HomeMy WebLinkAboutPermit Mechanical 1998-04-03RESIDENTIAL
PERMIT APPLICATION
lnspect
Off ice:
NGFTELE,
:ions: 726-3769
726.3759
JOB NUMBER Qgos Y\
225 Fifth Street
Sprlngfleld, Oregon 97477
LOCATION OF PROPOSED WORK:.i {h
ASSESSORS MAP:11 0 4 )(o 4z O q *e-o
LOT
-
BLOCK:
TAX LOT
SUBDIVISION
XNc Cct \ I PHONE:
a1Y-t1STATE:ZIP:
A**a^
s A
1Y7 - 2&v
lVto N. -?1lOWNEB:
ADDRESS:
CITY:
NEW
-
REMODEL ADDITION DEMOLISH OTH
,
ZO
1,I
lc f ex irtDESCBIBE WORK:
ADDRESS
,?e- Y
-1
sca'*I 4t 78u
11qr#
CONTRACTOR'S NAME
PLUMBING:
MECHANICAL:
ELECTBICAL:
GENERAL:
CONST.
CONTRACTOR , EXPTRES ,a PHONE, se.{
RANGF-:
- OFFICE USE -
LAND USE:
WATER HEATEFI:
ZONING CODE:
FLOOD PLAIN
* OF UNITS:
QUAD AREA:
* OF BLDGS:
# OF BDRMS:-OCCY GROUP:
r OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspection, you must call 726-3769. This ls a 24 hor.rr recorcJlno, All lnsDections requested before 7:oo a.m w!ll bemade the salrte working day, inspections requested after 7:00 a.m. wlll be made the followlng work day.
REQUIRED INSPECTIONS
Temporary Electrlc Rough Mechanlcal - Prlor to
cover.l---l Final Plumbing - When ail|J plumblng work is complete.
SIte lnspectlon - To be made
after excavatlon, but prlor to
settlng forms.
Rough Electrlcal - Prlor to Flnal Electrical - When all
electrlcal work is complete.cover,
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flnal Mechanlcal - When all
mechanlcal work ls complete.
Foollng - After trenches are
excavated.Flreplace - Prlor to faclng
materlals and framing lnsp.
Flnal Building - When all
required lnspectlons have been
approved and bullding is
completed.Masonry - Steel locatlon, bond
beams, groutlng.Framlng - Prlor to cover.
E Foundatlon - After forms are
erected but prlor to concrete
placement.Wall/Celllng lnsulatlon - Prlor to
cover.
Underground Plumblng - Prior
to fllllng trench.[-l Drywall - Prlor to taplng
ILE HOME INSPE TTONSUnderlloor Plumblngl Mechanlca!
- Prlor to lnsulatlon or decklng.Wood Slove - After lns
Post and Beam - Prlor to floor
lnsulatlon or decklng.lnsert - After llrep
Blocking and Set.Up - When ail
blocklng ls complete.
and installatlon of unl
Floor lnsulallon - Prlor to
decklng.Curbcut & AJrproaclr -
Conneclions - When
been connected to
forms are erected but prior to
placement of concrete.
er
Sanitary Sewer - Prior to fllllng
trench.on - WhenSidewalk & Driveway - After
excavation ls complete, forms
and sub-base malerial in place.
bt plumblng
n approvedSlorm Sewer - Prior to fllllng
trench.
lns
and the
the servl
nected to
Water Llne - Prlor to filllng
trench.
Fence - When cci-rrpleted
Street Trees - When all requlred
trees are planted.
Final - After all required
lnspectlons are approved andporches, skirting, decks, and
ventlng have been lnstalled.
Rough Plumbing - Prior to
cover.
OL
SECONDARY HEAT:
SOUARE FOOTAGE:
E
E
E
E
tl
tl
ffi*er Gn=*.Euicp
panel
E
fl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot TV, __
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
PL,HSE GAR ACC
N
S
E
.; THE PROPOSED WORK TN THE .
-HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
ll yes, this applicatlon must be slgned
and approved by the Historlcal
Coordinator prlor to permit issuance.
APPROVED:
VALUE
(A)
t
Total Value
Building Permit Fee
State Surcharge
Total Fee
X $/SQ. FT.
BUILDING PERMIT
ITEM SO. FT.
Main
Garage
Carport
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plans Reviewed By
,
E
Date
Plan Check Fee:
Date Paid
Receipt Number
Received By:
BUTLDING VALUE
AND BUTLDING P
i5mru cHEcK
,RMIT
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ITEM
Flxtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
FT.
FT.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
Nr
ADDITIONAL COMMENTS
a-131,
o&
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformation hereon is true and correct, and I lurther cerilfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCy will be made of any
structure without permission of the Building Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
proiect.
I further agree to ensure that all required inspections are
requested at the proper ilme, 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 remain
on the site at all times durlng construcilon.
Date 't- I n 6
Signatu re
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
* ls, -'
*
i-;Et-ggN
No
rc.-
Vent Fan
(D)
MECHANTCAL PERMIT
Furnace
Exhaust Hood
Mechanical Permit
lssuance
State Surcharge
Total Permit
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 4 and E Comblned)
aq3
Zrc'2
4<L)
-1
RECEIVED BY
VALIDATION
AMOUNT RECEIVED
RECEIPT NUMBER
DATE PAI[)
)9bostq
Systems Development Charge is due on all undeveloped
properties within tlre City limits which are being improved.
*,
Total Miscellaneous Permits (E)