HomeMy WebLinkAboutPermit Mechanical 2001-03-01}rGFIELE,
RESIDENTIAL
PERMIT APPLICATION
lnspect
Of fice:
ions: 726-3769
726-3759
t7 03 2-5 22*n 7fivo
.JOB NUMBER
225 Fifth Street
Springfleld, Oregon 97477
TAX LOT
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT BLOCK:SUBDIVISION
OWNER:
ADDRESS:
CITY:
PHONE:
ztPSTATE:
-o
NEW
-
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
GENERAL:
ELECTBICAL:
--
ADDRESS
%
EXPIRES 1 PHONECONTBACTOR'S NAME
MECHANICAL:
PLUMBING:
CONST.
CONTRACTOR #
BANGE:
- OFFICE USE -
LAND USE:
ZONING CODE:Y OF UNITS:
QUAD AREA:
* OF BLDGST
SECONDARY HEAT:
SQUARF. FOOTAGE:
OCCY GROUP:
,Y OF STORIES:
CONSTR. TYPE:
HEAT SOURCE:
To reotrest an insDection, yott rn'Jst e."l! 715 37e9" Tllle t.;-;:.?A hr::rrjr rc,tr?idi1:g. .Ail insp"atic.ns ,g,.iucstecj be{c;.c 7:CC a.m. !vili be
made the same worklng day, lnspections requested after 7:00 a.m. will be macle the following work day.
REQUIRED INSPECTIONS
A
Temporary Electric Rough Mechanical - Prior to
cover.
Flnal Plumbing - When atl
plumbing worl( is complete.
Site lnspectlon - To be made
after excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover,
Underslab Plumblng/ Electrical /
Mechanical - Prior to cover.E Electrical Service - Must be
approved to obtaln permanent
olectrlcal powor,
Final Mechanlcal - When all
mechanical work is complete,
l-] Footlng - After trenches areu excavated.Flreplace - Prior to faclng
materlals and framing lnsp.
Framlng - Prior to cover.
Final Building - When alt
required lnspections have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, grouting.
Foundatlon - After forms are
erected but prior to concrete
placement.
Other
Wall/Celling lnsutatlon - Prlor to
cover.
Underground Plumbing - Prior
to filling trench.Drywall - Prlor to taping.
MOBILE HOME INSPECTIONSUnderlloor Plumblng/ Mechanical
- Prlor to lnsulatlon or decking,Wood Stovo - Afler lnstallatlon.
Post and Beam - Prlor to floor
lnsulatlon or clecking,lnserl - After flreplace approval
and lnstallatlon oI unlt.
Blocking and Set.Up - When all
blocklng ls complete.
Floor lnsulation - Prior to
decklng.Curbcut & AJrproach - After
forms are er()cted but prior to
placemont of concrete.
Plumbing Connections - When
home lras been connected to
Water and seweri
Sanitary Sewer - Prior to filling
trench,Electrical Conneclion - When
blocklng, set-up, and plumbing
lnspoctions havo been apprgy€dand the homs ls connected to
the servlce panel.
Slonn Sewer - Prlor to lilllng
trench.
Sidewallr & Driveway - After
excavation ls complete, formsand 6ub-baso mRterlal ln placo.
Water Llne - Prlor to filling
trench,f] Fence - !!hen ccr',rpleted
Street Trees - When all required
troes aro planted.
Flnal - After all requlred
lnspectlons are approved and
porchos, sklrtlng, decks, andventlng have been lnstallect,
Rough Plumbing - Prlor to
cover.
ri
NR
# OF BDRMS:
-WATER HEATER:
FLOOD I)LAIN:
E
E
tl
E
tl
tl
tl
E
E
E
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-.
lnterior
_- Corner
..- Panhandle
-
Cul-de-sac
IS THE PROPOSED WORK TN THE .
HISTORICAL DISTFIICI, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this appllcailon must be slgnedarrd approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
PL.HSE GAR ACC
N
I
I
S
E
k
SO. FT. X $/SQ. FT. = VALUE
BUILDING PERMIT
(A)
ITEM
Main
Garage
Carport
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
BUTLDING VALUE, PLAN CHECKAND BUILDTNG PERNJ|IT
Thls pernrit is granted on the cxpress concjition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springftetd, including theDevelopment Code, regulating the construction and use ofbulldlngs, and may be suspended or revoked et any tlm€
upon violatlon of any provlslon! ol sald ordlnancca.
Plan Cheok Fee:
--
Plans Rcviewed Ely Date
Recelpt Numbe
Date Pald:
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City linlits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
Nx
FT.
FT.
(c)
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Fu rnace
Exhaust lloorj
Vent Fan No
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
(D)
Mechanical Permit
lssuance
State Surcharge
Total Permit
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true and correct, and I further cerilfy
that any and all work performed shall be done in accorrJance
wlth the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertalnlng to the work described
hereln, and that NO OCCUPANCy will be made of any
structure wlthout perrnission of the Bulldlng Safety Dlvislon.
I further certify that only contractors and employees who
are In compllance with ORS ZO1.O55 wlll be used on thls
prolect.
I further agree to ensure that all required lnspections are
requested at the proper time, that each address ls readable
from the street, that the permit card ls located at the front
of the property, and the apprwed set of plans will remaln
s durin s
Slgnature
Date
on the site at all structlon
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft _
Curbcut
---
ft
Demolition
State Surcharge
Total Miscellaneous Perrnits (E)
TOTAL AMOUNT DUE (excluding electricat)
(A, B, C, D, and E Combincd)
VAI-IDATION:
RECEIPT NUMBER -.-
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
FT.
(N