeMy WebLinkAboutPermit Mechanical 1994-6-23
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOS~()W~~ d;~.
ASSESSORS MAP' \') ,~ \ I
OWNER:' i~\\{l~Q \ ~\\ffi ~~ [)
ADDRE~'~~S.~ ~f)Yr\o ~()ti\Y .'\
CITY' \~ \)- cl STATE: \)~)~
DESCRIBE WORK" 1),(t l:\ J V\f:\D IT ,
REM~D~
lOT'
NEW
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
BLOCK:
ADDITION
DEMOLISH
OTHER
,
.
.
q4CQ~lo
JOB NUMBER
225 Filth Slreel
Springfield, Oregon 97477
TAX lOT:
SUBDIVISION:
O~y)
PHONF'
1Y\\.O~~8
ZIP:
C{I \~I' r )
*
," ...
ADDRESS
CON ST.
CONTRACTOR'
PHONE
MECHANICAL:
Do.~}offiD.(\('~. ,1).0 .\~
~44f~
ELECTRICAl'
EXPIRES
- OFFICE USE -
QUAD AREA: LAND USF' FLOOD PLAIN:
. OF BlDGS: . OF UNITS' ZONING CODE: _
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. 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. All Inspections requested before 7:00 a,m. will be
made the same working day, Inspections raques ad 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
seltlng forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D Footing - After trenches arc
. excavated.
D Masonry - Steel location, bond
,beams, grouting.
D Foundation - After forms are
erected but prior to concrete .
placement.
D Underground Plumbing - Prior
to filling trench. .
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking. .
D Floor Insulation _. Prior to
decking.
D
,
Sanitary Sewer - P~lor to filling
trench.
D Storm Sower - Prior to filling
trench.
D Water line - Prior 10 filling
trench.
D Rough Plumbing - Prior to
cover,
UIRED INSPECTIONS
ough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Musl be
approved to obtain permanent
electrical power.
D Fireplace - Prior to faCing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvel
and Installallon of unit.
o Curbcut & Approach - After
_ forms are erected but prior to
- placement of concrete.
D Sidewalk &. Driveway - After
excavation Is complete, forms
and sub.base material In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing w9rk Is complet.e.
D Final Electrical - When all
. electrical work Is complete.
D Final Mechanical. - When all
mechanical work Is complete.
D Final Building - When all
required Inspecllons have been
approved and building I.
completed.
(cfj)ther
[
I (llY
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
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 to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
,...
Lot (aces
LOI ~ype'.
LOI sq. Itg.
Interior
Lot coverage
Cornor
Topography
Panhandle
Tolal helghl Cul.de.sac
BUILDING PERMIT
ITEM SO. FT. X S/SO. FT. a
Main
Garage
Carport
Tolal Value
Building Permit Fee
Slale Surcharge
Total Fcc
(A)
<. I. .
. .: " .:" ~,:~ \',iC~;
: (, THE PR~P~SED WORK IN THE.
....HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application musl be signed
and approved by the Historical
Coordinator prior to permll Issuance.
I P.L.
IN
Setbacks
HSE GAR Accl
I
S
W
IE
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
A~ \'6~.
-\'~ -,D.g)
.1<"
&(0.11)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanllary Sewer FT.
Water FT.
Slorm Sewer FT.
Mobile Home
Plumbing Permit
Slato Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnserllFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge..
Total Permll
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Curbcul
It
Demolition
Slate Surcharge
FEE
Tolal Miscellaneous PermllS (E)
TOTAL AMOUNT DUE (excluding electrical) c90 9 f_)
(A, B, C, 0, and E Combined)
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 lime
upon vlolatl9n 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, thai I have carofully examined
the compleled application and do hereby certify thai all
Informallon hereon Is true and correct, and I furlher certify
that any and all work performed shall bo done In accordance
with the Ordlnanc~s of the CUy of Springfield, and the Laws
of tho St.ate orOregon pertaining to the work described
herein, and Ihal NO OCCUPANCY will be made of any
structure without permission of the Building Safety Otvlslon.
I furlher cerllfy thai only conlraclors and employees who
arc In compliance with OAS 701.055 will be used on this
project
I further agree to ensure thai all required Inspoctlons 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 sel of plans will remain
on the site ~t,lH tlm'es dUllng construction,
Slg~e""'~., _.'_ LLJ~
", I.
Date ..~ q 'f
/r
VALIDATION: /\ c:.fj']
RECEIPT NUMBE~ \~
DATE PAID lO . L!.l).4+ ,
AMOUNT RECEIVE~ ~ ~\,O.U)
RECEIVED BY ~I Uj