HomeMy WebLinkAboutPermit Mechanical 1994-12-27
v.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
/7/J ?
ASSESSORS MAP:
LOT:
,.
-.,
.
91/9/2-
<8 'l.s"' Ha... yJV," (j":J~,, f.,./
. ,
?/ /2...
BLOCI"
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
/),r)9~
PHON~'
OWNER' ~(,~,..f- O<-lc.~Jo
ADDRE~"" [3 'lS Hc'vJ(ln 6...;J'Y f!..J,
CITY- )fO rD,
STAT~' . (j n~',
DESCRIBE WORK' n!.pl"-<-e) 0.. 0; t C"'Mc:r l...:l-t 0.. q,,--,
NEW
REMODEL
PHONE
CONTRACTOR'S NAME
GENERA' .
PLUMBING'
MECHANICAl: Dev""r I!r,,,f.'...,,
, ./
ELECTRICAL: /)UJ,<.5&<?
ZIP:
~ '7 v, 7
.(1
,- , r. t
"'J"'~'tc.c.C-e.I'?a...s p{f1(-:; )_, I/rht 1#,)
OTHER '(..or.:"'cr eLf ~ (..1-
- OFFICE USE -
LAND Ui'~'
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
I'V( Rough Mechanical....: Prior to
~ cover. .
o Rough"Electrlcal - Prior to
cover.
o Electrical ServIce - Must be
approved to obtai n permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior: to cove':. .
o Wafl/Celllng In.Jlallon "7 -Prl.o~ to
cover.
o Drywall - Prior to t~plng.
,
ADDITION
DEMOLISH
ADDRESS.
CON ST.
CONTRACTOR #
o Wood Stovo - A.f~,~r Installation:
.0 Insert - After fireplace approvlll
'. and Installation of unit.
'0 Curbcut & Appro'ach - 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 Fen~e. - When ~omPleted.
o Street Troes - When all r~qurred
trees are planted. .
EXPIRES
1/-(,/-'1'-( 68'8",<;O(J~1
.3 00 'h.tlli!;"'U Etklh..,
(
t!J Lf'/P. ?
QUAD AREA:
# OF BLDGS:
OCCY GROUP'
# OF STORIES'
WATER HEATER'
FLOOD PLAIN'
ZONING CODE:
# OF BDRMS'
SECONDARY HEAT'
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 aller 7:00 a.m. will be made. the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
O Under.'ab PlumbIng/Electrical/
Mechanical - PrIor to cover.
o Footing - After trenches are
excavated. .
o Masonry - Steef locallon, 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
-.Prlor to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
", .... .
o Floor Insutallon - Prior to
decking. , \,'.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
D Water Line - .Prlor to filling
trench.
D Rough Plumbing - Prior to
cove~ .
D Final Plumbing - When all
plumbing W9rk Is complet,e.
o Final Electrical - When all
electrical work Is complete. c.
~ Final Mechanical - When all
~ mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building I.
completed.
~Other
C/ff
L./" .7E
MOBilE HOME INSPECTIONS
o Blocking and Set.Up - Whe[l all
blocking Is complete.' .
o Plumbing Connections - When
home has been con nected to .
water and sew1r.
o Electrical Connection - When
blocking, set.up, and plurgblng
InspectIons have been approved
and the home Is connected to
the service panel.
o Final - Aller all required
Inspections are approved and
porches, sklrtlng, decks, and
venting have been Installed.
I" ,
.. ", ':..;' \J~. \t.~.; _S THE PROPOSED WORK IN THE " '
Lot faces lot TYP. Setbacks,
1.P.l. , ACe I . '--HISTORICAL DISTRICT, OR ON
HSE GAR
lot sq. Itg. Interior IN I THE HISTORICAL REGISTER?
If yes, this appllcallon must be signed I
Lot coverage Corner Is I
and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total ~elght Cul.de.sac
IE I APPRov"n.
BUILDING PE.RMIT
ITEM sa. FT. x $/SO. FT. _ VALUE
~aJn
. Gacage
Carport .
.'.
.
Total Value
BuildIng Parmi t Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
, ITEM
Fixtures
,
Residential Bath(s) N'
Sanllary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
PlumbIng PermIt
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood -...
FEE
fit/v.
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
MechanIcal Permit
/c:; 9 ;:;>
/0.0-0
),2-0
7 /~ :L ()
Issuahce
State'Surcharge ,7j7'- ,jCJ
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) ?/... )..0
(A, B, C, 0, 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 Springfield, Including the
Development Code, regulallng the construcllon and use of
buildings, and may be suspended or revoked at any lime
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 appllcallon 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 property, and the approved set of plans will remain
on the site at all times during construction.
kature ~~~
Date /7-/27/7"f
VALIDATION:
RECEIPT NUMBER / S- f3 ~~
/)./2?/J4
AMOUNT RECEIVED 2G. .).0
4~_
DATE PAID
RECEIVED BY