HomeMy WebLinkAboutPermit Mechanical 1994-06-06RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-9769
Offlce: 726-3759
Post and Beam - prlor to floorrnsutailon or decklng.
Floor lnsutallon - prlor todecklng.
Sanltary Sewer - prlor to fllllngtrench.
g
JOB NUMBER
225 Fi{th Street
Sprlngfleld, Oregon 97477
LOCATiON OF PROPOSED WORK:2s
ASSESSORS MAP:z_ /-TAX LOT F)2-
SUBDIVISION:
-
To request an lnspecilon, you
made the same worklng cray, I
must cail 226-3269, Thls ls a 24 hour recordlng. Allnspecilons requested after Z:OO a.m. wttt J" rn.Ou
REQUIRED INSPECTIONS
[--l Temporary Etectrtc
SIle lnspectlon - To be madeailer excavailon, but prlor tosettlnO forms.L] :;#" Etectrlcar - Prror to
tl H::;:,1il'"i 1T,l 3? 1 5' ::y:;.,,,
ll Footlng - After trenches are
- excavated.
tl |!X;l,%;il?:, tocauon, bond
tl 5,!:l*'f?l ;,#lr J:tT;ff"ptacernent.
[-l Ungglsround ptumbtns _ prtor.J to fllllng trench.
n UnAerttoor plumblng/Mechanlcal
prlor to t nsu rait'o"n' ;il;;kl;;:
-X:f"t: Mechanlcat - Prtor to ,K ;,,m,?l;Tj?,?, ;"yff i" il:
fl llnrl Etectrtcar _ When ail
-
erectrtcal work ls complote.
E,'iij.ri_:-o,:z['i":;#;:,"*, X6*,gffjirl?,;#ffi?"il:electrlcal power. t;.,t
lnspecilons
the followln
requested before 7;00 a.m. wlll beg work day.
E
E P,:_rl Sewer - prtor to fil,ilng
-
trench.
Water Llne - prtor to fliltng
trench.
Rough Plumblng - Prlor to
!t19nt.a9e - prtor to faclngmaterlats and framlng lnsf
Framlng - prlor to cover.
fl y_lllr"elilns rnsurailon _ prtor to
-
cover.
[-l Drywafl - prlor to raptng.
f--l Wood Stove - Afror lnstailatlon.
fl *f k,flliJ^',;? T;c€ approva,
Curbcut & Approach - Aftertorms are erected but prlor topracement of concrete.
Sldewalk & Drlveway - Afteroxc.availon ls complete, formsand sub-base materlal ln place.
Fence - When compl6ted.
MOBTLE HOME INSPECTIONS
n Blocktng and Set.Up _ When alt
-
blocklng ls compleie.
Plumblng Connectlons - *iunnome has been connected towater and sewer.
Electrlcal Connectlon _ Whenpl9:Irl9, set.up, and prumbtnsrnspecllons have been approvedand the.home ls connected torne servlce panel.
[--l ftnat - After alt requlred,4 lnspectlons are approved andporchos, sklrilng, decks, andventlng have been lnstalled.
Street Trees - When all requlred
trees are planted.
PHONE:
ztP:STATE:?CITY;
ADDBESS:
OWNERT
NEW --- BEMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ADDRESS
.f
EXPIBES PHONE
CONTRACTOH'S NAME
GENERAL:
ELECTBICAL:
MECHANICAL:
PLUMBING:
CONST.
CONTRACTOR #
_ oFFtCE USE _
LAND USE:
# OF UNITS:
-
# OF BDRMS:
BANGE:
OUAD AREA:
'I OF BLDGS:
SECONDARY HEAT
SQUARE FOOTAGE:
OCCY GROUP;
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
n cover.
n
I
n [fi HJilf.,lg;, #Ji?,x,,'""napproved and bulldlng lscompleted.
n otner
Lot faces
Lot sq. ftg.
Lot coverage
TopograPhY
Total helght
Lot Type --
-
lnterlor
-
Corner
--
Panhandle
-
Cul'de'sac
PL.HSE GAR ACC
N
S
W
E
,S THE PROPOSED WORK TN THE.
- HISTOFIICAL DlsTFlcr, oB oN
THE HISTORICAL REGISTER?
-
ll yes, thls appllcatlon must be slgned
and'aPProved bY the Hlstorlcal
Coordlnator prlor to permlt lssuance'
APPROVEDT
BUILDING VALUE, PLAN CHECK
Ano BUtLDING PERMIT
Thls permlt ls granted on the express conditlon that the sald
conslructf on s-hall, ln all respecis, conform to the Ordlnance
;;;;i; Lv the criv oi sprlnsfleld' lncludlns the
Development Code, '"g't"ting ine constru-c-tlon and use of
;;ll;i;;;, ;no ."v oe'iu"pe-no"d.or revoked at anv tlme
ii." ,itrl,ron of any provisions of said ordinances'
Plan Check Fee:
Plans
DateBy
RecelPt Numbe
Becelved
Date Pald:
BUILDING PERMIT
VALUE
(A)
X $/SO. FT.SO. FT.ITEM
Maln
Garage
Carport
Total Value
Bulldlng Permlt Fee
State Surcharge
Total Fee undal eveloPedondueisenChargeopmDevelsSystemnarechmprovedbelwhltSllmtheIthlwCitynlertSropepSYSTEMS DEVELOPMENT
(B)
cHARGE (SDC)
ADDITIONAL COMMENTS
ITEM
Flxtures
Besldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
. /< rA/z/tO, / ) '',15* ,7f /'=o
FEE
Z/O
(c)
Plumblng Permlt
State Surcharge
Total Charge
MECHANICAL PERMIT
ace Unlt
<.h
r'4zzu
r{f + ,7s'
N0 zre
2J-
(D)
D
LO
Dryer Vent
Wood
aoMechanlcal Permlt
lssuance
State Surcharge
Total Permlt
Furnace
Exhaust Hood
Vent Fan
By slgnature, I state and agree' that I have carefully examlned
the completed appltcatlon anO do hereby certlfy that all
lnformatlon hereon ls true and correct' and I f urther certlfy
that any and all work performed shall be done ln accordance
*fin,nL Ordlnances of the Clty of Sprlngfleld' and the Laws
of the State of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structUrewlthoutpermissionoftheBulldlngsafetyDlvislon.
I further certlfy that only contractors and employees who
are ln compllance wlth ORS 701'O55 wlll be used on thls
prolect.
to ensure that all requlred lnspectlons ars
tlme, that each address ls readable
gnatu
Date
lon.
I furth€r agree
requested at the Proper
t card ls located at the f rontlrom the street, that the Perml
set of Plans wlll remalnperty, and the aPProvedof the Pro
at all tlmes durlng constructthe slte
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
--
ft
Demolltlon
State Surcharge
Tolal Mlscellaneous Permlts (E)
TOTAL AMOUNT DUE (excludlng electrtcat)
(A, B, C, Q and E Comblned)
VALIDATION:
BECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
BECEIVED BY
/ <2_
-: .r't..f'ia:
FT.
No
FT.
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