HomeMy WebLinkAboutPermit Mechanical 1995-10-11
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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SPRINGFIELD
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JOB NUMBER
225 Fifth Street
Sp,lngfleld, Oregon 97477
LOCATION OF PROPOSED WORK: 7"5"~ A/~ ~~ S?--
ASSESSORS MAP' /.R-~2-6)~/2 . TAX LOT:
LOT:
BLOCI"
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OWNER:
ADDRESS:
CITY'
DESCRIBE WORK: /,{y"~CL
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NEW
REMODEL
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DEMOLISH
OTHER
ADDITION
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SUBDIVISION'
PHONE:
-;;W"7"-/.'X" /
ZIP:
4?.,.....?~
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ADDRESS
CONST.
CONTRACTOR .
EXPIRES .. PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAI'~~~~_~
ELECTRICAL'
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~~~~~~?;~ ?h~ /~.%;.
95'Y~'
- 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: RANG~' SQUARE FOOTAGE:
To requesl an Inspection, you must call 726.3769. This Is a 24 hour recording, Alllnspecllons 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.
REQUIRED INSPECTIONS
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After (orms are
erected but 'prior to concrete
placement.
o
Underground Plumbing - Prior
to filling t,ench.
o Underlloor 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 - ~rlor to filling
trench.
D Slorm Sewor - Prior to filling
trench.
o Waler Line -.Prlor to filUng
trench. .
D Ro'ugh Plumbing - Prior to
cover.
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.
D Framing - Prior to cover.
o Wail/Ceiling Insulation' - PrIor to
cover.
o Drywall - Prior to taping,
o Wood Stovo 7"'"" After Installation.
o Insert - After fireplace approval
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 completed.
D Street Trees - When all required
trees are planted..: .
o
Final Plumbing - When all
plumbing w9rk Is complet.o.
D 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 Is
completed.
!Xl O\hor ?~~.~ ~.
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MOBILE HOME INSPECTIONS
o Blockln9 and Sol. Up - When all
blocking Is complete.
o PlumbIng Connoctlons - When
home has been connected to
waler and sewer.
tJ Electrical Connoctlon - 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 Type. '. ._ THE PROPOSEQ WORK IN THE.
Lot faces Setb'cks
Lot sq. flg. InterIor I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
I THE HISTORICAL REGISTER?
Lot coverage Corner N If yes, this application must be signed
S I "and approved by the Historical
Topography Panhandle .1 W I Coordinator prior to permi t Issuance.
Total height Cul.de.sac IE I
'APPROVED'
BUILDING PERMIT
ITEM SO. FT, X $/SQ. FT.
VALUE
Main
Garage
"
Carport
Total Value
Building Permi t Fee
State Surcharge
Total Fee
(A)
~
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(e)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Van t Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
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/c;: -'
/~-
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26.. ~
Mechanical Permit
,
Issuance
State Surcharge
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
It
Curbcut
Demolition
State Surcharge
Total MIscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding elept,lcal) ~ ::>~
(A, B, C, 0, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
. This permit is granted-on the express condition thai the said
cqnstruction shalf, in all respec.ts, 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 rovoked at any time
upon violation of any provisions of saId ordinances,
Plan Check Fee' ....',
Date Paid:
Recei pt Number.
Received By:
Plans Reviewed By
Date
....
. , .
~ Systems Development Charge is due on all undeveloped
properties within tilO City limits which are bclng,lmproved.
ADDITIONAL COMMENTS
By signature, I stato and agree, that I have carefully examined
the completed application and ~o 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 tho City of Springfield, and the Laws
of the State of Oregon pertaining to tho 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
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 tho 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 c.oo~'Y"~on.
Signature fl.-d' ::?'4"'~
. . f_"
Datp /?l-/,/- P:)
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VALIDATION:
RECEIPT NUMBER /,?'2_~C>
,~~~
AMOUNT RECEIVEr> 26-::?0
r-:;Z.$;a.~_~
d./~
DATE PAir>
RECEIVED BY
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