HomeMy WebLinkAboutPermit Mechanical 1992-09-09RESIDENTIAL
PERMIT APPLICATION
lrrspections: 726-3769
Office: 726-3759
LocATtoN oF Pno
ASSESSORS MAP:
OWNER:Groce fwJ
ADDRESS:sto _-^1_37t^
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225 Flfih Street
Springfield, Oregon 97477
PosED woRK:- --E/O- , -tll,. -3J f
/?€TAX LOT:o4va
LOT
-_.-
BLOCK:SUBDIVISION
PHONE:1q1' 1)t v
CITY:STAI'E:OY(t?Y78ZIP
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NEW -,_--- FIEMODEL ADDITION
CONTRACTOR'S NAME
6c.J s*a,r<- - 4or l,lvrtz !acrov.-
N DDIIESS
CONST.
CONTRACTOR #EXPIRF,S PHONE
CENERAL: - -- --
I'LUMBING: - .. -
MECHANICAL: -'
ELECTRICAL: ----
lY\ o- r< h4 l\3 -H
):<eJ i q sl G, sfr?ef 7qT1vY
2-g -L qo tu(zt lt z
OUAD AREA:
# OF BLDGS:
---OCCY GROUP: *
r Ot. STORIES:
WATER HEATER:
Sile lnspeclion - To be madt:
af ter excavation, but Prior to
setting forms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - Af ter trenches are
excavalec!.
Masonry - Ster.'l l()cation, bond
beams, grouting.
Foundation - After forrns ;tre
erected but prior to corlcrete
placentent.
Underground Plumbing - Prior
to filling trerlch.
Underlloor Plumbing / Me<;hanical
- Prior to insulation or clecking.
Posl and Beam - Prlor to lloor
insulation or decking.
Floor lnsulation - Prior to
decking.
Sanitary Sewer - Prior to f illing
trench.
Slorm Sewer - Prior to {illing
t renc h.
Water Llne - Prlor to filling
trench.
Rough Plunrbing * Prior to
cover.
- OFFICE USE -
LAND USE:
A OF UNITS:
CONSI'R. TYPE
HEAT SOUnCE: --
FLOOD PLAIN:
ZONING CODE:
,r OF BDRMS:
-SECONDARY HEAT:
SQUARE FOOTAGE:
Final Plumbing - When all
plumbing worl( ls complete.
Final Eleclrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical worl< is complete.
Final Building - When all
required Inspections have been
approved ancl builcling is
completed.
Olher
MOBILE HOME INSPE TIONS
Blocking and Set.Up - When all
blocklng is complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Conneclion - When
blocking, set-up, ancl plumbing
inspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
inspectlons are approved and
porches, sklrting, clecks, and
ventlng h:rve been installed.
RANGE:
To request an inspection, you must r,all 726 3769, This ls a 24 hour. recording. All inspections requested before 7:OO a.m. wlll be
made the same workilg day, inspections requested after 7:00 a.n.r. will be made the followlng work day.
REQUIRED INSPECTIONS
l-l remporary Electric Rough Meclranical - Prlor to
cover.
Rough Electrical - Prior to
cover.
Electrical Service - Must be
approved to obtain permanent
electrical power.
Fireplace - Prior to facln0
rn:rlt,rlals antl lramltrg lnsgr.
Framing - Prior to cover.
Wall/Ceiling lnsulation - Prior to
cover,
Wood Stove - Afler installatlon
lnserl - After flrePlace aPProval
and installation of unit.
Curbcut & ApProach - Af ter
forms are erectr:d but Prior to
pl acernen t of conc rr.'te.
Sidewalk & Driveway - After
excavation ls comPlete, forms
arrd sub-base matcrial in Place.
Fence - When comPleted.
Street Trees - When all required
trees are planted.
DESCRIBF: WORI(:
nr
E
T
E
f-l orVwall - Prior..to taping.
tr
r
tl tl E
ACCHSEGABP,L.
N
Lot faces
Lot sq. ftg.
Lot coverage
TopograPhY
Total height
Lot Type
_-- lnterior
-- Corner
_- Panhandle
-
Cul-de-sac
IS THE F'ROPOSED WORK IN THE
-HISTORICAL DISTRICT, OR ON
TI_IE HISTORICAL REGISTER? ----
lf yes, this application must be signed
ancl apProved bY the Historical
Coordtn;rtor prior to pcrmit issuance'
AF'PROVED:
ksS
S
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perrrrit is 11r;rrltc<i orl tl)e express cotrditiorl that the said
consiruction sllall, in arll rcspe<;ts, conform to tlte Ordinance
adopted by tlre City of Spring{ield, including the
Developlnent Cocle, re-qulatirrg the corlslrtrction and use of
buildings, ;rrrd may be suspencled or revoked at any time
upon violation of any provisions of said ordirrarrces'
Receipt Number:---
DatePlans Rcviewed BY
Plan Check Fee: -
Date Paid:
Bcceived BY
BUILDING PERMIT
VALU E
(A)
SQ. FT. X $iSO. FT.ITEM
Main
Garage
Carport
Systems Developnrcnt Chargc is due on all undeveloped
properties within tl'rc City limits wlrictr are being improved'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanltary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
N0
FT.
FT.
FT.
(c)
Plumbing Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent@r?.? r'*,-
MECHANICAL PERMIT
/ex
(D)
NoVent Fan
Fu rn ace
Exhaust Hood
Mechanical Permit
lssuance
State Surcharge
Total Permit
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Orclinances of tlrc City of Springfield, and tlre Laws
of tlre Stale of Oregon pertaining lo the work dcscribed
hcrcin, art<l tltat NO OCCLJF']ANCY will lle nl;rde of any
structurc wltlrout pctttri:;sion of tlrc Building Safcty Divis;iotr'
I f urtlrer cortif y tll;.lt ('rlly contractors ancl L'mployees who
are in conrpliance with ORS 701.055 will be used on this
proiect.
I further agree to ensure that all requlred inspections are
requested at tlre proper time, that each address is readable
from the street, that the permit carcl is located at the f ront
of the property, anc| the approved set of plans will remain
I
LDate ----_---,
on the site at ll tirncs during construction
1:l-
Signature
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sidewalk _-_.-_ ft
Curbcut ---
ft
Oemolition
State Surcharge
Total Miscellaneous Permi ts (E)
)
4 //a?DATE PAID
AMOUNT NECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMAETT
Total Value
Building Permit Fee
State Surcharge
Total Fee
-q
TOTAL AMOUNT DUE (excluding electrical)
--_.(A, B, C, D, and E Combined)