HomeMy WebLinkAboutPermit Mechanical 2001-08-17RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726-3769
Offlce: 726-3759
LOCATION OF ED WORK:
ASSESSORS MA
LOT
SPRIh.GFIEL])
t*
JOB NUMBER M{-{l 5u
225 Fifth Street
Sprlngfleld, Oregon 97477
TAX LOT O-o
SUBOIVISION: -
03 as
OWNER:PHONE:
CITY:ZIP:AASTATE
a-7L{G- 6q
-1L11-l
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DEMOLISH OTHER
DESCRIBE WORK:
NEW
-
REMODEL ADDITION
ELECTBICAL:
ADDRESS
l\\5
EXPIRES ,t PHONECONTRACTOR'S NAME
GENERAL:
MECHANICAL:
PLUMBING:
CONST.
CONTRACTOR #
RANGE:
- OFFICE USE -
LAND USE:
WATER HEAIEB:
ZONING CODE:
FLOOD I:LAIN:OUAD ABEA:
* OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE;
, OF BDRMS:
-
OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOUFICE:
# OF UNITS:
-__
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be ma<le the followlng work day.
REOUTRED INSPECTIONS
Temporary Eleclrlc f--l Rough Mechanlcal - Prlor tot---J cover.
Flnal Plunrblng - When allplumblng worl< ls complete.
Slte lnspecllon - To be mado
after excavatlon, but prlor to
settlng forms.
Rough Electrical - Prlor to Flnal Electrlcal - When all
electrlcal work ls complete.cover.
Underslab Plumblng/ Electrlcal /
Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flnal Mecharrlcal - When all
mechanlcal work is complete.
E Foollng - After trenches are
oxcavalod.Flnal Buildlng - When ail
requlred lnspectlons have been
approved and bulldlng is
completed.
Flroplaco - Prlor to faclng
materlals and framing lnsp.
Masonry - Steel locatlon, bond
beams, groutlng.
l-_l Framlng - Prlor to cover.
E Foundatlon - After forms are
erected but prlor to concrete
placemont.
Othor
tl Wall/Celling lnsulatlon - Prlor to
cover,
f] l'Jflff:'n"LliJn'.'rolns - Prror J-l Drywan - pnor to raprns
MOBILE HOME INSPECTIONSUnderlloor Plumblng / Mechanlcal
- Prlor to lnsulatlon or decklng.Wood Slovo - After lnstallatlon.
E Post and Beam - Prlor to floor
lnsulatlon or decklng.lnserl - After flreplace approvql
and lnstallatlon oI unlt.
Blocking and Set.Up - When alt
blocklne ls complete.
Floor lnsulallon - Prlor to
decklng.Curbcut & AJrproach - After
forms are ert:cted but prior lo
placoment ol concrete.
Plumbing Connectlons - When
lrome lras been connected to
water and sewer.
Sanltary Sewer - Prlor to fllllng
trench.Electrical Conneclion - When
blocklng, set-up, and plumblng
lnspectlons have been approved
and the home ls connected to
the servlce panel.
Storrn Sewer - Prlor to fllllng
trench.
Sidewalk & Drlveway - After
excavatlon ls completc, folms
ancl sub-base mar.erlal ln place.
Water Llne - Prlor to filling
trench.
Fenco - When coi'lpleted
Rough Plumblng - Prlor to
cover.
Str€st Treos - When all requlred
trees are planted.
Flnal - After all required
lnspectlons are approved andporchos, sklrtlng, decks, and
ventlng have been lnstalled.
BLOCK:
E
E tl
E
E
E
E
E
fl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
-
Corner
.- Panhandle I
-
Cul-de-sac
,l
,. I ;
Set IS THE PROPOSED WORK TN THE.. HISTORICAL D,STRICT, OR ON
THE HISTOFIICAL REGISTER?
lf yes, thls appllcatlon must be slgned
and approved bY the Hlstorlcal
Coordlnator prlor to permit issuance'
APP ED:
BUILDII$,G LAN CHECKE, l
PEAND BUILDING RMIT
Thls permlt ls granted on the express conditlon that the sald
constructlon shall, ln all respects, conform to the Ordlnance
adopted by the City of Sprlngfleld' includlng the
Development Code, regulatlng the constructlon and use of
oulldings, and may be suspended or revoked at any tlme
upon violatlon of any provislons of said ordlnances.
Plan Check Fee:
Date Pald
Recelpt Numbe
Received By:
Plans Reviewed BY Date
Systems Development Charge ls due on all undeveloped
properties wlthln tlre City limlts which are belng lmproved.
ADDITIONAL COMMENTS
ACCPL.HSE GAR
N
S
E
_try_-
VALUE
(A)
Itntrr
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
FT. X $/SQ. FT.
BUILDING PER
ITEM SO.
Maln
Garage
Carport
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ITEM
Fixtures
Residentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
N'
FT
FT.
FT.
PLUMBING PERMIT
r',, et,rmbtng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
(D)
NoVent Fan
Mechanlcal Permlt
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have carefully examlned
the completed appllcatlon and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I further certlty
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 perrnisslon of the Bulldlng Safety Divislon.
I further certlfy that only contractors and employees who
are ln compllance wlth OFIS 701.O55 wlll be used on thls
proiecl.
I further agree to ensurc that all requlred lnspections are
requested at the proper tlmq that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans wlll remaln
Slgnature
Date
on the slte at all tlmes durl n.
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surcharge
Total Mlscellaneous Pertnlts (E)
TOTAL AMOUNT DUE (excludlng electrlcal)
(A, B, C, O and E Comblned)C) G:I
t.J
co
Cts
F-{
--n
(}
{I}u
VAI-IDATION
RECEIPT NUMBEFI
DATE PAID
AMOUNT FIECEIVED
RECEIVED BY
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