HomeMy WebLinkAboutPermit Mechanical 1997-11-12IttGFIELE)RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Offlce: 726-3755
JOB NUMBER QttG /a
225 Fifth Street
Sprlngfleld, Oregon 97477
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:t1D7 ?z jz- D3*o
LOr ALOCK:
To request an lnspectlon, you must call 7
SUBDIVISION:
-
wlll be
Final Electrical - When all
electrical work is complete.
TAX LOT:
made the same worklng day, lnspections
l-l Temporary Electrlc
Underslab Plumblngl Electrical /
Mechanlcal - Prlor to cover.
E Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumblng/Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulatlon or decking.
Floor lnsulatlon - Prlor to
decking.
Sanilary Sewer - Prior to fllling
trench.
Storm Sewer - Prlor to fllllng
trench.
sit€ rnspectron - ro be mado n uStYiltqJiflY"3F3??",,"after excavatlon, but prlor to L--J cover.settlng forms.
requ
tl
Eleclrical Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and framing lnsp.
Framlng - Prlor to cover.
Wall/Colling lnsulatlon - Prlor to
cover.
Drywall - Prlor to taplng
Wood Stovo - After lnstallatlon
lnsert - After flreplace approvql
and lnstallatlon of unlt.
Curbcut & Alrproaclr - After
forms are erected but prior to
placement of concrete.
Streel Trees - When all requlred
trees are planted.
qZ|Fnal-Mechanica!
- When alltr- mechanical work ls complete.
Flnal Buildlng - When all
required lnspectlons have been
approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When all
blocklng ls complete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
inspectlons are approved andporches, sklrting, decks, and
ventlng have been lnstalled.
Waler Llne - Prlor to filling
trench,
PHONE:
STATE:ZIP:
OWNER:
ADDRESS:
CITY:
t'
LISH
--.
OTHER
DESCRIBE WORK:
NEW
-
REMODEL T- ADDITION DEM
GENEBAL:
ELECTRICAL:
ADDRESS
o
EXPIRES ,S PHONECONTRACTOR'S NAME
PLUMBING:
CONST.
CONTBACTOR #
RANGE:
I OF BDRMS:
- OFFICE USE -
WATER HEATER:
ZONING CODE:
QUAD AREA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE. FOOTAGE:
LAND USE:
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
# OF UNITS: _--
E
Rough Plumblng - Prlor to
cover.
MECHANICAL:
FLOOD PLAIN:
hour recordlng. All
work day.
ls N0l'
rs&H{DoNED FE:
5iffil.?[Tl?fl ,;#ffii"ii:
E
[--l Sidewalk & Drlveway - After
'4 excavation ls complete, forms
and sub-base material ln place.
l--l Fence - lVhen ccirrpleted.II
fl
E
E
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot T!_
-
lnterlor
-
Corner
-
Panhandle t
-
Gul-de-sac
Setbacks
PL.HSE GAR ACC
N
S
E
IS THE PROPOSED WOFIK TN THE "
HISTOFIICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this appllcatlon must be slgned
and approved by the H istorlcal
Coordinator prlor to permit lssuance,
APPROVED:
VALUE
(A)
nttt 'i ',; t
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
FT. X $/SQ. FT.
BUILDING PER
ITEM SO.
Main
Garage
Carport
Thls permit is granted on the express conditlon that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Springfield, includlng the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plans Reviewed By
,
E
Plan Check Fee:
Date Paid:
Fleceipt Num
Received By:
'|.PLAN CHECK
RMIT
BUILDING fiIUE
AND BUILDING P
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties withln the City limits which are being improved.
ITEM
Flxtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
Nr
FT.
FT.
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert / Fl replace Unlt
Dryer Vent
N0
(D)
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
Lts--iLp.:
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed applicatlon and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I further cerilfy
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
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Bulldlng Safety Divislon.
I further certify that only contractors and employees who
are ln compliance with ORS 701.055 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
Slgnatu
Date
on the site at I times during constructlon
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
,t
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Combined)RECEIVED BY
s
)
AMouNr FrEcErvED -f.J ,)o
4?,
DATE PAII)
VALIDATION:
RECEIPT NUMBER
Date
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