HomeMy WebLinkAboutPermit Mechanical 1995-12-05SPrlIrtGFIELE,
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7 A/.37& 'a.7ez ,/2 y'2.
TAX LOT
LOCATION OF PROPOSED WOFIK:
ASSESSORS MAP:
JOB NUMBER
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Offlce: 726.3759
LOT
-
BLOCK:SUBDIVISION: _
225 Fifth Street
Spri ngf leld, Oregon 97477
PHONE:
oa ZIP:
C
rA
STATE:q 7? zZCITY;
ADDRESS:
OWNER:
NEW
--
REMODEL ADDITION DEMOLISH OTHER
ADDRESS
I fo
EXPIRES .:, PHONE
ZC (/ P
CONTRACTOR'S NAME
GENERAL:
MECHANiCAL:
ELECTRICAL:
PLUMBING
CONST.
CONTRACTOR #
- OFFICE USE -
LAND USE:
* OF UNITS:
FIANGE:
QUAD AFIEA:
r OF BLDGS:
SECONDARY HEAT:
SQUARE FOOTAGE:
# OF BDRMS: _OCCY GBOUP:
* OF STORIES:
ZONING CODE:
CONSTR. TYPE:
HEAT SOUBCE:
To request an inspection, you must call
made the sanre working day, lnspection
Temporary Electric
Slte lnspection - To be madea{ter excavation, but prlor tosetting forms.
REQUIRED INSPECTIONS
Xrw: Mechanrcar - prior to &lm;l;'*lnn,. #Iil"ill
726-3769' Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll bers requested after 7:00 a.m. will be made the following work day.
l-l Masonry - Steet tocailon, bond
-
beams, grouting.
I--l Underslab plumbing/ Electrical/
-
Mechanlcal - prlor to cover.Electrical Servlce - Must beapproved to obtain permanent
electrlcal power.
Flreplace - Prlor to facing
materlals and framlng lnsp.
[-l Framlng - prtor to cover.
Wall/Celllng lnsutation - prlor to
Rough Electricat - prlor to
cover,
cover.
Wood Stovo - After lnstallatlon.
ffifinat Mechanicat - When ail
Z- mechanical wolk ls complete.
Flnal Building - When allrequired lnspecilons have beenapproved and building iscompleted,
potn"'
MOBILE HOME INSPE TIONS
Flnal Electricat - When ailelectrical work is complete.
Plumbing Conneclions - Whenhome has been connected towater and sewer.
Footlng - After trenches are
excavated.
Foundatlon - After forms areerected but prior to concrete
placement.
Underground Plumbin
to filling trench.
Post and Beam - Prlor to floorlnsulation or decking.
a
Floor lnsulation - prlor to
decking.
Rough Plumbing - prior to
cover.
E Underlloor Plumbing / Mechanical
- Prior to lnsulatlon or decking.
[--l lnsert - After ftreptace approval
-
and installation of unlt.
[-l Blocking and Set.Up - When ail
-
blocklng is compleie.
l-l Sanitary Sewer - prior to fiiling
-
trench.
Curbcul & Approach - Afterforms are erected but prior toplacemcnt of concrete.
l---l Storm Sewer - prior to filting|J trench.
Sidewalk & Driveway - Afterexcavation is complete, formsand sub-base rnaterial in place.
Electrical Connection - Whenblocking, set-up, and plumbinglnspections have been approvedand the home is connected tothe service panel.l--l Warer Line - prtor to fiilingu trench.
Fence - When completed.
[-_l Street Trees - When ail requlredu trees are planted.
Final - After all requiredinspections are approved andporc.hes, skirting, decks, andventlng have been lnstalled.
?5/ e6
DESCRIBE WOBK:
FLOOD PLAIN:
WATER HEATER:--_
E
E
r
f,atZ z'-
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterlor
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L.HSE GAR ACC
N
S
E
S THE PROPOSED WORK iN THE -
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
lf yes, this application must be signed
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
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.
I
Receipt Number:-
Plans Rcviewed By Date
Plan Check Fee
Date Paid
Received By:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.VALUE
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City linrits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM I
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
2/t)2 t
,/ 5?o
%.zo
N0
FT.
FT.
FT.
/,t'
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
r7f+t/f,
(c)
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
./o.o o
-./ 2-A./^(O ,
No
?,fo
/ zo
Mechanical Permit
Vent Fan
lssuance
State Surcharge
Total Permit
,7f t,/f
(D)
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By signature, I state and agree, that I have caref ully examlned
the completed application and do hereby certify that all
lnformation hereon is true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Buildir.rg Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
proiect.
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will remaln
on the site at all times during conqtruction.
|2Snn",,,.q{
Date / 2- --r
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
/"2/a
<oDATE PAID
AMOUNT RECEIVF.D
BECEIVED BY
VALIDATION:
RECEIPT NUMBER
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
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