HomeMy WebLinkAboutPermit Mechanical 1992-3-26
OWNER' .Jeff t b~oro.h ..\1il\k~U\s
ADDRESS: ~5 G,e.er.Vo.(e. tr.
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
CITY:
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SPRINGFIEL;D
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DESCRIBE WORK'
NEW REMODEL ~
ADDITION
DEMOLISH
OTHER
.
OJ'd.DL/Lfto
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
O~JOO
PHONE: ~/- '-l7.:SS
ZIP: ~'1'-t77
ADDRESS
CONST.
CONTRACTOR #
PHONE
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - PrIor to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing.- Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior,to taping.
o Wood Stove - Aft~r Installation.
D Insert - After fireplace approval
B.nd installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
a~d sub-base material in place.
D Fence ""-'When completed.
D Street.,Trees - When all require-d"
trees are planted. . .
EXPIRES
1013o~:J
.
3<,(01- &>IO(
CONTRACTOR'S NAME
GENERAl'
PLUMB,ING:
MECHANICAL: c.tlll'(\~rt.J:1DW Ue.o...kM G,S Grp~/CLte. IY. . :It:. a-{fn(J
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ELECTRICAL: ~'i o~h!l.("
- OFFICE USE -
QUAD AREA: c:; LAND USE: 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 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.
D Temporary Electric
o Site Inspection - To be made
~ after excavation, but prior to
setting forms.
D Underslab Plumbing/Electricall
Mechanical - Prior to cover.
D Footing --After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected 'but prior to concrete
placement.
D Underground Plumbing - Prior
to flllin9 trench,
D
Underfloor Plumbing I Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to tilling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
D Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
~Final Mechanical - When all
mechanical work is complete.
D Final Building - When all
required inspections have been
approved and building is
completed.
Qa-Other
(;t:>("-, L\~
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking is complete.
D 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.
D Final - After all required
inspections are approved and
. . . porches, skirting, decks, and
venting have been installed.
Lot faces Lol Type. Setb lcks I . THE PROPOSED WORK IN THE
Lot sq, ftg, Interior I P,L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be sIgned
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total height Cul-de-sac IE I
APPROVED:
BUILDING PERMIT BUILDING VALUE, PLAN CHECK
ITEM SQ, FT, X $/SQ, FT, VALUE AND BUILDING PERMIT
Main
. ,
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEV~LOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT,
FT.
Storm Sewer
Mobile Home
-t"\~ 'Pli
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Fireplace Unit
Dryer Vent
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\SOO
Mechanical Permit
Issuance
/r),OO
'-75-.
.:l S.IS
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
:1" -'l
This permit is granted on the. express cond,ition that the said
construction shall, in all resp.ects, conform 1'0 the Ordinance
adopted by, the Cily' 01 Sprlngf.ield, including the
Deve.lopment Code, regulating the co.nstruction 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:
Recei pt 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 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
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 pro.perty, and the approved set of Pla:;Js will rain
on the sl,te at all times during cO{lstr tion.
Signature>' 14/ - .
~#/' .
Date. ?::'J ~I q-:l
VALIDATION:
RECEIPT NUMBER
Lllnt
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m
DATE PAID
AMOUNT RECEIVEr>
RECEIVED BY