HomeMy WebLinkAboutPermit Mechanical 1995-11-30RESIDENTIAL
PERMIT APPLICATION
lnspections: 126-9169
Office: 126-JtSg
SPRt FIELE)
ASSESSOBS MAP 3 zZ 3
JOB NUMBER .,3
225 Fifth Street
Springfletd, Oregon 97 477
TAX LOT
LOCATION OF PROPOSED WOHK;
LOT BLOCK:SUBDIVIStON: ---
PHONE:
ZIP:,ryCITY:
ADDRESS:
OWNER:
NEW
-
FIEMODEL ADDITION DEMOLISH OTHER
-
DESCRIBE WORK:
ADDBESS
C; su /L/d Tzu,q Eo ects d673?6 L Fz.t
EXPIRES PHONE
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
_ OFFICE USE -
QUAD AREA:
I OF BLDGS:
]VRough Mechanlcal - Prior to
,Acover.
FLOOD PLAIN
Final Plumbing - When all
plumblng wqrl( is complete.
Temporary Electric
Site lnspection - To be made
after excavation, but prior to
setting Iorms.
Underslab Plumbing/ Electrical/
Mechanlcal - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, grouting.
Foundatlon - After forms are
erected but prior to concrete
placement.
Underground Plumbing - Pribr
to filling trench.
Underlloor Plumbing/ Mechanical
- Prior to insulatlon or decklng.
Post ahd Beam - Prlor to floor
insulation ot decking.
Floor lnsulalion - Prior to
decki ng.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbing - Prior to
cover.
LAND USE:
# OF UNITS
OCCY GROUP:
r OF STORIES:
r OF BDBMS:
BANGE:
SECONDARY HEAT:
SOUARE FOOTAGE:
To request an inspectlon, you must call 726-3769. Thls is a24hour recording. All inspectlons requested before 7:00 a.m. wlll be
made the sante worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
CONSTR. TYPEr
HEAT SOURCE:
Rough Electrlcal - Prior to
cover
Electrical Service - Must be
approved to obtain permanent
electrlcal power.
Fireplace - Prior to faclng
materlals and framing lnsp.
Framlng - Prior to cover.
Wall/Celling lnsulation - Prlor to
cover
lnsert - After flreplace approvql
and installation of unit.
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
l--l Fence - When completed.
Slreet Trees - When all required
trees are planted.
ffi finat Electrical - When all+electrical work is complete.
lVfinal Mechanical - When all,la(mechanical work is complete.
Final Buildlng - When all
required lnspections have been
approved and building is
completed.
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When all
blocking is complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspectlons are approved and
porches, skirting, decks, and
venting have been installed.
32
STATE:
ZONING CODE: _
WATER HEATER:
fl
tl
n
E
tl
E
E
tl
tl
E
E
E
tl
r
[--l Drywall - Prior to taping.
l-_l Wood Stove - After lnstallation.
E
tl
[--l other
E
r
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Typ*
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
ISTHE PFIOPOSED WOBK iN THE .
HrsroBlcAL DlsTRlcl oB oN
THE HISTORICAL REGISTER?
-
lf yes, this application must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
ACCP.L.HSE GAR
N
S
E
VALUE
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. 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, confprm to the Ordinance
adopted by the City of Springfield,,i ncluding 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 Rcviewed t3y Date
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tl.re City linrits which are being improved.
ITEM '
Fixtures
Residential Bath(s)
Sanitary Sgwer
Water
Storm Sewer
Moblle Home
FEE
(c)
No
FT.
PLUMBING PERMIT
FT.
FT.
Plumbing Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
state surcharse t 7f /, /f
MECHANICAL PERMIT
,ze-hlzo
Total Permit 2a-?o
Zz/( 1
(D)
N0
Mechanical Permit
lssuance
Fu rnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certify that alllnformation hereon is true ancl correct, and I f urther cerilfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Sprlngtield, and the Lawsof the State of Oregon pertaining to the work descrlbed
herein, and that NO OCCUPANCy wiil be macJe of any
structure without permission of the Buildirrg Safety Division.I further certify that only contractors and employees who
are ln compliance with ORS 7O1.O5S will be used on thlsproiect.
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 ls located at the frontof the property, and the approved set of p
5
ct
gnature
Date
will remain
on the site at all times duri
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk _ ft
Curbcut --_- ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Combtned)
*%_?!LaAMOUNT RECEIVED
RECEIVED BY
DATE PAID
VALIDATION:
RECEIPT NUMBER
X $/SO. FT.