HomeMy WebLinkAboutPermit Mechanical 1997-10-2
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF ~ROPO)\ED WORK: -dD~\Q
ASSESSORS MAP' \' t DAV::ttfj
LOT:
BLOCK'
OWNER: ~('(\Y ~~O~\L.' tw>~)ffi5_. ,~PHONE:I"L\. C M~
ADD~ ~~: ~ \.f'() Q (\ 0 (\ u..~i(H)f ~ p'/
CITY.~~ \. \ STA\E: l\ ZIP: Cl"l4-f(]
J0 (~O) ')
NEW
OTHER
DESCRIBE WORK:
CONTRACTOR'S NAME
GENERA' .
PLUMBINC" J. ^.
MECHANICAL: ~\'W\
ELECTRICAl'
DEMOLISH
ADDRESS
CON ST.
CONTRACTOR .
EXPI RES '.-:'1 PHON E
~onro.f\
(VclOO~
''A'''' ('1.""
- OFFICE U.Se:'C;;; , C'"
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LAND USF' ., . ~~~ ~)(IN'
~. . OF UNIT';' ., ,0' ~<<-\c>&t~G. ~'<oE:_
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O~\'~ ;;..pO~S~.R;TYPE:.:.J ~. <:o~lY" ((,~ -<'''''' ~'BDRMS'
~ ~\~~' .t;lEAt'sOl:J,RCE: ~o(\V ...t"~ $'((;) ,,-"'~CONDARY HEAT:
'W y..O'<"'" .t>\)' . ';)~V' ~~Y;'..<-~ R-''''
WATER HEATER' ~-s;. .lt~'6~j~~V ~~c;.,~'1)' f:"O ~O'iS'QUARE FOOTAGE:
'p~"'~9+):r>., "\ b.J~~" i/~:-<. ":~!<'
To request an Inspection, you must call 7~\l1I\7lJ9. This Is a 24 hour r~c ~:a.t~spectlons requested belore 7:00 a.m. will be
made the same working day. Inspectlonsmquested after 7:00 B.m. wAD ~e the following work day.
REQUIRED INSPEC~ONS
~~h Mechanical ~ Prior to
cover.
QUAD AREA'
· OF BLDGS:
OCCY GROUP'
. OF STORIES:
o Temporary Electric
D SUe Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcel/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms Bre
erected but prior to concrete
fllacemont.
o Undorground Plumbing - Prior
to filling trench.
o Undertloor Plumblng/Mechanlcel
- Prior to Insulation or decking.
o Post and Boam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to IIIl1ng
trench.
o Weter line - Prior to filling
trench. .
o Rough PlumbIng - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrlcel Service - Must be
approved to obtain permanent
electrical power.
o Flreplece - Prior \0 lacing
materials and fram)ng Insp.
o Framing - Prior to cover.
o Wall/C'elllng Insulation - Prior to
cover.
o Drywell - Prior to taping.
o Wood Stovo - After Installatlon.
D Insert - After fireplace approvlll
and Installation of unit.
o Curbcut & Approech - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When COIYlopleted.
o Street Trees - When all required
trees are planted.
~.4-.l{D
o Final Plumbing - When all
plumbing w9rk Is complet.e.
D FInal Electrical - When all
electrical work Is complete.
~I Mechanlcel - When all
mechanical work Is complete.
o Flnel Building - When all
required Inspections have been
approved and building is
completed.
DOiher
MOBilE HOME INSPECTIONS
o Blocking end Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrlcet Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Flnel - Alter all required
Inspecllons are approved and
porches, skirting, decks, and
venting have been Installed.
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BUILDING "ALOE, PLAN CHECK
AND BUILDING PERMIT
I P.L.
IN
Is
BUILDING PERMIT ';
ITEM SO. FT:
"
'.~
X S/SO. FT. =
VALUE
Main
Garago
"
Carport
Total Value
Building Permit Fee
State Surcharge
Total Foo
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
.'
,
Rosldentlal Bath(s)
"N'
.,.
,-
,
. ..
.~
FT.'
FT.
FT.
Sanitary S~wer
Water
"
'J .
~. .1"
, "
..
", "r/.
v,", . ,~..:..
,"0' ''t.-,' ..
)~ '.~, '-,':.. '"
.. :\'.. >;.,., ,,'
:l,', . (...,d'
..''',.
, "
Storm Sewer
Mobile Home
;'.'.'"
. -:.,
, ,
.
Plumbing Permll
...; '../)...
l,i,.. ~'\'"
.~:~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unll
,
ryer Vent '11' \
Mechanlcal~er~1t ~
Issuance J
State Surcharge 1- 3~
Total Permit (D)
lS pt) .
is PU;
{tJ.W
~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
fl
Curbcut
Demolition
Slate Surcharge
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding olectrICal)c!1f.p ..Q.O
(A, B, C. D,.and E Combined)
.
"(
IS THE PROPOSED WORK IN THE.
"'HISlORICAL DISTRICT, OR ON
THE HISlORICAL REGISTER?
II yes, Ihls application must be signed
and approved by the Historical
, Coordinator prior '0 permltlssuence.
APPROVED:
This permllls granted on the ox press condition thai ,the said
construction shall,ln all respects, conform to the Ordinance
adopted by the Clty.of Springfield, Including the
Dovelopment Code, regulating the construction and use of
buildings, and may be suspended or rovokod at any time
upon vlolatl.on of any provisions of saId ordInances.
Plan Check Fee'
Dato Paid:
Receipt Number:
.
Received By:
Plans Rovlewod By
Date
Systems Developmenl Charge Is due on all undevelopod
properties wllhln tho City limits which are being Improved.
ADDITIONAL COMMENTS
~.~.
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By signature, I state and agree, that I have carofully 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 the State of Orogon perlalnlng to tho work described
herein, and that NO OCCUPANCY will be made of any
structure wllhout permission of Ihe Building Safety Division.
I further certify that only conlractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspoctlons Bre
requested at the proper time, that each addreas la readable
from the atreet, that the pormlt card Is locatod at the front
~f t e property, and the approved set of plans will remain
on he site at r'jS during c~ctlon.
S natu~ l {rf,~() ~
. Date IO~ 7
i
VALIDATION: {\ (\ ~
RECEIPT NUMBER tj.' IS I ~
DATE PAID (() .,.() . qr;, , --,
AMOUNT RECEIVEr! -- i1IQ .f)..f)
RECEIVED BY I.:!'('o{l__ )