HomeMy WebLinkAboutPermit Mechanical 1991-11-25/
SP]lI}lCiFIELD
oS+ar)
BLOCK:
I
t10z ?J-+lt
LOI SUBDIVISION
TAX LOT:
LOCATION OF PROPOSED WORK:
ASSESSOFIS MAP:
JOB NUMBER
RESID ENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
225 Fifth Street
Springfield, aregon 97 477
PHoNE: 1L/q'11q1
ztP: q 1v11oSTATE:CITY:
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ELECTRICAL:
ADDRESS EXPIRES PHONE
Q1t!
Jd +-oJt'
CONTRACTOR'S NAME
MECHANICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
_ OFFICE USE _
LAND USE:
* OF BDRMS:
RANGE:WATER HEATER
ZONING CODE:
FLOOD PLAIN
* OF UNITS:
OUAD AREA:
S OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726'3769. This is a24hour recording. All inspections requested before 7:00 a.m. will bemade the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQU!RED INSPECTIONS
|-l temporary Electric Rough Mechanical - Prior to
cover.
Final Plumbing - When allplumbing work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When atl
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.Electrical Service - Must be
approved to obtain permanent
electrical power.
pzFinat Mechanical - When atl..^+ mechanical work is complete.
Footing - After trenches are
excavated.Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.
Fireplace - Prior to facing
materials and framing lnsp.
Framing - Prior to cover,
Foundation - After forms are
erected but prior to concrete
placement.
Other
Wall/Ceiling lnsulation - prior to
cover.
l--l Underground Plumbing - prior
-
to filling trench.Drywall - Prior to taping.
Underlloor Plumbing/ Mechanicat
- Prior to insulation or decking.
MOBILE HOME INSPECTIONS
Wood Stove - After installation
Post and Beam - Prior to floor
Insulation or decking.lnserl - After fireplace approval
and installation of unit.
Blocking and Set.Up - When allblocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - After
forms are erected but prior toplacement of concrete.
Plumbing Connections - Whenhome has been connected towater and sewer.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
Electrical Connection - Whenblocking, set-up, and plumbing
inspections have been approved
and the home is connected tothe service panel.
Water Line - Prior to filling
trench.
Fence - When completed
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved andporches, skirting, decks, andventing have been installed.
Rough Plumbing - Prior to
cover.
q n3??
,A.bi o' YYnflnhc.clnut t
E
E .110^Ot
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Set k . j THE PROPOSED WORK IN THE
HISTOFIICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
P.L,HSE GAR ACC
N
S
E
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.
Plans Reviewed By Date
Receipt Numbe
Plan Check Fee
Date Paid
Received By:
BUILDING PERMIT
ITEM SQ. FT. X $/SO. FT.VALUE
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
Mai n
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N0
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
MECHANICAL PERMIT
I< cro
lO oc>
-ls-
(D)?,s-rr
N0
Mechanical Permit
lssuance
State Surcharge
Total Permit
Fu rnace
Exhaust Hood
Vent Fan
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 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
proiect.
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
of the property, and the approved set of plans will
Date
sig natu re
n
on the site at all ti u rin€ construction.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
tt
Curbcut --- ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
31 32
")es lq r
/94
rsDATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
31 :s-
FT.
q R',^e_