HomeMy WebLinkAboutPermit Mechanical 1993-6-7
RESIDENTIAL ..
PERMIT APPLICATION ~ JOB NUMBER ~~ ;;r:::;J/'
Inspections: 726.3769 .Q 225 Filth Street
Office: 726.3759 ~'" Springfield, Oregon 97477
LOCATION OF PROPOSED WORK' <\- /7 7~ #EAl"Le:::> ~
/7 -,c;3-77-?"3" TAX LOT: L? ?~.::SO
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DESCRIBE WORK:~:;P~~
ASSESSORS MAP:
LOT:
OWNER'
ADDRESS:
CITY'
NEW
REMODEL __ ADDITION
CONTRACTOR'S NAME
CENERAI'
PLUMBING'
MECHANICAL: ,#-~
/P'E~."
,
ELECTRICAl'
SPRINGFIELD
SUBDIVISION:
PHONE:
-7~""~5S'
- II-
BLOCK'
STATE:~
ZIP'
A ~~ g'-Al'/~r:s:? ~5~~~~/'
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR N
EXPIRES
PHONE
- OFFICE USE -
LAND USE:
N Or- UNITS:
CONSTR. TYP'"
HEAT SOURCE:
RANGF'
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover, .
o Drywall - Prior to tapin\],
D Wood Stove - After Installation,
. "
o Insert - After fireplace approval
and installation of unit.
-.[]
Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
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OUAD AREA:
N OF BLDGS:
OCCY GROUP:
N OF STORI ES:
WATER HEATER:
FLOOD PLAIN:
ZONING CODE: ___
N OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you must call 726.3769, This Is a 24 hour recording, AlIlnspectlons requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 8.m, will be made the followIng work day,
o .Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
selting forms.
o
Undelslab Plumbing! Electrical!
Mechanical - Prior to cover,
o Footing - After trenches are
excavated,
o
Masonry - Steel locatIon, bond
bcams, grouting.
o
Foundation - Aftcr forms are
erected bu I prior 10 concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Undetfloor Plumbing/Mechanical
_ Prior to insulation or decking.
o Post nnd Bcam - Prior ,to floor
insulation or decking,
o Floo~ Insulation - f::'rlor to
deckl ng. ..
o Sanitnry Sewer - Prior to filling
trcnctl, .
o Storm Sewcr - Prior to fillIng
trcncll,
o Waler Line - Prior to filling
trcncll. _
o Rough Plumbing - Prior to
cover.
,
o Sidewalk & Drivcway - After
excavation is complete, forms
and sub-base. material in place,
D Fence - When completed.
o Street Trees .- When all required
trees arc planted.
o
Final Plumbing - When all
plumbing work is complet.e.
D Final Electrical - When all
electrical work is complete.
1\/1 Final Mechanical - When all
L.AJ mechanical work Is complete.
o Final Building - When all
requIred inspections have been
approved and building Is
completed,
o Other
,\
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete,
o Plumbing Connections - When
home has been connected to
water and sewer,
o
Electrical Connection - When
blocking, set-up. and plumbing
Inspections have been approved
and the home is connected to
the service panel.
o Final - Alter all required
Inspections are approved and
porches, skirting, decks, and
venting have been installed,
Lot faces
Lot Typo
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total holght
Panhandle
Cul.d e-sac
BUILDING PERMIT
ITEM
sa. FT.
X $/SO. FT.
Main
Garage
Carport
Total Value
Building PermIt Fee
State Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldontlal Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Pormlt
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
4171'7.
~ Stov~lrePlace Unit
Dryer Vent
C~~
,Jby~ 1}~7'7
"/
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding oloctrlcal)
.
.
Setbacks
'HSE GARIACcl
.1
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTEI~?
If yes, this application must be signed
and approved by the Historical
~oordjnator prior to permit issuance,
I P.L.
IN
Is
Iw
IE
VALUE
FEE
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APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express con'dition IIlat 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 time
upon violation of any provisions of said ordinances.
Plan Chock Foo'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
------
Dale
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefull,! examined
the completed application and do hereby cedify that all
information hereon is true and correct, and I further certify
that any and all work performed shall be done in ,Iccord,mce
with the Ordinances of the City of Springfield. and alC Laws
of the State of Oregon pertaining to tl1e work described
herein, and that NO OCCUPANCY will be made of any
structure wlli10ul permi~sion of the Building Safely Division,
I further certify that only contractors and employecs who
arc in compliance with ORS 701.055 will be used on this
project.
I further agree 10 ensure that all required inspeclio,\s are
requested at the proper time, that each address is readable
from the street, that the permit card is localed at the front
of the property, and the approved set of plans will remain
on the site at all tlme~ d~~ construction.
Signature /dL/~
Oat"
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VALIDATION:
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6- /-'7 ?
7/ -=-
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RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED