HomeMy WebLinkAboutPermit Mechanical 1997-11-07-\,.1L WLJ d^'.) yt1 lhlnn
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
LOCATION OF PROPOSED WORK:
ASSESSOBS MAP:/7o 3 3G l*O 4qa--a
LOT BLOCK:
S+
TAX LOT
SUBDIVISION: -
PHONE:
t ZIP:v STATE:
72o'a,)n rG {
a tO oTts*5k<--t-
CITY:
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
re 11 A-d--t-zDESCRIBE WORK:
GENERAL:
lr)r-Co
ADDRESS EXPIRES .A PHONECONTRACTOR'S NAME
PLUMBING:5.hMECHANICAL;
ELECTRICAL:
CONST.
CONTRACTOR #
RANGF-:
, OF BDFIMS
- OFFICE USE -
LAND USE:
WATER HEATEFI
ZONING CODE:
FLOOD })LAINQUAD AREA:
I OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
OCCY GBOUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspections reguested after 7:00 a.m, wlll be made the followlng work day.
REOUIRED INSPECTIONS
J--l TemRorary Electrlc Rough Mechanlcal - Prlor to
cover.
Flnal Plumbing - When all
plumbing worl( is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When allcover,electr work is complete.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Electrica! Service - Must be
approved to obtaln permanent
electrlcal power.
nal Mechanlcal - When all
mechanical work ls complete.
Footlng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
W.x'if :?,?;#Jix,,x"ou"n
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prlor to cover.
E Foundatlon - After forms are
erected but prlor to concrete
placemont.
Other
WalllCelllng lnsulatlon - Prlor to
cover.
Underground Plumblng - Prior
to fllling trench.l--l orywall - Prlor to taplng
Underlloor Plumblng/ Mechanical
- Prior to lnsulatlon or decking.E
Post and Beam - Prlor to lloor
lnsulation or decklng.
Floor lnsulalion - Prior to
decking.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
the servlce panel
Water Llne - Prlor to filling
trench.
Fence - Vvhen ccilpleted.
Rough Plumbing - Prior to
cover.
Str€et Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.
/h e-,
€
# OF UNITS:
-
E
tl
E
E
E
E
E
n
E
lnstallatlon.
;i--i t
MOBILE HOME INSPECTIONS
E
[--l Blocking and Set.Up - When ail|J blocklng is complete.
tl
E
tl
'e
lnsert
and
Curbcut &
forms are
placement
Sidewalk &After
excavation forms
and sub-base material ln place.
Connections - When
has been connected to
and sewer.
Eleclrical Connection - When
bloclring, set-up,
inspections have
and the home is
and plumbi ng
been approved
Drlveway -ls complete,
connected to
PL.HSE GAR ACC
N
s
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
--
Corner
-
Panhandle !
-
Cul-de-sac
rS THE PROPOSED WORK TN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be signed
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
BUILDING PERMIT
VALUE
(A)
SQ. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
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
,
E
Date
Flecei pt Numbe
Date Paid:
Received By:
Plan Check Fee
BUILDING IALUE
AND BUILDING P
Puru cHEcK
RMIT
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
FEE
(c)
Ni
FT.
FT.
Residential Bath(s)
FT.
Plumbing Permlt
State Surcharge
Total Charge
PLUMBING PERMIT
ITEM
Fixtures
Sanitary Sewer
Water
Storm Sewer
Moblle Home
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby cerflfy that all
lnformatlon hereon is true and correct, and I f urther certify
that 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 pertainlng to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure without permission of the Buildirrg Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on thls
proiect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address ls readable
Irom the street, that the permlt card ls located at the front
approved set of plans will remain
during construction.
Slgnatu
Date
on the site at m
of the property, and
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
&ry
#6
N0Vent Fan
'7{+,K
.?t "P
Mechanical Permit
lssuance
State Surcharse -/. O 32d
Total Permit (D)
MECHANICAL PERMIT
Furnace
Exhaust Hood
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, Q and E Comblned)
DATE PAII)
AMOUNT RECEIVED
RECEIVED BY
e0 4o -
-dr?P2?<- An-u- /?
"
VALIDATION:
FIECEIPT NUMBER
". _ ii.,