HomeMy WebLinkAboutPermit Mechanical 1999-01-07FIELl)RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759 ffi,
JOB NUMBER ??rc <
225 Fifth Street
Springfleld, Oregon 97 477
LOCATION OF PROPOSED WORK:2 7
ASSESSORS MAP:
LOT
-
BLOCK:
TAX LOT
?7?7
PHONE:
STATE ZIP:
brt a/ /n o o />F //o et sF-
72//
OWNER:
CITY:9rYzr^ /c l:r* C i\
ADDRESS:
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
r.rew Y
tG . a oo Zi-Lt C eg ,F()222. ,a,t + b crc.> t"l-tc .E *
PLUMBING:
ELECTRICAL:
ADDRESS
bo??oeL
EXPIRES 5 PHONE
A-,
CONTRACTOR'S NAME
GENERAL:
MECHANICAL:
CONST.
CONTRACTOR #
RANGE
- OFFICE USE -
LAND USE:
WATEB HEATER:
ZONING CODE:r OF UNITS:
OUAD AREA:
r OF BLDGS:
SECONDARY HEAT
SQUARE. FOOTAGE:
OCCY GROUP:
* OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls is a 24 hour recording. All lnspections requested before 7:00 a.m. will be
made the same worklng day, lnspections reguested after 7:00 a.m. will be made the following work day.
Temporary Electrlc
REOUIRED INSPECTIONS
J-71 Rough Mechanical - Prior to4 cover. /X fu/42 L>rn
J--_l Rough Electrical - Prior toL--J cover-
Final Plumbing - When all
plumbing worl( is complete.
Slte lnspectlon - To be made
after excavatlon, but prior to
setting forms.
Final Electrical - When all
electrical work is complete.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.
Electrical Service - Must be
approved to obtain permanent
electrlcal power.
hanical - When all
mechanical work ls complete.
E Footlng - After trenches are
excavated.
Flnal Building - When all
required lnspectlons have been
approved and building is
completed.
Flreplace - Prlor to faclng
materlals and framing lnsp.
Masonry - Steel locatlon, bond
beams, groutlng.Framing - Prior to cover.
Foundatlon - After forms are
erected but prlor to concrete
placemont.
Worher
Wall/Celtlng lnsulallon - Prlor to
cover.
tf Underground Plumblng - Prlor
to fllllng trench.Drywall - Prlor to taping.
MOBILE HOME INSPECTIONSEUnderlloor Plumblng / Mechanlcal
- Prlor to lnsulatlon or clecklng.Wood Stovo - After lnstallation.
Post and Beam - Prlor to tloor
lnsulatlon or decklng.lnsert - After flreplace approvsl
and installatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulation - Prior to
decklng.Curbcut & AJrproach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to fllling
trench.Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel.
Slorm Sewer - Prior to fllling
trench.
Sidewall< & DrivewaY - After
excavation ls complete, forms
and sub-base material ln place.
Water Llne - Prlor to lilling
trench.
Fence - When cciirpieted
Rough Plumbing - Prlor to
cover.
$tr€ot Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.E
' 'r:.,,i.
SUBDIVISION:
-
6./ )
# OF BDBMS:
-
FLOOD I]LAIN:
E tI
E
E
fl
Etl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Typ
-
lnterior
-_
Corner
I.- Panhandle
-
Cul-de-sac
Se I lS THE PROPOSED WORK tN THE .
HISTOFIICAL DISTBICT, OR ON
THE HISTOFIICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
P.L,HSE GAR ACC
N
S
E
VALUE
(A)
Mrri ' 'f
Total Value
Building Permit Fee
State Surcharge
Total Fee
FT. X S/SO. FT.
BUILDING PER
ITEM SO.
Main
Garage
Carport
.1 .. *,
BUILDING IALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the cxpress condition that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Springfield, inctuding 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.
Plans Reviewed By Date
Receipt Numbe
Date Paid:
Received By:
Plan Check Fee
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tlre City limits whioh are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
FT.
Nc
PLUMBING PERMIT
FT.
Plumblng Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true anct correct, and I f urther cerflfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs of the City of Springfield, and the Laws
of the State of Oregon perlalnlng to the work descrlbed
herein, and that NO OCCUPANCY wlll be made of any
structure without permission of the Bulldlng Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 701.05S wlll be used on thls
project.
I further agree to ensure that all required inspections are
requested at the proper time, 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
oate /-?-ff
on the si at all times during construction.
Sig natu re
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
/
(D)
No
2Z.ze
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
tfuir,
,?
/+*
l/2.'ei
MECHANICAL PERMIT
Furnace
Exhaust Hood
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, Q and E Combtned)
22,'2a 2.4
DATE PAID
AMOUNT HECEIVED
RECEIVED BY
VAI-IDATION:
RECEIPT NUMBER
I
FT
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