HomeMy WebLinkAboutPermit Mechanical 1997-10-06SPFlINGFIELD
RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Oflice: 726-3759
LOCATION OF PROPOSED WORK:zB
JOB NUMBEB ?7/167
225 Fifth Street
Springfleld, Oregon 97477
TAX LOT:zp?a )ASSESSORS MAP:/74 .7* ?t-
LOT BLOCK:
OWNER:
ADDRESS:
CITY:
PHONE:
ztP:STATE:
ADDITION DEMOLISH OTHER
DESCRIBE WORK:
NEW-- REMODEL
ADDRESS EXPIRES ,C PHONE
CONTBACTOFI'S NAME
ELECTBICAL:
MECHANICAL:
PLUMBTNG:
GENERAL:
CONST.
CONTRACTOR #
FLOOD PLAIN:
ZONING CODE:
, OF BDRMS: __
RANGE:
QUAD AREA:
* OF BLDGS:
SECONDABY HEAT:
SQUABE FOOTAGE:
OCCY GROUP:
* OF STOBIES:
CONSTR. TYPE:
HEAT SOURCE:
WATEB HEATER:*-
must calt 726-3769. Thls ls a 24 hour recordlng. Alllnspections requested after 7;00 a.m. wtti Je maoe
REQUIRED INSPECTIONS
ions requested before 7:00 a.m. wlll beowing work day.
To request an lnspecilon, you
made the same worklng day,
[-l femporary Etecrrtc
I Slle lnspectlon - To tre madeafter excavation, but prior tosettlng forms.
H,:*:,lij" f lHB? i S, :c
r ri c a, /
Footlng - After trenches areexcavated.
Masonry - Steel locailon, bondbeams, grouilng,
Foundatton - After forms areerected but prlor to concretepracemont.
f-l Unggrground ptumbing _ prior.J to fllllng trench.
n Unaerlloor plumblng/Mechanlcal
Prior ro tnsutait'o'n ;;;;;k1ffi:
fost al.rd Beam - prlor to ,loorrnsutailgn or decklng.
Floor lnsulation - prlor todecking.
Sanltary Sewer - prior to fllllngtrench.
Storm Sewer - prlor to fllllngtrench,
Y:l:t Ltne - prtor to fillingtrench.
Rough Plumblng - prlor to
lnspect
the fotl
tl i;#,: Mechanrcar - prror to tl fil;lr?l:TJ?fl,;"yff[il:
Rough Electrlcal - prior tocover,I-l Fjnal Etectrtcat _ When ail-- etectrical work ls complete.
Eleclrlsa.l Servlce - Must be W ll"l Mechanlcat _ When a1approved to obtain oerorectrrcar power. l;::,.ff, W lnu"n^^,.""i;;? r" "t'.pret".
E
Flreplace - prlor to faclngmaterlals and framing tnspl
Framlng - prlor to cover.
{all/Celting lnsulatlon _ prlor tocover.
l-l Drywatt - prlor to taping.
Wood Slovo - Alter lnstallailon.
[--l otrer
MOBILE HOME INSPECTIONS
E B,*[,'X3,'"'l,i",j;!L- When a,
Plumbing Connectlons _ Whenhome has been connected towater and sewer.
Flnal Buitdlng - When allrequired.lnspections have beenapproved and buildino iscompleted.
Electrical Connection _ When
:l::I,19, set.up, and ptumbtnsrnspections have been approvedand the.home is connected torne service panel.
Final - After all requiredrnspeclons are appioved and
.p.^"I9,no": sktrting, decks, andvenilng have been lnstalled.
cover.
I lnserl - After flreplace approvaland lnstallatlon of unlt.
Curbcul & AJrproactr _ Afterrorms are erected but prior toplacement of concrete.
Sidewalk & Drlveway _ Afterexcavailon ls complete, lormsano sub-base materlal ln place.
Fence - When coiitpleted.
$lreel Trees - When all requlredtrees are planted.
SUBDIVISION:
-
V6-zTz=
- OFFICE USE -
LAND USE:
# OF UNITS:
E
l:,"I
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Typ-_
-
tnterior
-
Corner
-
Panhandle I
-
Cul-de-sac
IS THE PROPOSED WOBK TN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls appllcatlon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
GAR ACCPL.HSE
N
S
E
AND BUILDING PERMIT
Thls permit is granted on the express conditlon that the said
construction shall, in all respects, conform to the Ordlnance
adopted by the City ol Springfleld, includlng the
Development Code, regulating the constructlon and use of
bulldings, and may be suspended or revoked at any tlme
upon violation of any provisions ol said ordinances'
Plans Heviewed BY Date
Beceipt Nu
BUI LDI N G LUE,LAN CHECK
Plan Check Fee:
Date Paid
Received By:
VALUE
(A)
-t
Total Value
Building Permit Fee
State Surcharge
Total Fee
ITEM
Main
Garage
Carport
.l
BUILDING PERITIITT
SQ. FT. X $/SQ. FT.
Systems Development Charge is due on all undeveloped
properties withln the City limits which are belng lmproved'SYSTEMS DEVELOPMENT CHARGE (SDC)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residentlal Bath(s)
SanitarY Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEE
Nt
FT.
FT.
FT.
(c)
By slgnature, I state and agree' that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlonhereonistrueandcorrect,andlfurthercertlfy
that any and all work performed shatl be done in accordance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure wlthout permission of the Buildlng Safety Divislon'
I further certily that only contractors and employees who
are ln compliance with ORS 701'055 wlll be used on thls
proiect.
I further agree to ensure that all requlred lnspections are
requested at the proper tlme, 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 will remaln
Sls
Date
all ti Son the si rlng constructlon'
Wood Stove/ lnsert/ Fl replace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Total Miscellaneous Pertnits (E)
MECHANICAL PERMIT
,/4r e
tb
(D)
va-Q
z4
No
-22
Mechanical Permit
lssuance
State Surcharge
Total Permit
Mobile Home
State lssuance
State Surcharge
Sldewalk __- ft
Curbcut
-
ft
Demolitlon
State Surcharge
Furnace
Exhaust Hood
Vent Fan
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
VALIDATION:
RECEIPT NUMBER z /
DATE PAIi')
AMOUNT RECEIVED
RECEIVED BY
22
(
(B)
Plumblng Permlt
State Surcharge
Total Charge
-)
24