HomeMy WebLinkAboutPermit Mechanical 1998-09-10SP'lINGFIELE,
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Office: 726-3759 qfi,
JOB NUMBER
225 Fifth Street
Sprlng(leld, Oregon 97 477
A,,tc
TAX LOT:
SUBDIVISION: '
'l l>LOCATION OF PHOPOSED
ASSESSORS MAP:ry"6
r nr. BLOCK:LVt.
PHONE:
ZIP:STATE:
7
q 1Y 1aYo [aJa
q - 791{
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fetle t" V.r r ,".tl .1 .
IY L}ADDRESS:
CITY:
OWNER: --.--
NEW -- REMODEL ADDITION DEMOLISH
v 6la .*$.cr/ ;P-DESCFIIBE WORK:
l-,'r c t Go.t wate{
at.'
CONTRACTOR'S NAME ADDRESS
GENERAL:
-s
EXPIFIES ,l PHONE
f qd
q.)PLUMBING:
MECHANICAL;
ELECTRICAL:
CONST.
CONTRACTOR ''
,y
,7
16
/F
SE:
lBo,"i4y
_ OFFICE USE _
OCCY GBOUP:
I OF BDRMS:
I OF STORIES:
OUAD AREA:
, OF BLDGS
SECONDARY HEAT:
SOUARF. FOOTAGE:
WATER HEATER:
To request an lnspectlon, you must call
made the same worklng day, lnspectiot
l-l TemPorary Electrlc
Slte lnsPectlon - To lre madc
after excavatlon, but Prlor to
settlng forms.
Underslab Plumblngl Electrlcal I
Mechanlcal - Prlor to cover'
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundallon - Alter forms are
erected but Prlor to concrete
placemont.
Undorground Plumblng - Prlor
to fllllng trench'
Posl and Beam - Prlor to floor
lnsulatlon or decklng'
Floor lnsulatlon - Prlor to
decklng.
Sanltary Sewer - Prlor to fllllng
trench.
Storm Sewer - Prlor to lllllng
trench.
Waler Llne - Prlor to filllng
lrench.
Rough Plumblng - Prlor to
cover'
n g. Alt lnspectlons requested before 7:OO a'm' wlll be
made the followlng work day.ns reques
Drywall - Prlor to taPlng
E yi?''lroiJ r'isfr:l':'Jx'T!3[1ff: [-l wood Srovo - Arter rnstarratron
REQUI PECTIONS
Rough Mechanlcal - Prlor to
cover.
Electrlcal Servlce - Must be
approved to obtaln Permanent
electrlcal Power.
l----l Flreolace - Prlor to faclngI I materlals and framlng lnsP'
Framlng - Prlor to cover'
Wall/Celllng lnsulatlon - Prlor to
cover.
lnsert - After flrePlace aPProval
and lnstallatlon of unlt'
Curbcut & AllProaclr - After
forms are ert:cted but Prlor to
placement of concrete'
Flnal Plurnblng - When all
plumblng worl( ls complete.
Final Electrlcal - When all
electrlcal work ls comPlete.
al Mechanlcal - When all
mechanlcal work ls comPlete'
Other
Flnal Bulldlng - When all
requlred lnsPectlons have been
approved and bullding ls
completed.
MOBILE HOME INSPECTIONS
Blocklng and Set'UP - When all
blocklng ls comPlete.
Plumbing Connectlons - When
home lras been connected to
water and sewer.
[-l fence - When coi-'rPleted
Slreet Trees - When all requlred
trees are Planted'
Sldewalk & Drlveway - After
excavation ls comPlete, lorms
and sub'base materlal ln Place'
Electrlcal Connection - When
blocklng, set'uP, and Plumblng .Lsoect[ons have been approved
,nd the home ls connected to
the servlce Panel.
Flnal - After all required
lnsoectlons are aPProved and
oorches. sklrtlng, decks, and
ventlng have been lnstalled'
Qr.t
o(
Er
E
E
E
d::::: Erectrrcat - Prior to
n
E
Lol faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
tbacks
P.L.|'JSE GAR ACC
N
S
E
IS THE PROPOSED WORK TN THE .
HISTORICAL DISTRIST, OR ON
THE HISTORICAL REGISTER?
-
ll yes, thls appllcatlon must be slgned
and approved by the Historlcal
Coordinator prlgr to permit issuance.
APPFIOVED:
BUILDING PERMIT
ITEM SQ. FT.
Main
t
X $/SO, FT.VALUE
Garage
Carport
Total Value
Building Permit Fee
Stale Surcharge
Total Fee (A)
BUILDING VALUE,
AND BUILDING PE
tl
PLAN CH ECK
RMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinanceadopted by the City of Springfleld, includlng the
Development Code, regulating the construcilon and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordlnances.
Plan Check Fee: _
Date Paid
Receipt Numbe
Received By:
Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties withln tlre City limits which are being improved.
PLUMBING PERMIT
ITEM
Flxtures
FEE
Besidential Bath(s)
Sanitary Sewer
Water
Slorm Sewer
Moblle Home
N'
FT.
FT.
Plumblng Permit
State Surcharge
Tolal Charge (c)
ADDITIONAL COMMENTS
)o)1.11
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
Wood Stove/lnserl/Flreplace Unlt
Dryer Vent
Mechanical Permit
lssuance
State Surcharge
Total Permit (D)
By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby cerilfy that all
lnformatlon hereon is true and correct, and I f urther cerilly
lhat any and all work performed shall be done in accorrJance
wlth the Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Oregon perlalnlng to the work descrlbed
herein, and that NO OCCUPANCY wlll be made of any
Structure wlthout perrnission of the Bulldlng Safety Divislon.
I further certify ttrat only contractors and employees who
are In compliance with ORS 701.O55 wlll be used on thls
proiect.
I further agree to ensure that all requlred lnspections are
requested at the proper tlme, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans wlll remaln
on the slte at all tl durlng constructlon.
Signatu re
Date -(4
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
tt
Demolltlon
State Surcharge
Total Mlscellaneous Pennils (E)
TOTAL AMOUNT DUE (excluding elec
(A, B, C, Q and E Comblned)
rl)
VALIDATION:
RECEIPT NUMBEFI
DATE PAID
AMOUNT RECEI'-)
RECEIVED BY
3
. FT.
No
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