HomeMy WebLinkAboutPermit Mechanical 1992-12-07-
SP'rI,\rGFIELr)
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
JOB NUMBER qUbb)
225 Fifth Street
Springfleld, Oregon 97 477
eq)o N. 1aL0'
ASSESSORS MAP:lloSl4 f TAX LOT:oq3pc)
LOT BLOCK:
PHONE:OWNER:
/1/ 3A4
STATE:zlPCITY:OE
ADDRESS:
' ay'zo
7z3,a.2.n4 rt
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCFIIBE WORK:
ADD EXPIRES
/o s/-Ps
PHONECONTRACTOR'S N
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
5
WATER HEATER:RANGE:
- OFFICE USE -
LAND USE:
ZONING CODE:
FLOOD PLAIN
* OF UNITS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
I OF BLDGST
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recording. All lnspections requested before 7:00 a.m. will be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electric Rough Mechanlcal - Prior to
cover.
Final Plumbing - When all
plumblng work is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Electrical Service - Must be
approved to obtain perrnanent
electrical power.
lr-]final Mechanical - When all4 mechanical work is comptete.
Footlng - After trenches are
excavated.Fireplace - Prior to faclng
materials and framing lnsp.
Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, groutlng.Framing - Prior to cover.
Foundatlon - After forms are
erected but prior to concrete
placement.
Other
Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to-filling trench.Drywall - Prlor to taping.
MOBILE HOME INSPECTIONS
Underlloor Plumbing / Mechanical
- Prior to insulatlon or decking.Wood Stove - After installation.
Post and Beam - Prior to floor
lnsulation or decklng.lnsert - After fireplace approval
and installation of unit.
Blocking and Set.Up - When all
blocking is complete.
Floor lnsulatlon - Prior to
decking.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumblng Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrlcal Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Storm Sewer - Prior to filllng
trench.
Sidewalk & Driveway - After
excavation is contplete, forms
and sub-base material in place.
Water Llne - Prlor to filling
trench.
Fence - When completed.
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved andporches, skirtlng, decks, andventing have been installed.
l-l Rough Plumblng - Prior tot--J cover.
SUBDIVISION:-
7/l- fr/B
# OF BDRMS:
-
tl
E
tl
E
E
E
E
tl
tl
E
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typ-
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L.HSE GAFI ACC
N
S
E
IS THE PFIOPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTOBICAL REGISTER?
-
lf yes, this application must be slgnedand approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED
BUILDING PERMIT
VALUE
(A)
SQ. FT. X $/SO. FT.ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
ThiS permit is granted on the express condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfield, inctuding theDevelopment Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances.
Plans Reviewed By Date
Receipt Nu
Plan Check Fee
Date Paid:
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
Residentiat Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
No
(c)
FT.
FT.
FT.
Plumbing Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
Mechanicat Permit )V\r""-
lssuance
State Surcharge
Total Permit (D)
MECHANICAL PERMIT
I3 .oo
N0
lo .oCI
J<
e<.f s
Furnace
Exhaust Hood
Vent Fan
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
lnformation hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCy will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 7O.|.OS5 will be used on this
project.
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 is located at the front
of the property, and the approved set of plans will remain
r)/'tlaa
Signature
Date
at all times duri ruct ion.on the site
i
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding etecrricat) ?S.-73
(A, B, C, D, and E Combined)
VALIDATION:
RECEIPT NUMBER l..,{lA
AMouNr REcEtvED 0S.=)<
t> )-lqa
i9gRECEIVED BY
DATE PAID