HomeMy WebLinkAboutPermit Mechanical 1996-01-02SPRThlGFIELt)RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WOBK:Z 7
JOB NUMBEH
225 Fifth Street
Springfleld, Oregon 97477
elL
efr,
ASSESSORS MAP 7n
LOT BLOCK:
3 TAX LOT:
PHONE:
STATE;ZIP:
-/)
77
2_
CITY:
ADDRESS:
OWNER:
DEMOLISH OTHER
DESCRIBE WORK:
NEW -._----- FIEMODEL ADDITION
ADDRESS
EXPIRES PHONE
CONTFIACTOR,S NAME
ELECTRICAL:
CONST,
CONTRACTOR #GENERAL:
PLUMBING
- OFFICE USE -
/ OF BDRMS
WATER HEATER:
RANGE
LAND USE:
/ OF UNITS
QUAD AREA:
r OF BLDGS:FLOOD PLAIN;
ZONING CODE:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE;
HEAT SOURCE:
Io request an inspecllon
made the sante working
[--l Temporary Etectric
ij':i;$ijH,i?1",;.,,.,?,?it3..
il':ffi:Jf"r3H B: i5,:c rrica, /
L9^.jlng - Afrer rrenches areexcavated.
tl |!H:,%;i:?:, ,ocaron, bonc,
D s,'.,:,uefJ ; #13' J;[; ff
.
t'J'ff H;li:d?rumbins - Pri or
3 ff ,'j','iJ,?'Jffl,,,:?, llT:;[,,;;]
,?".i1 i,?i^%?:ll;, IJI "' t o f , oo r
Floor lnsulation _ prior todecking.
Sanitary Sewer _ prirrrench. or to filling
;:on'S."u*"r - Prior to firlins
El ,Y;;:;Line - Prror ro rirns
[ |;;;tl Prumbins - Prror ro
, you must cail 726-3769. Tltis ls a 24 hoday, inspections requested af ter 7:00 a.
REQUIRED IN
l-l !-ousrr Mechanicat - prlor to.-.- cover.
ur recordlng. All lnspect jons
m. wlll be made the foilowln
SPECTIONS
requested before 7;00 a.m. will beg work day.
l-l !-ouen Etecrrtcat - prtor to..--.-. cover.
^Electrical Servlce _ Must be
:i*l?tT i'J:f ' " permanen t
II:tj,":" _ prtor to factnsmalertals and framlng lnspi
Framing - prlor to cover.
W:lllCelling lnsulallon _ prlor tocover.
Drywall - prlor to taplng.
Wood Slovo _ After lnstallatlon.
| :?." [ ;,flI,L',i? rJ;i,: app rovs,
Pj:o^"1, & Approach _ Afterrorms are erected bUt prior loplacement of concrete.
ij1:*.1|. &.Drrveway _ After
:; ;T [ :,: j: ffIjl:ii "':1,:;
Fence - When completed.
I ;:::,.[";;;ynen arr requrred
5il;i.?l;t'i?nn, . "I,I ff" ill
5,',x;1,,:::T::i
"
;y,ff [,1]
inal M ffilTt?,;"yffi?"il1
.(otn"t
MOB'LE HOME INSPECTIONS
S,*i,'iS,i'i.i"J;YL - wheh a,,
k*iHii1""#:;YJ",
i{ti*i{,i'th,,turyi}r'x"o"un
r
filiii"flii",.t?: ** :#f:.and the home istlre servic!'pl rrlconnected to
E [:*ian:' T:'ffi*r'uuoo u n oporches, sktrting,.decxi,
"io"venung have beEn rn.tiirJj."
?6ffi'*
MECHANICAL:
Lot faces
Lot sq. ftg.
Lot coverage
TopograPhY
Total height
Lot Type -
-
lnterlor
-
Corner
-
Panhandle
-
Cul'de-sac
Setbacks
APPROVED:
PL.HSE GAR ACC
N
S
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granf ed on the express condition that the sald
"oni[tl"tion siall, in all respects, conform to the ordinance
,Jopt"a by the City of Springfield' including the
Developrnent Code, reiulating the construction and use of
IuirOin's., and may bJ suspended or revoked at any tlme
,pon uiof .ti"n of any provisions of said ordinances'
Plan Check Fee: _---
DatePlans Rcview cd t3Y
Receipt Numbc
Date Paid
Received BY
BUILDING PERMIT
VALUE
(A)
SO. FT. X $/SO. FT.ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Systems Development Charge ls due on all undeveloped
propurtie" within thc City limits which are being improved'SYSTEMS DEVELOPMENT C
(B)
HARGE (SDC)
ADDITIONAL COMMENTS
ITEM
Flxtures
Resldentlal Bath(s)
SAnitarY Sewer
I
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
No
FT.
FT.
FT.
(c)
Plumblng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
a* -raztr i *+ / E
MECHANICAL PERMIT
No
,-,?f +,t'J
(D)
Furnace
Exhaust Hood
Vent Fan
tfd
, /t/./aeMechanical Permlt
lssuance
State Surcharge
Total Permlt 2/-?
By slgnature, I state and agree' that I have caref ully examlned
th€ completed application anO do hereby certify that all
lnformation hereon is true ancl correct' and I f urther c€rtlly
that any and all work perlormed shall be done in accordance
,i,n ,nL Ordinanccs of the City of Springf ield' and the Laws
of the State of Oregon pertalning to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
StrUctUrewithoutpertnissionoftheBuildirrgsatetyDivislon.
I further certily that only contractors and employees who
are ln compliance with ORS 701'055 will be used on thls
proiect.
sure that all required inspections are
Signature
Date
n
I further agree to en
that 6ach address is readable
requested at the Proper time'
It card ls located at the frontthe permf rom the street, th
set of Plans will remalnd the aPProvedof the ProPertY'ioncoimeson the site at al
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ll
Demolitlon
State Surcharge
(E)
Total Mis cellaneous Permits 2pDATE PAID
AMOUNT RECEIVT-.D
RECEIVED BY
VALIDATION:
RECEIPT NUMBEB
TOTAL AMOU
(A, B, c, D' an
NT DUE (excluding electrical)
rd E Comblned)
r-,/ AO..rc.
. --rS THE PROPOSED WORK iN THE
HISTORICAL OISTRICT, OR ON
THE HISTORICAL REGISTER? .-
lf yes, this applicatlon must be slgned
and aPProved bY the Historlcai'
Coordinator prior to permit issuance'
!
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