HomeMy WebLinkAboutPermit Mechanical 1991-09-25SPRI'{GFIELD
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED
ASSESSORS MAP:
LOT:BLOCK:
JOB NUMBER
225 Fitth Street
Spri ngfield, Oregon 97 477
TAX LOT:
SUBDIVISION
-1fi{\0C)PHONE:
ZIP:STATE:
OWNER
ADDRESS:
CITY:
ADDITION DEMOLISH OTHER
D
N
ELECTRICALi
EXPIRES PHONEADDRESSCONTRACTOR'S NAME
IVIECHAN ICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
FLOOD PLAIN
ZONING CODE:UD[A'
RANGE:
* OF BDRMS:
- OFFICE USE _
LAND USE:\\\ \
WATER HEATER:
* OF UNITS:
QUAD AREA:
# OF BLDGS
SECONDABY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspectlons 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.
REOUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing work is complete.
Site lnspection - To be made
after excavation, but Prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Final Mechanical - When all
mechanical work is complete.
Footing - After trenches are
excavated.Fireplace - Prior to facing
materials and framing lnsP.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.Framing - Prior to cover.
Other
Foundation - After forms are
erected but Prior to concrete
placement.
Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to filling trench.l--l Drywall - Prior to taning.
MOBILE HOME INSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking'Wood Stove - After installation.
Post and Beam - Prior to floor
insulation or decking.lnsert - After firePlace approval
and installation of unit.
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - After
forms are erected but Prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to f illing
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prior to filling
trench.
Sidewalk & DrivewaY - After
excavation is complete, forms
and sub-base material in Place.
Water Line - Prior to filling
trench.
Fence - When comPleted
Rough Plumbing - Prior to
cover.
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
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Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N
S
E
Setbacks
VALUE
(A)
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that 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.
Receipt Number:-
Plans Reviewed By Date
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtu res
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
FT.
N0
FT
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
FT.
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fireplace Unit
o
(D)
No
r Vent
Vent Fan
nical Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
lssuance
State Surcharge
Total Permit
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, 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 f urther 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, and the approved set of
Signature
Date
ti
F-->v
will re
on the site at all ti uring
MISCELLANEOUS PERMlTS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
aVALIDATION
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the H istorical
Coordinator prior to permit issuance.
APPROVED:
Plan Check Fee:
-
C
rPermit No:
Address:
lssued by Date;q,l
r N Fo R MArro N - gtr]ti=+f XIb, =*ry owN ERSABOUT CONSTRUCTTON nesporrrstBtLtriLs-'-
Note: oregon Law,oRS,7o1.o55(4), requires residentiar buirding permit appricantswho are not reoistered with tdi'construction Contrictors Board to dign thefollowing staterient before in"oriroi"g permit can be iisued. Licensed Architectand Engineer appricants, exempt fiom iegistration ino.|' oRS 201.010(7), neednot submit this statement. Thii statemeit *irl-# fii;;;itir:#ffiilli]
1
Fill in the applicable blanks, and initial box 1 and either box 2A or 28
I own, reside in, or wirr reside in the compreted structure
My general contractor is
Contractor registration number
l.will instruct my generat contractor that all subcontractors who work onthe structure must be registered with the Constrrciion Contractors go"io.
2.A
I hereby certify that the ab
the Information Notice to
reverse side ol this form.
ove information is
Property Owners
OR
B I will be my own general contractor.
lf I hire subcontractors, I will hire only subcontractor
h'l.:xrsl:ieif :il';l,ni[hiHix"#kffi #,n}.?:;H,?.{F!?'#'il"lffi
9onstructibn contraCioii aodiotno'i'wiiilmiiieiiiier}"n'oilii"tn'6''ohti..issuing this building permit of the name oi ihe'co;traitor. '
correct and that I have read and understand
about Construction Responsibilities on the,.\
*J
gnature
CONSTRUCTION CONTRACTORS BOARD
024N 1U24tN
Date
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
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