HomeMy WebLinkAboutPermit Mechanical 1998-6-22
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
ASSESSORS MAP'
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LOT'
BLOCK:
OWNER'
ADDRESS'
CITY'
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DESCRIBE WORK'
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL:~,c /f-J>>fhtu.T
ELECTRICAl'
QUAD AREA'
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:
STATF' ~
DEMOLISH
OTHER
.
JOB NUMBER
q~o 7'5 I
225 Filth Street
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION:
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'7
7:2/#- &~~7
PHONE: _
ZIP:
"77t,.f77
. /kAC-
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES ,~ PHONE
Pt!J.& "j?r7n<
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NOTICE:
. OF UNITS:
THIS PERMIT SHALL EXPIRE IF THE WORK
CONSTR. TYPE'
AUTHORIZED UNDER THIS PERMIT IS NOT
l.iUMMI:Nl.iI:U UH IS ABAN55WEOCfflWE:
....- 'n,. "'-"""""00 RANGE:
"1'11 IOVIJr\l Fliii.nl .
- OFFICE USE -
LAND USE:
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS:
SECONDARY HEAT:
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.
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, grouting.
o 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 Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
O Sanitary Sewer"':" Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover. .
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materIals and framing Insp.
o Framing - Prior to cover.
o Wafl/Celllng Insutatlon - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approvel
and installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete. forms
and sub-base material In place.
o Fence - When corl'lpJeted.
o Street Trees - When all required
tree.s are planted.
o Flnat Plumbing - When all
plumbing wc;>rl< is complet.e.
"
D Final Electrical - When all
electrical work Is complete.
~nal Mechanical - When all
mechanical work Is complete.
o Final Building - When all
requIred Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water 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
Lot ~yp.
Lot sq. Itg.
Interior
Lot coverage
Corne r
Panhandle 'f
Topography
Total height
Cul.de-sac
BUILDING PERMIT'.
'I~ '.~
ITEM
sa. FT.
X $/SO. FT. -
Main
Garage
Carport
Tolal Value
Building Permit Fee
State Surcharge
Total Fee
(A)
:.;.
1 p.L.
IN"
Is
VALUE
"
. . .
y,:' .', ':'1 \~:,;~h'\ir.1~~'
'S THE PROPOSED WORK IN THE.
"HISTOi'lICAL DISTRICT, OR ON
THE HISTORtCAL REGISTER?
If yes, this application must be signed
and approved by' the Historical
Coordinator prior to permit issuance.
Setbacks .
I I I '1
HSE GAR ACC'
I
I
IN
---
E
APPROVED:
',. .~.'" ;. _' 'J
BUILDING VALl'JE, 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
ouildings, and may be suspended. or rev9ked 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 (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 Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
Systems Development .Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
FEE
"
/ .,' . ,',
t ,~ ~ I ". ~ . . ,
By signature, I stato 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 Sprlngfleld, and the Laws
of the State of Oregon pertaining to the work described
herein. and that 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 t.hls
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 located at the front
of the property, and the approved set of plans will remain
on the site at all times during constructIon.
Slgnaturf"
Oat""
VALIDATION:
RECEIPT NUMBER .030 ~,o
fo/~ l../CTr
AMOUNT RECEIVED L b- 2f<i
d/WwJj
DATE PAID
RECEIVED BY