HomeMy WebLinkAboutPermit Mechanical 1992-9-8
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD ""
LOCATION OF PROPOSED ~R~ C. ~..:J.Q_~
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ADDITION DEMOLISH OTHER tI
LOT:
ADDRESS'
CITY:
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
~
PLUMBING: ,_____
'f. MECHANICAL -9_~,~6-:t~1L~~
X ELECTRICAL: I iZ,.../ &Nt Lrl"IYtA..;
GENERA' '
BLOGK'
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JOB NUMBER~\ ~?f[
225 Fifth Slreet
Springfield. Oregon 97477
SUBDIVISION'
pHONF'
ZIP'
tJ?4/'77
STATE:
ADDFlESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
~74'..rg
.
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~7 ..J,o
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01 <II 3.9.s- '-At.s
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/0--01 - 9'a-- ~-..) Itrl
- OFFICE USE -
QUAD AREA: LAND USF' FLOQD PLAIN:
. OF BLDGS' . OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR, TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' 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 (jay, inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Elcclrlc
D Sile Inspection - To be made
illler cxcavution, blll prior to
setting forl1l~.
o Undcrslnb Plumbing/Electrical!
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o
Masonry - Sleel location, bond
beams, grouting.
o Foundation - AHer forms are
crectc(j but prior: to concrete
placement.
o
Underground Plumbing - Prior
to filling trencll.
o
Underlloor Plumbing/Mechanical
_ Prior to Insulation or decking.
o
Post and 8eam - PrIor to floor
Insulation or decking.
o
Floor Insulntion - Prior to
decking.
o
Sanitary Sewer - Prior to filling
trcnch.
D
Storm Sewer - Prior to filling
trench.
o
Water line - Prior to filling
trench.
o
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
CI Rough Mechanical - Prior to
cover.
D 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.
D Framing - Prior to ~over.
o Wall/Ceiling Insulntion - Prior to
cover.
o Drywall - Prior to laplng.
o Wood Stove - After Installation.
o Insert - After fireplace approval
ilnd Installation of unit.
o
Curbcul & Approach - AHer
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete. forms
and sub.base material In place.
D Fence - Wilen completed.
o Street Trees - Wilen all requIred
trees are planted. .
o
Final Plumbing - When all
plumbing worl< is complet.e.
D Final ElectrIcal - When all
electrical worl< is complete.
~nal Mechanical' - When all
mechanical work Is complete.
Final Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When 011
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - Wtlen
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
Lo( Type.
Lo( sq. Itg.
Interior
Lot coverage
Corner
Topography
Panhandle
To(al height
Cui-dc-sac
BUILDING PERMIT
ITEM sa. FT. x $150. FT.
Main
Gmage
Carport
Total Value
Building Permit Fcc
Slate Surcharge
Total Fcc
(A)
. THE I'ROPOSED WOI,K IN THE
HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
If yes, this applicatlon must be signed
and approved by the Historical
Coordinator prior to pOl'mit issuance.
Setbacks
I PL. HSE GAR ACC
N
-----
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~=--1--1
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water
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
Mechanical Permit
Issuance
State Surcharge
To(al Permit
(D)
MISCELLANEOUS PERMITS
Mobile Homo
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
FEE
1:5 ,U(!
J( ) (),U
.'J'2;
~o. (15
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrICal)r{),'}!./S
(A, B, C, D, and E Combined) '.
APPROVED:
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 ttle Ordinance
adopted by the City of Springfield, including the
DevcloplllOnt Cocle, regulating the construction and use of
bulldin~ls. and may be suspended or revoked at any time
upon violation of any provisions of silid ordinances.
Plan Cllcck Fcc:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which arc bcin~J improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully ex~mined
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 Safely Division.
I further certify that only contractors and employees who
are In compliance Witll ORS 701.055 will be used on this
project.
I further agree 10 ensure that all roquired inspoclions arc
requested at the proper time, that each address Is readable
from the street, that the permit card is located at the front
of the properly, and tile approved Got of plans will lemain
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Da(e 1:\ G(jN
VALIDATION: {p I3D
RECEIPT NUMBF'" .
DATE PAID Ct R.Lf~
AMOUNTRE~ 4fO. 7~
RECEIVED [l~7J l!)1_,