HomeMy WebLinkAboutPermit Mechanical 1993-3-17
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REMODEL ADD ION
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
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LOT'
OWNER'
ADDRESS:
CITY:
DESCRIBE WORK'
NEW
CONTRACTOR'S NAME
GENERA' '
PLUMBING'
.
SPRINGFIELD
BLOCI<"
STATE:
"R
~ /.-r--,I~(J
DEMOLISH
OTHER
.
, JOB NUMBER 9?y/3S~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
~O~O
PHONE: _7'1h - 3~c; c
ZIP: _Cl'7tJ77
ADDRESS
CONST,
CONTRACTOR'
PHONE
MECHANICA' .
QlM ..6~ tle'/rhr /.f-~7 Cd, S-il , Z.
c~#U:1 p/,z:;.-~r
ELECTRICAL:
, EXPIRES
1t>S'IS'
I;) ";>1- '7.3
~V-~I/J1
- OFFICE USE -
QUAD AREA: LAND 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
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbingl Electrlcall
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.
o
Storm Sewer - Prior to filling
trench.
o
Water Line - Prior to filling
trench.
o
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
l.2S[~OU9h Mechanical - Prior to
cover.
~Rough Electrical - Prior to
~cover.
o Electrical Service - Must be
approved 10 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 - Prlor'to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation ot unit.
o Curbcut & Approach - AHer
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 - Wilen completed.
r 1 Slreet Trees - When all TCqulred
trees are planted,
o Final Plumbing - When all
plumbing work Is complete.
tvrFlnal Electrical - When all
~electrlcal work is complete.
~Final Mechanical - When all
I,C)..mechanical work Is complete.
o Final Building - When all
requIred Inspections have been
approved and building is
completed,
DOlher
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - Whcn
home has been connected to
watcr 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
Lol Type ,
Lot sq, flg,
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul-de-sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
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 Sewer
FT.
FT,
Water
Storm Sewer
FT.
Mobile Home
PI u mbl ng Perml t
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Ftreplace Unit
Dryer Vent
Mechanical Permit
Issuance
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)
I .THE PROPOSED WORK IN 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
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S
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BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
VALUE
FEE
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7J
25,7J
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APPROVED:
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adoptoel 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 viQlation of any provisions of said ordinances.
Plan Cl10Ck Fee.
Dale Paid:
Receipt Number.
Received By:
Plllns 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 Ihe State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure wittlOul permission of the Building Safety Division.
I furltlcr certify tllat only contractors and employees who
LlrO in compliance with GAS 701.055 will be used on this
project.
I further agree to ensure that all required inspections arc
requested at the proper time, that each address is readable
from ttle street, that the permit card is located at the front
of the properly, and the approved set of plans will remain
on the site at all E,m. during (j,"struction,
Xignaturn . Jt?Hy{
/
Datp t:/ -/7 - 93
VALIDATION:
RECEIPT NUMBER
'7~ 21
1/;7/<33
L. "'l, 7 S-
.~
DATE PAID
AMOUNT RECElv"n
RECEIVED BY