HomeMy WebLinkAboutPermit Mechanical 1994-8-16
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPO~ED WORK: /9CJ<I / N/..Il AI tl tv ft V
ASSESSORS MAP: /1I'~-::IJ.e::>:::ii!.- -="; ~
LOT:
OWNER: J././:'" L F JJ
ADDRESS" /90 Lj
BLOCI<"
Se.IIOE N
I/oILftNb 1.r.JItV
I
SPJe IN I...'P-/FLI'>
CITY:
DESCRIBE WORK: /1.1.5 r,4 L L
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA' .
STATF'
012
J../rH-T
'POmP
DEMOLISH
OTHER
.
JOB NUMBER .:::; V/2~ '2.
225 Fifth Street
Springfield, Oregon 97477
TAX LOT' ~ '?c.--~ ...--
SUBDIVISION'
PHONE:
7.lh- ,/.;1.,/[,
ZIP' 97~ 77
ADDRESS
CONST.
CONTRACTOR #
EXPIRES
PHONE
PLUMBING:
MECHANICAL: ('nmr:OIZT Ft.ow .Jj,& 2'5''5" W./ S/'EU b-
ELECTRICA' .
. {;JOt//:,0
10/;. 7/9 S' - 3-.1:2. g/~I
.
- OFFICE USE -
OUAD AREA' LAND USE: FLOOD PLAIN:
. OF BLDGS: # OF UNITS' ZONING CODF'
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.
o Temporary Electric
D Slto Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing I Electrical!
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 to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
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 10 filling
trench.
o Rough Plumbing - Prior to
cover. .
'.
REQUIRED INSPECTIONS
o Rough Mechanical - 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/Ceiling Insulation - Prior to
cover. '.
o Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - After fireplace approval
and Installation of unit.
o
Curbcut & Approach - After
forms are erected but orior to
placement Of concrete.
o Sidewalk & Driveway - After
excavatlon is complete, forms
and sub.base material In place.
o
Fence - When complctp.d.
o
Streot Trees - Wher. all reauired
lreez an: p!~nlcd,
o Final Plumbing - When all
plumbing work Is complete.
D Flnnl Electrical - When all
elec.trlcal work Is complete.
o
Final Mechanical - When all
mechanical work Is complete.
o
Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o BIClcking and Sel.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Eh!ctrical Connection - When
blocking, set-up, and plumbing
Imipections have been approved
and the home is connected to
th(:! service panel.
o Final - After all required
In:~pectlons arc approved and
pc>rchcs, skIrting, decks, and
venting have been Installed.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type .
Interior
Corner
Panhandle
CuI-dc-sac
BUILDING PERMIT
ITEM SO. FT. X $/ SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
Setbacks
P.L. HSE I GA; AC~-
I
S I
.'!!.-- ~---
. E ,--- -l I J
N
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
N'
FT.
FT.
FT..
(C)
Wood Stove/lnsert/Fireplace Unit
N'
Dryer Vent ~
~ /-VN~--"
Mechanical Permit /'7F~
~
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, 0, and E Combined)
FEE
/L-
t7
-
,;'d'..-
~ ~.~
_'2$6:<0
111 '.
: . I:; 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.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition ttlat 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 Cllec:k Fee:
Date Paid:
Receipt NUlTluer:
Received By:
Plnns Reviewed By
Date
Systems Development Ctlargc is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state amI agree, that I have carefully examined
the compleled applicntion 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 Ordinancl;ls of the City of Springfield, and the Laws
of the Slate of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure WltilOUt permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance wllll 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, andoohe pproved set of plans will remain
on the site it a'/JJre tiring .construction.
Signature icj!~~ /~
Date ~/h -W
VALIDATION:
RECEIPT NUMBER
(C;/~ Y7
g>V~~Y
2C_"?C>
-~-- -,.
-- ~~ -..,~....--
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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