HomeMy WebLinkAboutPermit Mechanical 1997-10-10
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RESIDENTIAL
PERMIT APPLICATION
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JOB NUMBER
Inspections: 726.3769
Office: 726.3759
225 Fifth Street
Springfield, Oregon 97477
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LOT'
BLOCK'
SUBDIVISION'
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OWNER' -n'i\.A..
ADDRESS' 'I -::>.., ')
CITY: ~,,"V.\c\
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PHONE:
. STATE;' or J
0llf77
ZIP:
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DESCRIBE WORK: ~ fi (:'0 +(J Q~r p-;:"
NEW REMODEL ADDITION ;:x DEMOLISH
~..TQ-"/L.--
OTHER
CONST.
'.. CONTRACT9R'
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL: ~-M.b()1}() od,M"VI\,J (I~
ADDRESS
EXPIRES
PHONE
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,ELECTRICAl'
- OFFICE USE - ,.,o?>V--
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QUAD AREA: LAND USE: ojr.f:. \r ~\ \~~OD PLAIN'
. OF BLDGS' . OF U~'fI!\c.~' -db.\'\' ~'I< \~~ ?~?>\lI t"\ r(;{ONING CODE,_
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OCCY GROUP: CONS't'R ~S~ - 'IN.\)Y;; ttN.\)O . OF BDRMS'
. OF STORIES: HEAT S:'R"~?>\"/.'(;.~; a?> \'2>: ' SECONDARY HEAT:_,
P'\l' ~~I.Jt.:- ~\\Jv'
WATER HEATER: RANGE: c('\~\lI v''-I?€ SQUARE FOOTAGE:
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To request an ,Inspection, you must call 726-3769. This Is a 24 hour recording: Alllnspecllons 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.
REQUIRED INSPECTIONS
D Temporary Electric
D Rough Mechanical - Prlor'to
cover.
D' Final Plumbing - When all
plumbing worl< Is complete.
, ,
D Site Inspection - To be made
after excavatlon, but prior to
setting forms.
D Rough Electrical - Prior to
cover. .
o Final Electrical - When all
electrical work is complete.
~nal Mechnnlcal - When all
mechanical work Is complete.
D Underslab Plumbing/Electrical/
Mechanical - Prior to co.....er.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After trenches are
excavated.
D Final Building - Whlln all
required Inspections have been
approved and building Is
completed.
D Fireplace - Prior to (acing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting.
D Framing - Prior to cover.
D Olhor G-A'"-. \; ~
D Foundation - After forms are
erected but prior to concrete
placement.
D Wail/Ceiling Insulation - Prior to
cover.
D Underground Plumbing - Prior
to filling trench. .
D Drywall - Prior to laplng.
MOBILE HOME INSPECTIONS
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Wood Stovo - After Installation.
D Blocking and Set.Up - Whcn all
blocking Is complete.
D Post and Beam - Prior to floor
Insulation or decking.
D Insert - After fireplace approvel
and Installation of unit.
D Floor Insulation - Prior to
decking,
D Plumbing Connections - When
home has been connected to
waler and sewer.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Santlary Sewar - Prior to filling
trench.
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Sidewalk & Drlvewav - After
excavation Is complete, forms
and sub.base material In place.
D Storm Sewer - Prior to filling
trench.
D Fence - VI/hen completed.
D Water Line - Prior to filling
trench.
D Final -,After all requlrcd
inspections are approved and
porches, sklrllng, decks, and
venting have been Installed.
D Rough Plumbing - Prlo.r to
cover.
D Street Troos - When all requIred
trees are planted.
.
Lot faces Lot Type
lot SQ, fIg, InterIor I P,l,
IN
Lot coverage Corner
Is
Topography Panhandle
Iw
Total height Cul,de.sac
IE
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT, c VALUE
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Setbacks
HSE GAR Accl
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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
~,O~ ~ Development Code, regulaling the construe lion and use of
(~' ,,~ buildings, and may be suspended or revoked at any tIme
~~v ~ upon violation of any provisions of said ordinances.
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~<<-' ~. { Plan Check Fcc'
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SYSTEMS DEVELOPMEN-fl~1\~E (SDC)
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Main
Garage
"
Carport
Total Value
Building Permi t Fee
State Surcharge
Total Fcc
PLUMBING PERMIT
iTEM
FEE
FIxtures
.' r, .
"
Residential Bath(s)
N'
'. '.hl~>.
Sanlt.ary S~wer
Water
FT.
FT.
Storm Sewer
FT,
MobIle Home
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.....: .... _............~
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Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
GA.."I~IU '-1 ~,t(n-4 \.\t.Ju-
4>f.t,,<:;;D
f 1<,-
4 10,
Mechanical Permit
Issuance
State Surcharge + 0,037,
Total Permit (D)
~lo. .J..9-
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
~
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
Slale Surchargll
Total Misceilaneous Permlls (E)
TOTAL AMOUNT DUE (excludln(1 electrical)
(A, B, C, 0, and E Combined)
IS THE PROPOSED WORK iN THE,
'''HISTORICAL DiSTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appilcation must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Date Paid:
Receipt Number:
Received By:
Plans Reviewod By
Dale
Systems Development Charge is duo on all undeveloped
properties within tho Cily limits which are being" Improved.
ADDITIONAL COMMENTS
By sIgnature, I state and agree, that J have carefully examined
the completed applicatIon and do hereby certify that all
Informatlon hereon is true and correct, and I further certify
that any and ail work perlormed shail be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to tho work described
herein, and Ihal 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 agreo to ensuro that all required Inspections are
requested at the proper tlme, that each address Is readable
from tho street, that the permit card Is located at the front
of the property, nnd the approved set of plans will remain
on the site at al~ times during construc~ ~
Slgnaru~'h"~l ~ ~..IM..O..01
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VALIDATION:
RECEiPT NUMBER ~ d-7 c., & 0
DATE PAIP , b - \ D - q 7
~..2lr, erd
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AMOUNT RECEIVED
, RECEIVED BY