HomeMy WebLinkAboutPermit Mechanical 1995-11-2
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RESIDENTIAL
PERMIT APPLICATION
Inspecllons: 726,3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP'
LOT'
/9, (') 2.
..
SPRINGFIELD
.IIIL. tip
i..j 7./),1 .:c";; 1
o:5""? /
BLOCI"
OWNER'
ADDRESS'
CITY:
12:0;/ I.! OvIVlO,.,
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DESCRIBE WORK'
NEW
REMODEL
STATE:
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JOB NUMBER
9s/47~
ADDITION
DEMOLISH
OTHER'
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: _/"J.s 2... f"7C?
SUBDIVISION:
PHONE:
1LJ?- 4's-//J.
ZIP'
..
,.,..
HI/Ar_
ADDRESS
CONST,
CONTRACTOR'
PHONE
REQUIRED INSPECTIONS
~OU9h Mechanical - Prior to
~'~ver.
..e::::;::rAough 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/e"elllng Insulation - PrIor to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After Installallon,
o Insert - After fireplace approvel
and Installation of unit.
o Curbcut & Approach - After
forms afe erected but prior 10
placement of ooncrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base materIal In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. ..
EXPIRES
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))N, <7s- ~~-d</P"
CONTRACTOR'S NAME
GENERA' '
PLUMBING:
MECHANICAL:~ltml
ELECTRICAL: .fd: ..;.~ W'..L..~7'I--
s72J+.
~..I/'
. f/
- OFFICE USE -
QUAD AREA' LAND USF' FLOOD PLAIN'
. OF BLDGS: . OF UNITS: ZONING CODE: _
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SQUARE FOOTAGE:_
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Atllnspectlons 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 Inspoctlon - To be made
after excavatlon, bUI prior 10
seltlng forms.
o
Underslnb' Plumblngl 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
Underlloor Plumbing/Mechanical
- Prior to Insulation or deckIng,
o
Post and Boam - Prior to floor
InsulatIon or decking.
o Floor Insulation - Prior to
decking,
D 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.
o Final Plumbing - When all
plumbing wQrI< Is complet.c,
~ ~.Inal Elcclricnl - When all
.~.ectrlc.al work Is complete.
-r~:;YF:lnal Mechnnlcal - When all
. ~mechanlcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Sel-Up - When all
blocking Is complete.
o Plumbing Connections - When
homo has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up. and plumbing
Inspec'tlons have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porchos, skirtIng, decks, and
venting have been Installed.
Lot faces
Lot Typa
Lot sq, rtg,
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul,de,sac
BUILDING PERMIT
ITEM SQ, FT,
X $/ SQ, FT.
Main
Garage
Carport
Total Value
Building Permi I Fee
State Surcharge
Total Fcc
(A)
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT,
FT,
FT,
Water
Storm Sewer
Mobile Home
Plumbing Permit
Stato Surcharge
Total Charge
(C)
MECHANICAL PERMIT
. Furnace # ~
Exhaust Hood
Vent Fan
N'
Wood Stove/insert/Flreplace Unl,l
Dryer Vent
-::fIG! r=-P.;/Wli.D
Mechanical Permit
//?/A./,
IS,suancD
Slate Surcharge ,7) of- , -;r'fl '
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding ~Iec"lcal)
'(A, B, C, 0, and E Combined) ,
FEE
,-:; &t:)
1~80
_LD,~,
/2()
?..~ ~o
, 2~2.0
Setbacks
'IS 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: ,
,"
This permit is granled on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City 01 Springfield, including the
Development Code, regulating the constructlon and use of
buildings, and 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 tho City limits which are being Improved,
ADDITIONAL COMMENTS
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By signature, I state and agree, that I h:Jve carefully examined
tho 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 tho work described
herein, and thai NO OCCUPANCY will be made 01 any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
arc In compliance with ORS 701.055 will be used on this
projecl.
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
01 the property, and the approved set of plans will remain
on the site at all times during construction,
~$( IM"'IL.
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Signature
Date
VALIDATION:
RECEIPT NUMBER
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY