HomeMy WebLinkAboutPermit Mechanical 1995-2-21
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: ~/7 2-1
/7"" ) 7_ r
ASSESSORS MAP'
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LOT'
BLOCK'
OWNER: &~#utE
ADDR~"'" ' 1 7,;;1 / j/;1-jl:J6Y' ~.tJ?E ,1;),,)
CITY: ' ,~r<-rl STATF' ~/2...
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JOB NUMBER
225 Fifth Slreet
Springfield, Oregon 97477
4,
TAX LOT'
/2 rcnJ
SUBDIVISION'
PHONE:
'747-7/11
ZIP:
77<1/7/
DESCRIBE WORK:~...,tJ ,(,,v t:::: '&.4-.5 UN/ <.J~fl=YI!!!.L-A.f~<!~4r
NEW
REMODEL
ADDITION
DEMOliSH
OTHER
CONTRACTOR'S NAME ADDRESS 1
GENERA" 482/t!hJ ~;}-S ~4'Mu...-:' .'SdfkJ/C<$ 4~
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CONST.
CONTRACTOR'
7?t.., L /
c; / tulfl
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Lf-?0
PLUMBIN'"
II
MECHANICAl' II
ELECTRICA' '
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It
Ie
EXPIRES
PHONE
f's<l~ ((
- 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: 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.
o Underslab Plumblng/Electrlcall
MechanIcal - Prior to cover.
o Footing - Atter 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,
.' 0 Underfloor 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 IIlling
trench. . \
o Rough Plumbing ~ Prior t~
cover. ... . ~.
;
REQUIRED INSPECTIONS
r2T Rough Mochanlcal - 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,
o Framing - Prior to cover.
o Wall/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After Installation.
o Insert - After fireplace a'pprovlll
and Installation of unit.
o Curbcut & Approach - 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 Fence - When completed.
.-0 Street Trees - When all required
trees are planted. . .
o
Final Plumbing - When all
plumbing work is complet,e.
D Final Electrical - When all
electrical work is complete.
r5?i Final Mechanical - When all
~mechanlcal work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
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MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blockIng Is complete.
o 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.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been installed.
Selbacks
I PL. I HSE I GAR'
I N I I
I S I I
Iw I I I I
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Lot faces
LOI TYP.
LOI sq, flg,
Interior
Lot coverage
Corner
Topography
Panhandle
Tota' height
Cul-de-sac
BUILDING PERMIT
ITEM SQ, FT,
x $/SQ, FT, = VALUE
Main
..
Garage
Carport, ,,\' \.
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" ....:..... _.'..... \ \ \
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Total Value
Bul/ding Permit Fee
State S.urcharge_
'-
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\ \',(A),
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Total Fee
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SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N'
Sanllary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood StovellnserllFlreplace Unit
Dryer Vent
~f./IJgJ (.d~/ /IJ.S~.r
Mechanical Permit
JY/i.v ,
I) ,j-o
;(').00
I 2.>0 '2::l' .:.....:
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Issuance
State Surcharge ,? J""" /4 J
Tota' Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
fl
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and' E' Combined)
2t;:..;).O
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ACC I
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I IS THE PROPOSED WORK IN THE, '
"'"HiSTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
1/ yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPRqVED:, '
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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 constructl,on and use of
bultdlngs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
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,Plan C,he~k Fee"-. '
-
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Date Paid:
Receipt Number:
,
Recelyed By: ,
" ,'> "" '..,.\
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Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properlles within the City limits which are being Imp,oved,
ADDITIONAL COMMENTS
By signature, I stale 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 Ordlnanc~s of the City 01 Springfield, and the Laws
of the State of Oregon pertaining to tho 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 re9ulred Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the fronl
of the propertY'iin lhe approved sei of plans will remain
on the site at all Ime~urlng construction.
~ture IJj, ~h ,
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7 ~z.,( -9t5
Date
VALIDATION:
RECEIPT NUMBER 2/ fb f" '(
2/7_1 /5' r
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AMOUNT RECEIVED _ fi'{' ?b
RECEIVED BY ~/ ~
DATE PAID
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CITY OF SPRINGFIELD
CIIy Hall
Sprlngftold, Oregon
Development Services
OFFICIAL RECEIPT
Date 21/.,"2.-11 19
Rec'd From ,~M#t".p] ~
Address ~~ ~~/,L,1/11t.J
Received For: ~~JJt!'-
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21853
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