HomeMy WebLinkAboutPermit Mechanical 1995-11-27
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SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
9s- I ~s..s-
JOB NUMBER
Inspections: 726-3769
Office: 726-3759
225 Filth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK' /).21
/703
TAX LOT:_/")7,c, ~'?
SUBDIVISION:
27
ASSESSORS MAP:
LOT:
BLOCK'
OWNER' I{;A}.I}, It L 1/ ).i;";ft%/
ADDR"CC,' /.:J %.J ;A IH/VU , :')MtJ
CITY:' --A (J./>/Injfotltf., - I
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DESCRIBE WORK: JM1A/h1 'lJRIIA&/J. du.1/JAi; { ,(k;ftuilLN'i(lu7/.Ju
NEW REMODEL ADDITION DEMOLISH OTHER
7/f/-7.2.J'()
PHONE:
979-77 A
It\.
W
o.e
STATF'
ZIP:
CONST.
CONTRACTOR'
13%cJC,
CONTRACTOR'S NAME
GENERAL: ~l3e f A~~
PLUMBING:
MECHANICAl'
ELECTRICAl'
ADDRESS
to. kd~;P'fMI.
EXPIRES
5/9(,
PHONE
931-39j!,-
- OFFICE USE -
QUAD AREA: LAND USE: 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.,wlll be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day, "-
REQUIRED INSPECTIONS
o Temporary Electric
I"x1' Rough Mechanical - Prior to
~over.
o Final Plumbing - When all
plumbing w<;Hk Is complet.e.
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Rough Electrical - Prior to
cover.
D Final Electrical - When all
electrical work Is complete.
""R71' Final Mechanical - When all
~echanlcal work Is complete.
o Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Footing - After trenches are
excavated.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
o Framing - Prior to cover.
;g( Olh~r ~~ U,oE
F4t~ G~
r
D Foundation - After forms are
erected but prior to concrete
placement.
o Wail/Ceiling Insulation - Prior to
cover.
D Underground Plumbing - PrIor
to (1Il1ng trench.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stovo - After Installation.
o Blocking and Set.Up - When all
blocking Is complete.
o Post and Beam - Prior to floor
Insulatlon or decking.
o Insert - After fireplace approval
and Installation of unit.
o Floor Insulation - Prior to
decking.
o Plumbing Connections - When
home has been connected to
. water and sewer.
o Curbcut & Approach - After
(orms are erected bllt prior to
placement of concrete.
o Sanitary Sewer - Prior to fllllng
trench.
o Electrical Connecllon - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench. .
o Fence - When completed.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
o Rough Plumbing - Prior to
cover.
o Street Trees - When all required
trees are planted. .
r-,
Setbacks
I P.L. 'HSE GAR
I N I
I S I
Iw I I I I
lLLLl.J
Lot faces
Lot sq. flg.
Lol Typee
Interior
Lot coverage
Corner
Topography
Total hel ght
Panhandle
.-
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT. X $ISO. FT.
VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
FIxtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Hnme
~
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
.;:;~ UIIJ~ .F."o. /JJsOttT/
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. .'
~If.
?n/AJ,
It:::; &ro
//)~
~.20
26 ?-to
"
Mechanical Permit
Issuance
State Surcharge ,7<) T .-IJ'"
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) ?~.2--0
(A, B, C, D, and' E. Combined)
;;.i,\.....:::...:::
.......
~ 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.
'.
ACC I
I
I
APPROVED: -
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on Ihe 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 construct/on and use at
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 Hy
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 completed appllcallon and do hereby cerllfy that all
Information hereon is true and correct, and I further certify
thai any and all work performed shall be done In accordance
with the Ordinances of Ihe City 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 certHy 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 re9ulred Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the fronl
of the property, and the approved set of plans will remain
on the site at all times during construction. ,
Signature 'x:' ("7 ~ ~
Date h-~" ---9 rt/' .
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
/ 9 ~ f?;2-
jI/; 0)-
I -z...::; ..2. 0
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