HomeMy WebLinkAboutPermit Mechanical 1996-7-15
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RESIDENTIAL
PERMIT APPLICATION
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SPRINGFIELD
Inspeclions: 726,3769
Office: 726,3759
LOT:
BLOCK:
OWNER:
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ADDITION
OTHER
ADDRESS:
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CITY:
STATE:
DESCRIBE WORK:
NEW V REMODEL
DEMOLISH
CONTRACTOR'S NAME
GENERAL: __
ADDRESS
CONST,
CONTRACTOR'
PLUMBING'
MECHANICAL: fJ 11/).' be.,. 11-1:. {-
ELECTRICA" (/ tf
//:Jti7ft/, SJ], &... ,'I7t.fOt j'pSVS
./
OUAD AREA'
3~~
- OFFICE USE -
LAND USE: -1L5.n
. OF BLDGS'
OCCY GROUP:
. OF UNITS'
CONSTR, TYPE:
. OF STORIES: ___
HEAT SOURCE:
,WATER HEATER:
RANGE:
.
qrooroq I
JOB NUMBER
225 Firth Slreel
Springfield, Oregon 97477
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SUBDIVISION'
PHON'"
ZIP:
9?~7 P'
. >'
EXPIRES
PHONE
~.ft
39'Y'-,,) Vu
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you must cDIt 726.3769. This Is a 24 hour recordIng. All Inspections requested before 7:00 a.m. will be
Il1mlc the sallie worklna day. Inspections ra uestcd after 7:00 a.m. will be made the following work day.
I~ Tcmpor:....v Electric
Q IRED INSPECTIONS
ough Mechanical - Prior to
Gover.
D
D Rough Electrical - Prior to
cover.
Site Inspection - To be mndc
after cxc;lvntion, but priol to
setting loons.
o
Underslub Plumbing I Electrlcall
Mechanical - Prior to cover.
o Eleclrical Service - Must be
approved to obtain permanent
elec'trlcal power.
o Footing - After trenches are
excavated.
o Fireplace - Prior to facing
mnterlals and framing Insp.
o Masonry - Steel locntlan, bond
beams, grouting.
o Frarnln{J - PrIor to cover.
o Foundation - AHcr forms are
erected but prior to concrete
placement.
o Wall/Ceiling Insulation - PrIor to
cover. .
o
Under!Jround Plumbing - Prior
to filling trench.
o Drywall - Prior to taping.
o
Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
o Wood Stove - After Installation.
o Post llncl 8e3m - Prior to (iOOt
lnsulntion Of decking.
o Insert - Atter r1replace approval
and Installation of unit.
o Floor Insul<ltion - Prior to
dccl<inu.
o Curbcut & Approach - After
forflls arc erected but prior to
placement of concrete.
o
Sanitary Sewer - Prior to filling
trench.
o
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base materIal In place.
Storm Sewer - Prior to filling
trench.
D Wuler Line - Prior to 1I11in{l
trench.
D Fence - When completed.
o Rough Plumbing - Prior to
cover.
o Street Trees - Wilen all required
trees me planted.
o
Final Plumbing - Wilen all
plumbing work Is completc.
D Final Electrical - Wilen all
'-----' 7trlcal work Is complete.
~ ~~~I Mechanical - When all
mechanIcal work 1'5 complele.
o Final Building - When all
required Inspections have been
approved and blllldlng Is
completed.
OOthor
MOBILE HOME INSPECTIONS
D Blocking and Sot-Up - When nil
blocking Is complete.
o Plumbing Connections - When
home has been connected 10
watcr and sewer.
o Electrical Connection - Wtlen
blocking, set-up, anej plumbIng
inspections have been approved
and the home is connected to
thc servIce panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
I'
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Lot Type.
Lot faces
Lot sq, ltg,
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.dc.sac
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fec
(A)
.~
~, THE PROPOSED WORK tN THE
qlSTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes. this application must be signed
and approved by the Historical
,Coordinator prior to permit issuance.
Setbacks
.BL HSE GAR ACC
N
~-
~-- --,---
~1____I___I____J
APPROVED:
VALUE
(8)
SYSTEMS DEVELOPMENT CHARGE (SDC)
WIt'" JiDD_
sll~1 \5.{)n
JO.12Q
+ 3'70 cry M",j/\ Fit.. \.10
11o,2.Q
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s) NO
Sanitary Sewer
FT,
Water
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Drrr;;tpv~r
Mechanical Permi 1
Issuance
Slate Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Homo
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
Ii
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, 0, and E Combined)
FEE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is wanted on the express condition that the said
construction sllall, in all re::-,pects, conform to the Ortlinance
adolJted by tile Cily of Springfield, incluuing the
Developmont Code, regulating the construction and llse of
buildings, flnd may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number:
Recci vod By:
Plans f~oviewed By
Date
Systems Development Charge is due on all undeveloped
properties wilhin the City limits which arc being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully ex?mined
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 lhe LilW:';
of the State of Orellon perlilining to the work de:icribed
herein, and thai NO OCCUPANCY will "be made of any
stwclure without perlTli~;sion or the 8uildinU Safety Divi~;ion.
I further certify that only contractors and crnployce~; who
arc in compliance witll ORS 701.055 will be used on tllis
project.
I furLhcr agree 10 ensure th;]t all required inspections .Jr(J
requcstcd at 1I1C propm tilllC, Hw.t cacll addless i~; reauo.blc
frOIn lho strect, that the pcrmit card i:i IOGated at 1I1C fronl
of tllC properly, and lIw approved sot of pl..lIls will lunwin
011 U1l.) tiilo al .:di iillles during construction.
signature_~L//d (arK
'-- - 1-
d'7- /..5- ~c.
Dat(>
VALIDATION:
125 {("
DATE PAID 7 - Lfo - q (/J
AMOUNT RECEIVED J.lo ' ') ()
\ A",
RECEIPT NUMBER
RECEIVED BY