HomeMy WebLinkAboutPermit Mechanical 1994-12-27R
P
ESIDENTIAL
ERMIT APPLICATION
lnspectlons: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
NGF
JOA NUMBER ?4r 7s7
225 Fifth Street
Sprlngfleld, Oregon 97477
ASSESSORS MAP:.2. 1 TAX LOT
SUBDIVtStON: _
PHONES7
ZIP:STATE:CITY:
ADDRESS:
OWNER:
NEW
-
BEMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
ADDRESS EXPIRES PHONE
CONTRACTOR'S NAME
ELECTBICALI
MECHANICA
PLUMBING:
GENERAL:
CONSI.
CONTfIACTOR #
- OFFICE USE -
LAND USEI
* OF BDRMS:
OUAD AREA:
r OF BLDGS:
FIANGE:WATER HEATER:-
OCCY GROUP:
* OF STORIES:
SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPE
HEAT SOURCEI
, OF UNITS:
-
FLOOD PLAIN:
To reques
made the
Footlng - After trenches areexcavated.
n fUasonry - Steel locailon, bond
-
Deams, groutlng.
:
l-l Foundatlon - After forms are
-
erected but prlor to concreteplacement.
[l Unaerground p]umblng _ prlor'J to fllllng trench.
[l Unqeriloor ptumbtng/ Mechantcalprtor to lnsulatlon or decklng.
I-l post and Beam - prtor to ftoor
-
lnsulatlon or decklng.
[-] Floor lnsulatlon - prtor tou decklng.
3 ^Sqntt3V Sewer - prtor ro filnng
-
trench.
fl g.rq Sewer - prlor to fililns
-
trench.
fl w:re1 Llne - prtor to fililngu trench.
l57zl Rough plumblng - prtor to
,/ia(\Cover.
t an lnspectlon, you must call 726-3Z69.Thls ls a24hoursame worklng day, lnspecilons requested after 7:00 a.m.
REQUIRED INS
l-l Temporary Etecrrlc
Slle lnspectlon - To be madeafter excavailon, but prlor tosettlnO forms.
recordlng. Al'1. lnspectlons requesled before 7:00 a.m, wlll be made.the foltowlng work day.
PECTIONS
X*"t: Mechanrcar - prror to X:l::_?llr.bllg,- when a,/___\gtumblng work ls complete.
[-l flnal Etectrlcat - \Mren ail
-
electrlcal work ls complete.c
frggffii,fiL?,;#li?"il:
wlll be
Rough Electrlcal - prlor tocover.
tl H,:H:",lr,i1T,l3? 15' ::yi:,,,Electrlca! Servlce - Must beapproved to obtaln permanent
olectrlcal power.tl
t-l Flreplace - prlor to faclno
-
materlals and framlng lnspl
l-l Framlng - prtor, to cover.
Flnal Bulldlng - When altrequlred lnspectlons have beenapproved and bulldlng lscompleted.
Final - After all requiredrnspecilons are aBpioved andporc.hes, sklrting, decks, andventlng have been lnstalled.
Wall/Celllng tnstitailon _ prtor tocover.
X\orher Lt,E
MOBILE HOME INSPE TIONS
f-l Drywafl - prtor to raptng.
n Wooa Stove - Aft6r lnstailatton
[-l tnsert - After flreptace aDDrovat
-
and lnstallailon of unlt_
[--l Fence - When compteted.
f l Street Treee - When alt requtred
-
trees are planted.
I-_l Blocltlng and Set.Up _ Whep alt
-
blocklng ls complete.
Curbcul & Approach - Afterrorms are erected bUt prlor toplacemont of concrete.
Plumbing Connectlons _ Whenhome has been connected towater and sewgr.
Sldewalk & Drlveway - Afterexcavailon ls completo, formsand sub-base materlal in place
Electrlcal Conniction _ When
P-lggkllg, ser-up, and prurpbinjtnspectlons have been approvedand the home ls connected tothe servlce panel.
'z/^ 7
n E
P,L.HSE GAR ACC
N
S
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total tlelght
Lot Type-
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Se \-rS THE PROPOSED WORK IN THE -
HISTORICAL DISTBICf,, OR ON
THE HISTOBICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved bY the H lstorlcal
Coordinator prlor to permlt lsSuance.
APPFIOVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt is granted on the express conditlon that the said
construction shall, ln all respects, conform to the Ordlnance
adopted by the City ot Springlleld, includlng the
Development Code, regulating the constructlon and use of
bulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provisions of sald ordlnancos'
Plans Reviewed By Date
Becei pt Numbe
Plan Check Fee:
Date Paid
Recelved By:
N
(A)
X S/SO. FT. VALUE
Gaqage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Foo
BUILDING PE'RMIT
ITEM SO. FT,
Main
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
ITEM
Fixtures,.
Resldentlal Bath(s)
Sanitary Sewer
Water
Storm Sevver
Moblle Home
Plumblrrg Permlt
State-Surcharge,75 +, /,
Total Charge (C)
N0
/fe"
FT.
FT.
FT.
za
,(,?'
PLUMBING PERMIT
FEE
/3/4).
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan N0
By slgnature, I state and agree, that I have caref ully examlned
the completed applicatlon and do horeby certlfy that all
lnformatlon hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done in accordance
wlth the Ordinances of the Clty 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 certlfy that only contractors and employees who
are ln compllance with OBS 701'055 will be used on this
proiect.
I {urther agreo to ensure that all requlred lnspections are
roquested at the proper tlme, that each address ls readable
from the street, that the Permlt card ls looated at the front
of the property, and the approved set of plans wlll remaln
on the site at all times durlng constructlon'
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
r br.e I t '
Mechanical Permit
lssuahce
State Surcharge
Total Permit
,7f r' ,y'f
,r'ZzrU
ao
/o ?"
t Lo
---) / Zo-Z-(- ,(D)
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
--
ft
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
Slgnature
Date
VALIDATION:
RECEIPT NUMBER /; e/)
2DATE PAID
AMOUNT RECEIVED
RECEIVED BY
Z y'oZt 4o
Systems Dovelopment Charge ls duo on all undoveloped
propertles wlthln the City llmits which are being lmproved.
u " - ,'P-', *