HomeMy WebLinkAboutPermit Mechanical 1998-11-25ThlGFIELE,RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
0tJOB NUMBER
225 Fifth Street
Springf leld, Oregon 97 477
Srr r/ 3t
ASSESSORS MAP:/762 3tz
LOT:
-
BLOCK:
TAX LOT:O0o aa
SUBDIVISION:
7r z- 3f 37PHONE:
ea4
Gn ZIP:e f7 cr 7y
Lqs
CITY:STATE:
ADDRESS:
OWNER:Sf-0u.1 fn
€72 La-^,,
NEW
-
BEMODEL ADDITION DEMOLISH OTHEFI
/^/{t\7/,lt; fr r/CrQ* t GtDESCRIBE WORK:
GENERAL:
ELECTBICALi
ADDRESS
- /8/3
EXPIRES .1 PHONE
, /67ro 7t*
CONTRACTOR'S NAME
PLUMBING:
MECHANICAL;
CONST.
CONTRACTOB #
IllTffir,s.uRa.,m##llJ:t"pHr$ffiffl?"Bqh,-"''""HANdE" _ eailing the eenter. (NotestheAab@aoE:
AUTHORIZED UNDER# OF STORIES
WATER HEATER:
iAY PFHiNO nr rmhar {ar llra f\raann I lti litv Notilicalion
- OFFICE USE -
To request an lnspectlon, you must call726-3769. Thls ls a24hour recoG0f$9Ai$r1rffiQ&?s?34dilsteo before 7:00 a.m. wil be
made the same worklng day, lnspections requested af ter 7:00 a.m. wlll be macJe the following work day.
REOUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prior to
cover.
Flnal Plumbing - When alt
plumbing worl< ls complete.
Slte lnspectlon - To be made
after excavatlon, but prlor to
settlng forms.
Underslab Plumblngl Electrical/
Mechanlcal - Prlor to cover.
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 PlumblnglMechanlcal
- Prlor to lnsulatlon or decklng.
Post and Beam - Prlor to floor
lnsulatlon or decklng.
Floor lnsulalion - Prior to
decklng.
Sanltary Sewer - Prior to fllling
trench.
Storm Sewer - Prlor to filling
trench.
Water Llne - Prlor to filling
trench.
Rough Plumblng - Prlor to
cover.
Rough Electrical - Prior to
cover,
Electrical Service - Must be
approved to obtain permanent
electrlcal power.
mec
I Mechanlcal - When all
hanical work ls complete.
lnsert - After flreplace approvql
and lnstallatlon oI unlt.
Curbcut & Alrproaclr - After
forms are erected but prior to
placement of concrete.
Sidewalk & Driveway - After
excavatlon ls complete, forms
and sub-base materlal ln place.
Fence - When cciilpleted.
Street Trees - When all required
trees are planted.
Flnal Bullding - When alt
required lnspectlons have been
approved and building is
completed.
Other
MOBILE HOME !NSPE TIONS
Blocking and Set-Up - When all
blocklnO ls complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
lnspectlons are approved and
porches, skirting, decks, and
ventlng have been lnstalled.
QUAD AREA: LAND USE: FLooD I:LAIN:
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[-l Flnal Electricat - When alt
'J electrical work is complete.
/f-
EJ-l Flreptace - Prlor to factngu materlals and lramlng lnsp.
I Framlng - Prlor to cover.
l-l WalllCelllng lnsutatlon - Prtor tolJ cover.
l-l Drywatl - Prlor to taplng.
n Wooa Stovo - After lnstallatlon.
fl
E tl
E
il
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
-
Corner
-
Panhandle !
-
Cul-de-sac
S THE PROPOSED WORK iN THE "
HrsToBlcAL DtsTRlcI, oR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
arrd approved by the Historlcal
Coordinator prldr to permit issuance.
APPROVED:
P.L.HSE GAR ACC
N
S
E
BUTLDING PERMIT
SO. FT.VALUE
(A)
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
i:.\
X $/SQ. FT.
BUTLDING VALUE, i5INru CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the constructlon and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of sald ordinances.
Plans Fleviewed By Date
Plan Check Fee:
Date Paid:
Receipt Num
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
FT.
N'
FT,
PLUMBING PERMIT
Plumblng Permlt
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
(D)
No
/9 - rt u
Jo-_!!_
as /tt-LT;
Vent Fan
Wood Flreplace Unit
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERM!T
Furnace
Exhaust Hood
Dryer Vent
7li)"""/ r (i*I
By slgnature, I state and agree, that I have caref ully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is 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 perlalning to the work descrlbed
herein, and that NO OCCUPANCY wlll be made of any
structure without perrnission of the Bulldlng Safety Divislon.
I further certi{y that only contractors and employees who
are in 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 tlre street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
2
times d-u rlng
Slgnature
Date
on the site at structlon
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrtcat)
(A, B, C, Q and E Comblned)
RECEIPT N
DATE PAII)
AMOUNT R
RECEIVED
d3 2/t f
it Lj'
BY
VAl-IDATION
UMBER
ECEIVED