HomeMy WebLinkAboutPermit Mechanical 1995-5-4
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Oftlce: 726.3759
LOT'
OWNER'
ADDRESS:
CITY'
BLOCK:
STATF' .
fJ!i--
DESCRIBE WORK:
NEW REMODEL
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ADDITION .
CONTRACTOR'S NAME
GENERA' .
DEMOLISH
OTHER
.-
JOB NUMBER ~t:::rJ 4/__
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
f) .p-- ;p)( )
SUBDIVISION:
PHONE:
14./ ~3~/
ZIP:
.4 /tJ7~
ADDRESS.
CON ST.
CONTRACTOR'
PHONE
EXPIRES
PLUMBINC"
MECHANICAL:.jnkVl UJJ~~ (jl/S p;p~ 2fJ7?q 6/'rnfJJ/Aif Rd ?!/{7J~ /JLqf ~I
ELECTRICAl'
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS' ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE' SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, All Inspecllons 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
o Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting torms.
D Underslab Plumbing/ ElectrlcalJ
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel locatlon, bond
,beams, grouting.
D Foundation - 'After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to IIIIIng trench,
O Underlloor Plumbing/Mechanical
-,Prior to Insulation or decking,
{
o Post and Beam - Prior to floor
Insulation or decking. .
O Floor Insula lion ...... PrIor to
decking,
o Sanitary Sewer - Prior to IIl1lng
trench.
D Storm Sewer - Prior to fllJlng
trench.
o Water Line - Prior to filling
trench.
D Rough Pl,umblng - Prior to
cover.
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 Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After Installation.
o Insert - After fireplace approval
\ and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fen~e - When completed.
D Street Treos - When all required
trees Bre planted.
o Final Plumbing - When ell
plumbIng w9rl~ Is complet,e.
D Final Electrical - When all
',electrlcal work Is complete.
D Final Mechanical - When alt
mechanical work Is complete.
o Final Building - When all
required InspectIons have been
approved end building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set,Up - When all
blocking Is complete.
o PJumblng Connections - When
home has been connected 10
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Ins"pectlons are approved and
porchos, sklrttng, docks, and
venting have been Installod.
I PL. HSE GAR
IN
Is
Iw I I I
~I
,.
Lot faces
Lot TY..
Lot sq, flg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de,sac
BUILDING PERMIT
ITEM SO. -FT, X $/SO. FT, = VALUE
Main
Garage
Carport
"
TOlal Value
Building Permit Fee
State Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
i
I.
Fixtures
Resldenl/al Balh(s)
N'
Sanitary Sewer FT,
Water FT,
Storm Sewer FT,
Mobl/e Home
Plumbing Permit
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/ Fireplace Unit
Dryer Vent
Mechanical Permit
I t5. 6{)
I O.r5D
I, Zf)
iio-W
Issuance
I~i, ''<k
'fib 13 c;6
State Surcharge
Total Permit
(D)
MISCELL.~NEOUS PERMITS
Mobile ,Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demol/I/on
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
2l,.W
:.:~.; :~.c:fk'\H~j
'1
Setbacks
., IS THE PROPOSED WORK IN THE,
....HISTORICAL DISTRlcr, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcal/on must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Acc'l
I
I
APPROVED: .
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construcl/on shall, In all respects, conform to the Ordinance
adopted by the Clty.of Springfield, Including the
Development Code, regulal/ng the construcl/on and use of
buildings, and may be suspended or revoked at any I/me
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 duo on all undeveloped
properl/es within tho City IImlls which are being Improved,
ADDITIONAL COMMENTS
By signature, I stato and agree, that I have carefully examined
the completed appllcal/on and do hereby cerl/fy 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 01 Oregon pertaining to tho work described
herein, and that NO OCCUPANCY will be made 01 any
structure without permission of the Building Safety Division,
I further cerl/ly 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 pormlt card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
slgna.d,A J-<tu., _ ~N
Date ( -*~tfkjo
VALIDATION:
RECEIPT NUMBER /72H3
~r4 -C[~
AM'OUNT RECEIVED '7 J/J -71)
RECEIVED BY ~ 0
DATE PAID