HomeMy WebLinkAboutPermit Mechanical 1997-10-02I
SPRRESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
JoB NUMBE " 1l t +,a Y
225 Fifth Street
Sprlngfleld, Oregon 97 477
LOCATION OF PROPOSED WORK:I S"
ASSESSORS MAP:t-lo3zc,z+oolo o TAX LOT
LOT
-
BLOCK:SUBDIVISION:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:OO a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made
nz6urneD tNSPEcrtoNS/
Temporary Electric tZ H"rr: Mechantcat - Prlor to
the followlng work day.
l--l Flnat Plumblng - When alllJ plumblng work ls complete.
E
Slte lnspectlon - To be made
after excavatlon, but prior to
setting forms.
Underslab Plumbing/ Electrlcal /
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Underground Plumblng - Prior
to fllllng trench.
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng.
Post and Bgam - Prlor to floor
lnsulatlon or decklng.
Floor lnsulatlon - Prior to
decklng.
Sanltary Sewer - Prior to fllllng
trench.
Storm Sewer - Prlor to fllllng
trench.
Water Llne - Prlor to filling
trench,
Rough Plumblng - Prlor to
cover.
Rough Electrical - Prior to
cover,
Electrlcal Servlce - Must be
approved to obtaln. permanent
electrlcal power.
Framlng - Prlor to cover.
WalllCelllng lnsutatlon - Prlor to
cover.
Drywall - Prlor to taplng.
Wood Stovo - After lnstallatlon.
lnsert - After flreplace aPproval
and lnstallatlon of unlt.
Curbcut & Approach - After
forms are erected but prior to
placemont o( concrete,
Sldewalk & Orlveway - After
excavation ls complete, forms
and sub-base material ln place.
Fence - When coinpleted.
Flnal Electrlcal - When all
electrlcal work is complete.
Final Mechanlcat - When all
mechanical work ls complete,
Flnal Buildlng - When all
requlred lnspectlons have been
approved and bullding is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Sel.Up - When all
blocklng ls complete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Electrlcal Connectlon - When
blocklng, set-up, and plumbing
lnspections have been approved
and the home is connected to
the servlce panel,
Flnal - After all required
lnspectlons are approved and
porches, sklrtlng, decks, and
ventlng have been lnstalled.
PHONE:
STATE:Ora-ztPt q -7 41-7CITY:
ADDRESS:
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHER
C-t+DESCRIBE WORK:
MECHANICAL:
ADDRESS
I
EXPIRES ,a PHONECONTRACTOR'S NAME
GENERAL:
PLUMBING:
ELECTRICAL:
CONST.
CONTRACTOR '
r$0
\r Nc'\\S
hN{RANGE:WATER HEATER:SQUARE FOOTAGE
HEAT
- OFFICE USE -
LAND USE:
E OF UNITS:
QUAD AREA:
r OF BLDGS:
OCCY GROUP:
E OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
n $treet Trees - When all requlredU trees are planted. i
E
tl
tl
E
tl
E
E
E
tl
tl
fl
fl
t]
Flreplace - Prlor to faclng
materlals and tramlng lnsp.
EE
E
Lot facee
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot .._.r
-
tnterlor
-
Corner
-
Panhandle
-
Cul-de-sac
Set IS THE PROPOSED WORK TN THE .
HlsroRlcAL olsTRtcT, oR ON
THE HISTOFIICAL REGISTER?
-
lf yes, thls appllcatlon must be slgnedand approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
BUILDTNG PERMIT
VALUE
{
ITEM
Maln
Garage
Carport
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
SO. FT. X $/SQ. FT.
BUTLDING \TALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express conditlon that the said
construction shall, ln all respects, conform to the Ordlnanceadopted by the City of Springfield, lncluding the
Development Code, regulating the construcilon and use ofbulldings, and may be suspended or revoked at any tlme
upon violation of any provisions of sald ordlnances.
Beceipt Number:-.
Plans Rcviewod By Date
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties withln the City limits which are belng improved.
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
Plumblng Permlt
State SurcharSe t O,O4?o
Total Charge
Nc
FT.
(c)
tq,-----------\-
rj:40 _
1ffi,
PLUMBING PERMIT
1$.-
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/ Fl replace Unlt
@
(D)
hanlcal Permlt
Dryer
lssuance
State Surcharge
Total Permlt
hat
app
By slgnature, I state and agree, that I have caref uily examlned
the completed appticailon and do hereby cerilfy that all
lnformatron hereon rs true ancr correct, and r f urther cerilfy
that any and all work performed shall be done in accortlance
wlth the Ordinanccs of the City of Sprlngfleld, 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 permisslon of the Bulldlng Safety Divislon.
I further certify that only contractors and employees who
are ln compilance with ORS 701.055 wlll be used on thtsprolect.
sls
s
n.
c
Date /o -a^a7
from the street,the ls located at the front
of plans wlll remaln
I further agree to ensure that
requested at the proper tl
of the pro
on the slte
red lnspections are
address ls readableMISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
lt
Curbcut
-
ft
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (excludtng electrtcat)
(A, B, C, D, and E Combtned)
VALIDATION:
REcErPr NUMBER -AZ1_O_L_/6-
'
-17DATE PAID
EIVED b.20AMOUNT REC
RECEIVED BY
PL.HSE GAR ACC
N
S
W
E
I
(A)
(
FT.