HomeMy WebLinkAboutPermit Mechanical 1994-9-2
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP' /)-d?-~""3-'3
LOT'
OWNER'
ADDRESS'
CITY:
DESCRIBE WORt<'
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' .
.
SPRINGFIELD
/8.11-
A-l2t:&1vt+ (E,
BLOCt<'
STAT~'
(JR.
.
-,,,.JOB NUMBER
225 Fifth Street
Spilngfleld,Oreg
j)~OiJ6
TAX LOT'
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SUBDIVISION'
PHON~'
7~" - /7'1-,/
ZIP:
9 7 't,.:!..:?
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ADDITION
DEMOLISH
OTHER
ADDRESS
CONST,
CONTRACTOR #
PHONE
PLUMBING'
MECHANICAL: #1f-A..lJo/ ;. P,clrG:. c."
ELECTRICA"
(5I.p/ ~ fVVflUC 1 "<'A-y-
J;tJ.s.o.JE.. 9~
EXPIRES
() 0011
(Q-J (~'f'f
7lj6 ~t';l.(
- OFFICE USE -
OUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS: . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR, TYPE: . OF BDRMS'
. OF STORI ES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To requesl 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
o 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.
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling Irench,
o Underfloor 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. .
D Water Line - Prior to filling
. trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cove~ .
o 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 Wail/Ceiling Insulation - Prior to
cover. .
D Drywall - Prior to taping,
D Wood Stove - After l~stal/at'lon,
o Insert - After fireplace approval
and Instal/atlon of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - Whe,~ completed.
o Street Trees - When 'all required'
trees are planted.
o Final Plumbing - When all
plumbing work Is complete.
o Flnsl Electrical - When all
electrical work Is complete.
GEl Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
"-
'MOBILE HOME INSPE~
''\
"
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
, I nspectlons are approved and
, porches, skirting, decks, and
venting have been,lnstalled.
Lot faces
Lot sq. Itg,-" _ ::::::L
-.... !'. ... . ,
~:.,;'-: "',l.~\.'"
Lot coverage ~
.\ -
\l'( ':'.""
Topography.
"
Total height
Lot Type .
. Interior
Corner
Panhandle
Cul.d.e~sac
BUILDING PERMIT
ITEM SO. FT, X $/SO, FT.
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
( .HE PROPOSED WORK IN T~E
"'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I P,L. HSE GAR ACC I
IN
Is
Iw I
IE '1
VALUE
SYSTEMS DEVELOPMENT CHARGE (SpC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace <:G""~~,,::V
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
k~
#,?
Mechanical Permit
Issuance
State Surcharge
Total Permit
~-1",
~
T-?'~
(D)
MI$CELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Su rcharge
Total Miscellaneous Permits
(E),,,, .
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
/~-
/~.-
-'~
26. 20
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
constructron shall, In all respects, conform to the Ordinance
,'adQpted, 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 vlolatlon of any provIsIons of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
syste'1's Development C;:harge Is due ,on ~I undeveloped
prope~tles 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 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 wilh 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 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 rz=s';Pjzuctlon /&-'--
Slgnaturet'~/{"';'UtT 9Z;f}~ CJ.
Date, c;, - ~- ~
VALIDATION:
RECEIPT NUMBER / V"S''''5' '7
Q-2.-:?Y
2.6- <=-
DATE PAIl"
AMOUNT RECEIVEr>
RECEIVED BY r:::?~~ 7
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