HomeMy WebLinkAboutPermit Mechanical 1993-2-25
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RESIDENTIAL ..
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSEO WORK'
ASSESSORS MAP:
LOT:
OWNER:
AOOREss,
CITY:
DESCRIBE WORK'
NEW
REMOOEL
AODITION
CONTRACTOR'S NAME
GENERA' .
SPRINGFIELD
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II 0 ~ -::l C-, -::l-:J.
E.LOCK'
STATF'
or<.
DEMOLISH
OTHER
JOB NUMBER
CJ ~O:::L3q
225 Fifth Street
Springfield, Oregon 97477
~
TAX LOT: _(,)0':::1-:l:2.
SUBOIVlsION:
PHONE: ~() - 't-'6 I :')
ZIP: C/,'-I77
ADDRESS
CONST.
CONTRACTOR #
EXPIRES
" PHONE
PLUMBING'
MECHAN ICAL: .r1/VY\.. l:1,v:, 4ifl{lJ A Cv-...". I" I 'X
ELECTRIC." '
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l In ~ Jibw-- 5,-/ -t::t -Y) /,,-:) I
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1'-1" '
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- OFFICE USE -
QUAD AREA: ~ LANO USE: FLOOD PLAIN'
# OF BLDGs: . OF UNITS' ZONING CODE:
OCCY GROUP: CONsTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE" 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
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. .
o Water Line - Prior to filling
trench.
I
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 Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After installation.
D 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.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing work is complet.e.
D Final Electrical - When all
electrical work is complete.
~inal Mechanical - When all
mechanical work is complete.
o Final Building - When all
. required inspections have been
approved and building is
completed.
I2a Other
~'::f..~
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 Type . Setb,cks IS n.ROPOSEO WORK IN THE
I Pol, ACC I " HISTORICAL OISTRiCT, OR ON
Lot sq. ftg. Interior HSE GAR
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is and approved by the Historical
Topography Panhandle Iw Coordinator prior to permit issuance.
Total height Cul-de-sac IE
APPROVED'
BUILDING PERMIT
ITEM SQ. FT, X $/SQ, FT,
VALUE
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
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Mechanical Permit
~
It::::. 00
10.60
.J$""
';:lS./ s;-
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curb~ut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) gc:::." jC::-
(A, B, C, D, and E Combined)
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 Springtleld, 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:
Date 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 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 Ordinanctls of the City of Springfield, 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 QRS 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 located at the front
of the property, and the approved set of plans will remain
on the s\ a.t a~ ~s uuri'Yonstruction,
Signatuj \, #d4'L/ duL-#
:l- b <:,1 c,?,
Date
VALIDATION:
RECEIPT NUMBER
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d b~ 10;
.$ ~C;. 7 e::;-
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OATE PAlO
AMOUNT RECEIVEO
RECEIVEO BY