HomeMy WebLinkAboutPermit Mechanical 1993-9-7
.RESI9ENTIAl::4...... ,,~~
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP: /7.....,3-3.">'-~/
LOT:
OWNER:
ADDRESS:
W~~NE
bS'~
SPR,c::..,J
z/ m/7/L!!!:7'-n?~
n7/9-//I/ .s 7
CITY'
DESCRIBE WORK: /AI~/I
REMODEL X
ADDITION
NEW
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL:
ELECTRICAl'
~ff~
I'~<:
QUAD AREA"
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:
.
SPRINGFIELD
64g
S/.
.
JOB NUMBER 93/$~ L_
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
~_~O~
/7119/N
,
BLOCK'
STATE:
0,-
PHONE:
7~7-33o/__
h/&v
d 1(1 c....
ZIP:
Q7V"'?""7
DEMOLISH
OTHER
ADDRESS
CON ST.
CONTRACTOR'
I'HONE
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and (ramlng Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover. '.
o . Drywall - Prior to taping.
o Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - Alter
forms arc 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.
Il Streot Trees - When all required
EXPIRES
ozJ~/"f
7V6767".,
"
Ll6f:1...I//17t:UN-
~a.
<"<r: t:,1(- 2-
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT ~OURCE:
RANGF'
FLOOD PLAIN:
ZONING CODE:__
. OF BDRMS:
S=.CONDARY 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 foHowing work day.
REQUIRED INSPECTIONS
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Undcrslab Plumbing I Electricall
Mechanical - Prior to cover.
o
Footing - After trenches are
excavated.
o
Masonry - Steel locatlon, bond
beams, grouting.
o Foundation - After forms are
erecled but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbingl 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 filling
trench.
" Rou<lh Plumbing - Prior to
o
Final Plumbing - When all
plumbing worl( is complete.
o Final Electrical - When all
electrical work is complete.
[Xl Final Mechanical - Wilen all
mechanical work Is complete.
o Final Building - Wilen all
required inspections hilVC been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - Wilen all
blocking is complete:
o Plumbing Connections - When
home has been connected to
water and sewer.
o
Electrical Connection - When
blocking, sot.up, and plumbing
Inspections tl<:lVC been approved
and the home is connected to
the service panel.
o Final - After all reQuiled
Inspections are approv'~d and
porches, skirting, decks. and
.
Lot lacl~:;
Lot TYI,e
Lol sq. Itg.
Interior
Lot coverage
Corner
Topograph',
Panhandle
Tot~r height
Cul-dc.sac
BUILDING PERMIT
ITEI'~ so, FT,'
x
$/SO. FT.
Main
Garage
Carport
':-
-""""\_.-
Totnl Value
Building Permit Fec
Stale Smcharge
Total Fcc
(AI
.
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes,~this applicatior; must be signed
and approved by the Historical
Coordinator prior to permit issuance.
___._ 3etb'1cks
P.L. HSE GAR ACf..
N
S
-----
W
_E_.____
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING. PERMIT
ITEM
Fixtures
Residcnti.l1 Bath(s)
N'
Sanitary Sewer
FT
Water
FT.
Storm SeVier
FT.
Mobile HOl11e
Plumbing Permit
State Smcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace f1'l~c y~. -
Exhaust Hood
Vent Fan
N'
Wood Stove! Insert/Fireplace Unit
Dryer Vent
Mcchaniciil Permit
~...v,
Issuance
State Surct1alge
Tolar Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Stale Issuance
State Surcharge
Sidewalk
It
Curbcllt
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exclllding electrical)
(A, 8, C, D, ami E Combinccl)
..
FEE
/.... -
-
-/12'
-~~
"2 S: '/$
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
~ .....buildlngs, al)d\may be-suspended. or revoked at any time
. . ~'.' .. .. \ ~ . .
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 arc being improved.
:' ,ADDITIONAL COMMENTS
... . . ,". ' .
'.
By signature, I state 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 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 al Imcs during construction.
~.
Signaturp
/
Date 9 / 7
. I
/Y'" /
r
jQq
I
VALIDATION:
/d//o;;e.
-;-7-9"3
AMOUNT RECEIVED Z$: ?'5""
RECEIVED 8Y _~~
RECEIPT NUMBER
DATE PAID
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