HomeMy WebLinkAboutPermit Mechanical 1994-7-7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
-.
SPRINGFIELD "
.
UCt (-\
JOB NUMBER
9y'/~o/
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: .I !-f/ ~~ ba~./ Rood
ASSESSORS MAP: /7-.::1 ':3-::::;?S"\ '2 / . 7 TAX LOT. /'::f;>cs.e
~ aJ([!lf/
(//PW ~~ hr.~I
_ ')}/~'.e(;' STATE:
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REMODEL ADDITION DEMOLISH
LOT:
OWNER:
ADDRESS:
CITY:
DESCRIBE WORK:
NEW
CONTRACTOR'S NAME
GENERAL.
PLUMBING:
MECHANICAL:
tJl/b711,u./~ 1
ELECTRICAl.
OUAD AREA.
. OF BLDGS:
OCCY GROUp.
. OF STORIES:
WATER HEATER:
BLOCK.
at:
SUBDIVISION:
PHONE:
~1I?- 4/,fZr
ZIP:
~1.!L77
4,;'-- &w:Ir.>4d>-.~/
OTHER
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES
PHONE
4J.S-( ~
(/
4176(,/5-
i)..ec . t; V
3?'v,.;)9-ft
- OFFICE USE -
LAND US".
. OF UNITS.
CONSTR. TYPE:
HEAT SOURCE:
RANG".
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 after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be made
alter excavation, but prior to
setting lorms.
D
Underslab Plumbingl Electricall
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 10 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 Sower - Prior to rilling
trench.
D
Water Line - Prior -to filling
trench.
o Rough Plumbing -: Prior to
cover. ' .
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approvcc! 10 obtain permanent
electrlcal power.
o Fireplace - Prior to facing
materlals and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to' t3ping.
o Wood Stove - After installation.
o Insert - Arter fireplace approval
and installation Of unit.
o CurbciJt & Approach - After
forms :UG erected but prior to
placement of co"ci~le.
D Sidewalk &. Driveway - After
excavation i~ compie~e. forms
ana sL!b.b.::1se materiC':.1 :n place.
D Fence - When cornplnted.
o Street Treos - When ::l.iI rt=Quircd
trees arc p!B"ted.
o
Final Plumbing - Whcn all
plumbing work Is complct,e.
D Final Electrical - When all
electrical wcrk is complete.
~ Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required inspections have been
approved and building is
completed.
DOthcr
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
o Plumbing Connections - When
:lama has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the !'lome is connected to
the service panel.
o Final - After all required
Inspections are approvcd and
porches, skirting, decks, and
venting have been installed.
Lot f?ces
.
Lot sQ. Itg.
.
Lot Type
Lot coverage Corner
Interior
Topography Panhandle
Total height Cul.de.sac
BUILDING PERMIT
ITEM SO. FT. X $/SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
.
IS 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.
P.L.
Setbacks
HSE GAR Accl
N
S
W
IE
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobllc Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
N'
FT.
FT.
FT.
(C)
Dryer Vent
Wood StovellnsertlFlreplace Unit
N'
Mechanical Permit
Issuance
State Surcharge
Total Permit
~UJr.
,...~
r- :;-':?~
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C, D, and E Combined)
FEE
/-5:. -
A!/1. -
'.~
~20
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 the Ordinance
adopted 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 violation of any provisions of said ordinances.
Plan Check Fee.
Dale Paid:
Receipt Number.
Received By:
Plans Reviewed By
Datc
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 thai 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 tllat 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 streot, that the permit card is located at the front
of the property, and the approved set of plans will remain
on the site at al limes during construction.
~ [;;,,7f.
~
Signature -..
Date
1J7-/l7~9y
VALIDATION:
RECEIPT NUMBER /-:>79~
7--;/- 9 Y"
AMOUNT RECElvm :?~. <~
RECEIVED BY ~ -~ .. - .....
'l-
DATE PAIr>
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