HomeMy WebLinkAboutPermit Mechanical 1999-12-09PHONE:
ZIP:STATE:
CONST.
CONTRACTOR 'fADDRESS
t
I 4f
ADDITION DEMOLISH OTHEB
EXPIRES ..t PHONE
CONTRACTOB'S NAME
ELECTRICAL:
OWNER:
ADDFIESS:
CITY:
DESCRIBE WORK:
MECHANICAL:
PLUMBING:
GENERAL:
NEW- REMODEL
NOTICE;- OFFICE USE -
, OF BLDGS DtrR
QUAD AREA:TH,S
OCCY GROU
AUTHORZEDI
r OF STOBIES:
lSODAYPER'OD
THIS
FIANGE:
FLOOD PLAIN:
SECONDABY HEAT
SQUARE FOOTAGE:
ZONING CODE:
NDONpDFOBTYPE:
-HEAT SOURCE: -
, OF BDRMS:
-
RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726.3769
Offlce: 726.3759
LOCATION OF PROPOSED WORK:.a l8
SPRIN
b
JOB NUMBEB
225 Fifth Street
Sprlngfleld, Oregon 9Z Atl
TAX LOT:0 ooASSESSORS MAP;I17 O\DG n
LOT: BLOCK:SUBDIVISION:
(r
ro reeuest an rnspectron. you mrrst r-arr 726-376g. Thls ic;i 24 iioii; recuidirig. Aiimade the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made
REQUIRED INSPECTIONS
Temporary Electrlc Rough Mechantcal - prlor to
cover.
inspecilons requested before 7:00 a.m. wlll bethe followlng work day.
[-_l Hnal ptumbtns - When ailu plumblng worl< ls complete.
l-_] flnal Electrlcat - When ail
-
olectrlcal work ls complete.
[-l rtnat Mechanlcat - When ail
-
mechanlcal work ls complete.
I y{ Flnal Bultdlng - When ails requlred lnspecilons have beenapproved and bulldlng is
completod.
Slte lnspoctlon - To tre madoafter excavatlon, but prlor tosettlng forms.
[-] Underslab plumblng/Etectrlcal/
-
Mechanlcal - prlor to cover.
Rough Electrlcal - prior to
covor.
[l Masonry - Steel tocatlon, bond
-
beams, groutlng,
Footlng - After trenches are
excavated.
Foundatlon - After forms areerectod but prlor to concrete
placomont.
Floor lnsulatlon - prlor to
decklng.
Electrlcal Servlce - Must beapproved to obtaln permanent
olectrlcal power.
f-l rlreptace - prtor to factng
-
materlals and framlng lnsp.
[-l Framlng - prtor to cover.
Other
Wall/Celllng tnsutatlon - prlor to
cover.
[l UnOerground plumblng - priors to fllllng trench.
n Underttoor ptumbtng/Mechanlcal
Prlor to lnsulailon or decklng.
n Posl and Beam - prlor to floor
-
lnsulatlon or decklng.
l-l orywatt - prtor to taptng,
l-l Wooa Stovo - Aftor lnstailatton.
[--] tnsert - After ftreplace approvat
-
anc, lnstallatlon of unlt.
Curbcut & Approach - Afterforms are erected but prlor toplacomont of concrote.
Sldewalk & Drlveway - Afteroxcavatlon ls comploto, formsand sub-base materlal ln place.
Fence - When co.-npleted.
MOBILE HOME INSPECTIONS
[-l alocktng and Set.Up - When ail
-
blocklng ls complete.
Plumblng Connectlons - Whenhome has been connected towater and sewer.Sanltary Sewer - prlor to fllllng
trench.
Storm Sew6r - Prlor to fllllng
trench.
n Water Llne - prlor to fililng
-
Irencn.
| 1/Bough Plumblng - prlor tou cover.
Electrlcal Connectlon - Whenblocklng, set.up, and plumbinglnspocllons have been approvedand the home ls connected tothe servlce panel.
I--l Street Trees - When ail roqutred
-
trses are planted.
l-| Flnal - After ail required
-
lnepectlons are approved andporchos, sklrtlng, decks, andvenilng havo been lnstaiteo.
lF^llEW6i-
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
tnterlor
-
Corner
-
Panhandle
-
Cul-de-sac
IU-.IE PROPOSEO WORK }N THE .
HISTOBICAL DISTRICT, OR ON
THE HISTOHICAL REGISTER?
-
ll yes, thls appllcatlon must be slgned
and approved by the Hlstorlcal
Coordinator prlor to permlt issuance.
APPROVED:
PL.HSE GAR ACC
N
S
E
VALUE
(A)
Total Value
Building Permit Fee
State Surcharge
Total Fee
,.
'2
X S/SQ. FT.
Thls permit is granted on the express condition that the sald
constructlon shall, ln all respects, conform to the Ordlnanceadopted by the City of Sprtngfleld, tnctudlng the
Development Code, regulaflng the constructlon and use of
bulldlngs, and may be suspended or revoked at any tlm€
upon vlolatlon of any provlslons of sald ordlnances.
Recolpt Number:_
Plans Revlewed By Date
BUILDING VJqLUE,
AND BUILDING PE RMIT
LAN CHECK
Plan Check Fee:
Date Pald
Recelved By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties wlthln the Clty llmlts whlch are belng lmproved.
ITEM
Flxtures
Resldential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
llD, 5?
$
(c)
{J:I.os ,f ,
s
N'
FT.
PLUMBING PERMIT
Plumblng Permit
state surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
(o)
Mechanical Permlt
lssuance
State Surcharge
Total Permlt
By slgnature, I stato and agree, that I have carefully examlned
the completed appllcailon and do hereby certlfy that all
lnformatlon hereon rs true and correct, and r f urther cerilfy
that any and all work performed shall be done ln accordance
wlth th6 Ordlnanccs of the Clty of Sprlngfleld, and the Laws
of the State of Oregon pertalnlng to tho work descrlbed
heroln. and that NO OCCUPANCy wlll be made of any
structure wlthout perrnission of the Bulldlng Safety Dlvislon.
I further certlfy that only contractors and employees who
are In compllance wlth ORS 7O1.OSS wlll be used on thtsprolect.
I further agree to ensure that all requlred lnspections are
reguested at the prgpor ilme, that each address ls roadable
from tho street, that the permlt card ls locatec, at the ,rontof the property, and the approved set of plans wlll remaln
on the slto at s durlng lon.
Slgnature
Date
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk _ ft
Curbcut
-
ft
Oemolitlon
State Surcharge
Total Mlscellaneous permlts (E)
TOTAL AMOUNT DUE (exctudlng electrlcat)
(A, B, C, Q and E Combtned)
VALIDATION:
RECEIPT NUMBER
DATE PAID - u -q'l
AMOUNT BECEIVEO q
3'*3 q.{
RECEIVED BY 4\
b .s-a
BUILDING PERMIT
ITEM SO. FT.
Main
Garage
Carport
,
FT.
FT.