HomeMy WebLinkAboutPermit Mechanical 1995-01-18SPFlII\lG
R
P
ESIDENTIAL
ERMIT APPLICATION
lnspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
/)
2fr,
4!&
JOB NUMBER
225 Fifth Street
Sprlng fleld, Oregon 97 477
TAX LOT:ASSESSORS MAPI *27*%,^/^-
LOT
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BLOCK:SUBDIVISION
PHONE:
ZlPi
OWNER:
ADDRESS:
CITY:
DEL
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ADDITION DEMOLISH OTHER
DESCRIBE WORK:
NEW- REM
ADDRESS EXPIRES PHONE
CONTRACTOR'S NAME
GENERAL:
ELECTRICALI
MECHANICAL:
PLUMBING:
CONST.
CONTRACTOR '
- oFFtcE usE -
r OF UNITS:
r OF BDFIMS:
QUAD AREA:
I OF BLDGS:
OCCY GROUP:
* OF STORIES:
SECONDAFIY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
ZONING CODE:_
LANDUSE:_FLOOD PLAIN:
WATER HEATER:-BANGE:
To request an lnspecilon, you must call 726-3769. Thls ls amade the same worklng day, lnspectlons requested after ,
,2 hour recordrng. Al|lnspections requested before 7:00 a.m. wlil be7:00 a.m. wlll be made the followlng work day.
REOUIRED INSPECTIONS
l-l remporary Etecrrlc Rough Mechanlcal - prlor tocover.
Rough Electrlcal - prlor tocover,
[--l Flnat ptumbtng - When ail
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plumblng work ls complete,
l--l Flnal Electrtcat - \A,rhen alt
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electrlcal work ls complete.G
ffi Flnal Mechanlcal - When ail
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mechanlcal work ls complete.
Slte lnspectlon - To be madeafter excavatlon, but prlor tosettlng forms.
l-l Understab plumbtng/ Electrlcat /lJ Mechantcal - prloi to "or"i.-"
fl Footlng - After trenches are
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excavated.
tl
Masonry - Steel locaflon, bondbeams, grouflng.
Foundatlon - After forms areerected but prlor to concretepracement.
Underground plumblng _ prlorto fllllng trench.
Underfloor plumblng / Mechanlcal
- prtor to lnsulatlon or clecklng.
Posl. and Beam - prlor to floorlnsulatlon or decklng.
l--l floor lnsulatlon - prtor to
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decklng.
Sanltary Sewer - prlor to fllllngtrench.
Storm Sewer - prlor to fllllngtrench.
Water Llne - prlor to fllllngtrench.
Flnal Buildlng - When ailrequlred.lnspectlons have beenapproved and bulldlng iscompleted.
f] y-:llt"eillns rnsurailon _ prtor..to
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cover.
l-l Drywafl - prtor to taptng
l-l Wood Stovo - Aft6r tnstailatlorr
fl |}"; ll ;,fl liJ",,;?'J ice a pp roval
Curbcul & Approach _ AfterIorms are erected but prlor toplacemont of concrete.
Sldewalk & Drlveway - Afterexc.avauon ls completo, formsand sub-base materlal in place.
I-l fence - When completed.
f_l ^S,l::, Trees - When ail requtred
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trees are planted.
Other
MOBILE HOME INSPECTIONS
tl 3"ff['13 ,:"3.;,"J;3[ - whep a,
Rough Plumbing - prlor tocover.
Plumblng Connectlons _ Whenhome has been connected towater and sew?r.
Eleclrical Conniction _ Whenpl?!I119: set.up, and plurpbins,nspections have been approvedand the.home ls connected totne servlce panel.
Flnal - After all requiredrnspections are appioved andp9r9.hesl sklrilng, decks, andvenilng have been lnstalled.
l.
STATE:
n Electrlcai Servtce - Must be
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approved to obtaln permanent
olectrlcal power.
,.
f-l Flreptace - prtor to factno
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materlals and framlng lnspl
[-l Framtng - prtor,to cover.
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total tJelght
Lot Typr
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lnterior
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Corner
. Panhandle
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Cul-de-sac
ks THE PBOPOSED WORK TN THE -. HISTOFIICAL DISTRICT, OR ON
THE HISTOBICAL REGISTER?
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lf yes, thls applicatlon must be slgned
and approved by the H lstorlcal
Coordinator prlor to permit lsSuance.
APPBOVED:
P,L.HSE GAR ACC
N
S
E
(A)
X $/SO. FT. VALUE
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SO. FT.
lv.4ain
Gar.age
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit ls granted on the express condition that the said
construction shall, ln all respects, conform to the Ordlnance
adopted by the City of Springfield, includlng the
Development Code, regulating the construction and use of
bulldlngs, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances,
Receipt Number:-
Plans Reviewed By Date
Date Paid
Recelved By:
Plan Check Fee:
Systems Development Charge ls due on all undeveloped
propertles wlthln the City limits which are being lmproved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Flxturest.
Resldentlal Bath(s)
Sanitary Sewer
Water
Storm Sev,rer
Moblle Home
FEE
FT.
FT.
(c)
N0
FT.
PLUMBING PERMIT
Plumbirtg Permlt
State. Surcharge
Total Charge
Wood Stove/ tnsert/ Flreplace Unlt
Dryer Vent
/7/.y'
W
fr 26.22(o)
N0
MECHANICAL PE
Mechanical Permit
lssuahce
State:surcharge
Total Permit
RMITL?TFurnaco
Exhaust Hood
Vent Fan
By slgnature, I state and agree' that I have carefully examlned
the completed appllcatlon and 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 in accordance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertalnlng to the work descrlbed
herein, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Bullding Safety Dlvislon'
I further certify that only contractors and employees who
are ln compllance with ORS 701'055 wlll be us€d on thls
proiect.
I further agree to ensure that all required lnspections are
requested at the proper tlme, that each address ls roadable
from the street, that the pormlt card ls looated at the lront
of the property, and the approved set of plans wlll remaln
on the site at all times durlng constructlon.
Slgnature e{Date
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk _-- ft
Curbcut --
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)2A
/-/s-?5-DATE PAID
AMOUNT RECEIVED
BECEIVED BY
VALIDATION:
RECEIPT NUMBEB
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
,at2ee-
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