HomeMy WebLinkAboutPermit Mechanical 1993-9-8
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726,3769
Office: 726-3759
SPRINGFIELD
~t@
LOCATION OF PROPOSED WORt<.
".fSl6"7 /YY
/I-C:>::?~S- =< Y
9:
ASSESSORS MAP:
LOT'
. BLOCK.
OWNER:
ADDRESS:
BILYtI)S'KYJ
UWI,{j IVY
.3 r R. \ I\) b f\ S \.-t:>
3+e. \J €..
CITY.
DESCRIBE WORK'
I f\)STAj...)...
NEW
REMODEL ~ ADDITION
'-
STATE:
OR
.
~ goo
JOB NUMBER '9?/?~
225 Fifth Street
Springfield. Oregon 97477
TAX LOT'
SUBDIVISION'
d/~6e>
PHONE:
'14 I.j -9~1 lj,=5
ZIP:
Q7C/7X'
AIR
('.nnJJ) 11'10 AJ 5 t:.. ( J). Y,tJ -I-rrn )
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prlor 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 Stove - 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 Fence - W~en completed.
o Street Trees - When all required
trees are planted.
ADDRESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
CONTRACTOR'S NAME
GENERAl.
PLUMBING:
MECHANICAL,0mn\Cr-+ ~\DI.J,) ~e.o..-\-\~ 'i\S5\u \.5t r:::'J..r..E':ros-<f1tJD..1 004lPD %'1}ql/ 3 I.)J..81lJ/
DEMOLISH
OTHER
ELECTRICAl'
- OFFICE USE -
OUAD AREA: LAND USE: FLOOD PLAIN'
. OF BLDGS. . OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYP'" . 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
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Undcrslab Plumbing/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 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 to filling
trench. .
.'
o Rough Plumbing - P.r1or to
cover. ~
\
o Final Plumbing - When all
plumbing work Is complete.
o Final Electrical - When all
electrical work is complete.
[Kl 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 Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel'up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
o Final - After all requIred
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
I
.
Lot faces
Lot Type
Lot sq, fig,
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
., .
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT, X $/SO. FT.
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
I~E 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.
I PL
IN
Is
Iw
IE
Setbacks
HSE GARIACCI
I I
I
I
I
VALUE
,
SYSTEMS DEVELOPMENT CHARG'E (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
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 Stovellnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
~~.
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobiie Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricai)
(A, B, C, D, and E Combined)
FEE
~5: ,z::.
/t?- diP
../5'
~7'!?
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
. This permit islgranted ~n the express ~ondjti6~ that the said
..construction, shall, in all respects, conform to the Ordinance
adopteci: oy the Cily 'of 'Sprlnglield., Including the
Development Code, regulating the construction and use of
buildings, and may'he suspended or revoked at any time
upon violation of any provisions of said ordinances.
. Pian Check Fee:
Dale Paid:
Receipt Number:
Recei ved By:
Plans Reviewed .By
Date
Sys.tems Development C"harge is'due on,'all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
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 shalf be done in accordance
with the Ordinanct;;!s of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that 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 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 fronl
of the property, and the approved set of plans will remi'li
on the site at all timC~uring construct!
Signature ~J;r J
Dale 'l r~7/#
VALIDATION:
RECEIPT NUMBER
/ttP/K"Z.
~-""'? ;-
-::z.E>~
~~.
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
- -