HomeMy WebLinkAboutPermit Mechanical 1997-11-13
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
JOB NUMBER q 7/ (0)... (
225 Fifth Street
Springfield, Oregon 97477
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'\ LOCATION OF PROPOSED WORK' ~ C '-1/
1"7 n ~ Z. '2. / ~ I
C)"".JO<P
7400
ASSESSORS MAP:
TAX LOT'
SUBDIVISION'
',' ',",
,
BLOCK'
LOT'
XOWNER~,q..,\ ~Al>\A
~DDRESS" '<,i5Q ( q ,...IJ oj Sf> ~ {...
CITY' c:;'P 1': OA ,j-l\'..U
PHONE: _ -, L/ 1- ~ Ll..A::J
STATE: ' <:9", ~ r II V
.
ZIP: 9')~.,.
DESCRIBE WORK'
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CON ST.
CONTRACTOR .
. I( CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL:_~l},A'r.L..A. ~
ELECTRICAl'
ADDRESS
EXPIRES 0 PHONE
&'1'6 ~~'*'7/it>J-1
- OFFICE USE -
QUAD AREA'
. OF BLDGS:
OCCY GROUP'
LAND USE'
FLOOD PLAIN'
ZONING CODE:
. OF UNITS'
CONSTR. TYPE:
. OF BDRMS:
. OF STORIES:
HEAT SOURCE:
'NO?\'>.
WATER HEATER' RA~~""'1'l-\t SQUARE FOOTAGE:
_1'\(":E: . p"?\ ..' JC"- Ie:. t>\U \
\'l" (. e:.l'I"'''- 01-\'\' .1.
To request an InSpeCt1b~1,~~~C':\II.?~~1W't\~hrs.I,;;'i\~~\Ycur recording. Alllnspecllons requested before 7:00 a,m. will be
made the same worklngrtlli\t: 1~~IQ'MlJh;qUB'i>.~\!l011ei'-'7:00 a.m. will be made the following work day.
f>,l.li\-lO Elo\Ct\)O?\S_~EQUIRED INSPECTIONS
D Temporary EloctrlJJOW.\o1I ,,()f>,'1 ?t.~' Rough Mechanical - Prior to
"lo\'1 ,~" cover.
SECONOARY HEAT:
D Final Plumbing - When all
plumbing work Is complete.
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Rough Electrical - Prior to
cover.
D Final Electrical - When all
electrical work is complete.
~eChanIcal - When all
mechanical work Is complete.
D Underslab PlumblnglEloctrlcall
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After trenches are
excavated.
D Final BUilding - When all
required Inspections have been
approved and building is
completed.
D Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
. .beams, grouting.
D Framing - Prior t.o cover.
DOihor
D Foundation - After forms are
erected but prior to concrete
placement.
D WolJlC'olllno Insulotlon - Prior to
cover.
D Undorground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Wood Stovo - After installation.
D Blocking and Set.Up - When all
blocking Is complete.
D Post and Beam - Prior to floor
Insulation or decking.
D Insert - After fireplace approval
and Installation of unit.
D Floor Insulation - Prior to
decking.
D Plumbing Connections - When
home has been connected to
water and sewer.'
D Curbcut & Al'proach - After
forms are erected but prior to
placement of concrete.
D Sanitary Sewer - Prior to filling
trench.
D Electrical Connection - When
blocking, set-up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Sidewalk & Driveway - Alter
excavation Is complete, forms
and sub-base material In place.
D Storm Sewer - Prior to filling
trench.
D Fence - When conlpleted.
D Wator Llno - Prior to filling
trench.
D Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.'
D Rough PlumbIng - Prior to
cover.
D .St~eet Trees - Whtln all required
trees are planted.
Lot faces
L~l ~yp.
Lot SQ. Itg.
Interior
Lot coverage
Corner
Panhandle ..
Topography
Total height
Cul~de.sac
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'.,.':
I P.L.
IN
Is
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IE
BUILDING PERMIT ',j ',; .~
ITEM sa. FT. x $/SO. FT. ~ VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
6450 [i~
/0&
MechanIcal Permit
Issuance
State Surcharge -f O.D 3'0
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
Slate Surcharge
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE <excluding electrical)
(A, B, C, 0, and E Combined)
"
FEE
l1../s, -
.$ /0.
,7S'f' .45
:iJ:L(,. .;t~
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.
(....IS THE PROPOSED WORK tN 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.
Setbacks .
HSE GAR Acc'l
I
I
I
I
APPRov"n.
. .!:'\-- '; n
BUILDING vALl'JE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construct/on 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 time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Oate
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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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 Ordinances 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 ORS 701.055 will be used on this
prolect.
I further agree (0 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 co~tructlon.
~Ignatu~ ~
'fate~1 - I ~ - eel'
VALIDATION: