HomeMy WebLinkAboutPermit Mechanical 1996-1-22
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: J;;'/~ ~.#~cT ?/",
ASSESSORS MAP' J? 'O3-;;;;'~- '"":::?":?
LOT'
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OWNER' ~.RM'"~~ ~""Goo'7? C e 7"-
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CITY'
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STATE: _~q..
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JOB NUMBER
'9~v
225 Fifth Street
Sprlnglleld, Oregon 97477
TAX LOl' OB'5. ., "
SUBDIVISION:
PHONE:
?y :/-<:-/2. y~
ZIP:
"97<;/"/?
DESCRIBE WORK: N~~~L ~~ ~,Z:L_
,
7' /-.r?~/~cF~ ~~.
OTHER
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA' .
PLUMBING'
MECHANICAl.
ELECTRICAl'
DEMOLISH
ADDRESS
CONST,
CONTRACTOR'
,. " ~~C:c'-;::>7'-
~~~#~~?/n- ./~-~
QUAD AREA'
. OF BLDGS:
OCOY GROUP'
I
. OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
.'
EXPIRES
PHONE
'7'7'S'V/.#'-~~_ /::g;-.s/~>I'
. .
FLOOD PLAIN:
ZONING CODE: ___
. OF BDRMS:
SECONDARY HEAT: ___..
SQUARE FOOTAGE: .____.
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day. Inspectlons requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to .
setting forms.
o Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms Bre
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/MechanIcal
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
O Floor Insulation ~ Prior to
decking. .
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
O Water LIne -- Prior to filling
trench.
o Rough Plumbing - Prl.or to
cover.
REQUIRED INSPECTIONS
r\71 Rough Mechanical - Prior to
l4-J cover. .c?#-5
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior 10_ cover.
o Wall/C.elllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
0' Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
. forms are erected but prIor to
placement of concrete.
, ,
o Sidewalk & DrIveway - Afler
excavation Is complete, forms
and sub.base material In place.
D Fence - When completed.
D Street Trees - When all required
trees Bre planted.
o FInal Plumbing - When all
plumbing W9rk Is complete.
D Final Electrical - When all
electrical work Is complete.
r7.?I Final Mechanical - When all
L.d.-I m~#~I,work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
CB Other ~~?,~'W~
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.
D Electrical Connection - When
blocking, set.up, and plumbIng
Inspections have been approved
and the home is connected to
the service panel.
o
Final - After all required
Inspections are approved and
porches, skirting, dec!<s, and
ventlng have been installed.
:.:.' ......IS THE PROPOSED WORK iN THE.
Lot TY. ,.
Lot faces Setbacks
I P,L. HSE GAR ACC I HIST08ICAL DISTRICT, OR ON
Lot sq. Itg. Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit Issuance.
Total height Cui-dc-sac IE .~
APPROVEr>'
BUILDING PERMIT
ITEM sa. FT. x s/sa. FT.
VALUE
Main
Garage
Carport
"
Totnl Value
Building Permit Fee
Slate Surcharge
Total Fcc
(A)
,
SYSTEMS DEVELOPMENT CHARG~ (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit'
State Surcharge
Total Charge
(C)
MECHANICAL PERMIJ /.
Furnace #Lv~
Exhaust Hood
~-">
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
~~7~~
Mechanical Permit . ~~
~
/?:- -e:>
/tP~ -
: Z-5-i-
26. "2C >
Issuance
I State Surcharge
..Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
.Cu~bcul
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excludlng,electrlcal)
(A, B, C. D. anel E Combined)
......
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall. In all respects, conform to the Ordinance
adopted by the Clty.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 Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
. Systems Development Charge Is due on all undeveloped
properties wiihln th~ City limits Which are being Improved,
ADDITIONAL COMMENTS
I
By slgnature,l state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinanc~s of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thai NO OCCUPANCY will be made of any
struClure without permission of the BuildIng Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree 10 ensuro that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the front
of the property, and the app.roved se'iff pi s will remain
on the site at all times during construe .
Signature 7f4f&~ mfhrt1
Dar4C::_/ P P ~
VALIDATION:
RECEIPT NUMBER ,,<O/<,?
DATE PAin / - -:< 2. ':7~
AMOUNT RECEIVED ~..::?""'"
RECEIVED BY ~~..?-_
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