HomeMy WebLinkAboutPermit Mechanical 1995-4-17
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olllce: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: ~t':7 M~~4'"IZ"7 ?;-::-.
ASSESSORS MAP: /?-d?"":?:J'- ~
LOT'
BLOCi<'
OWNER:_71uc:v ~ ~/.::::;-~ c:;
ADDRESS:~ 2L:>~A"~'?
CITY: /=--.. Z> STATF"
~/' <- I'
DESCRIBE WORK' /~~'::'L
NEW
REMODEL
CONTRACTOR'S NAME
~7?
~~ h~~
ADDITION
DEMOLISH
OTHER
--
JOB NUMBER
"J.XJ '/.s:?~
225 Filth Street
Springfield, Oregon 97477
TAX LOT: /:::J...iJ',_:~
SUBDIVISION:
PHONE:
?.Y~:~$'~
ZIP'
~/'?0 ':::>
j.
*
ADDRESS
CONST.
CONTRACTOR'
PHONE
GENERA' '
PLUMBING'
MECHANICA' ~4;.....;....~.A' 6~,~t;!i:.~
ELECTRICAl'
EXPIRES
G./"B~~'
~~-~/::>- 72c.2/. /~~S"~5'r'sI~~
" ~ ~ ;
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SOUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. wilt be
made the same working day. Inspectlons requested after 7:00 a.m. will be made tho followIng work day.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
~
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches Bre
excavated.
D Masonry - Steel location, bond
beams, grouting,
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench,
D UnderUoor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation ..-. Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facIng
materials and framing Insp.
D Framing - PrIor to cover.
D Wall/Cefllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approv4!
and Installation of unIt.
,
D
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation IS complete. forms
and sub.base material In place.
D Fen~e - When completed.
D Street Trees - When all requIred
trees are planted.
D
Final Plumbing - When nit
plumbing w~:Hk Is complel.c.
D Final Eloctrlcal - When all
electrical work Is complete.
IA:I
Final Mechanical - When all
mechanical work Is complete.
D
Final Building - When all
required Inspections have been
approved and building is
completed.
~~~~-G.
[Z]Othor
, , ,
-
MOBILE HOME INSPECTIONS
D Blocking and Set. Up - When all
blocking is complete.
o
PJumbing 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 15 connected to
the servIce panel.
D
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been Inslat/cd.
,.
Lot faces
Lot TY.
Interior
I P.L.
Setbacks
HSE GAR Acc'l
Lot sq. ftg.
. .
Lot coverage
N
Corner
Topography
Total height
S
Iw
I ~.
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM sa. FT x $/sa. FT, ~ VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fce
(A)
SYSTEMS DEYELOPMENT CHA.RGE (SDC)
(B)
PLUMBING PERMIT
tTEM
FEE
Fixtures
Rosldentlal Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
Slato Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit /l?r/Y /~,oe>
v ~
/19. c:oz:>
Issuance
State Surcharge ~~ :~1-
-~
Total Permit (D) 26 ' -;u::p
MISCELL.~NEOUS PERMITS
Mobile ,Home
Slate Issuance
State Surcharge
Sidewalk
ft
Curbcul
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
':.~:' ~~'\17~;'
.IS THE PROPOSED WORK IN THE.
"'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVEr>'
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.
. 'P'lan Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
. 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 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 Ordinances of the City of Springfield, and the Laws
of the State of Oregon perlalnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure 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
I
I further agreo to ensure 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 approved set of plans will remain
on the site at. ~I ~.ies during construction.
Signature ~.P~
Date' ~/7-~
VALIDATION:
RECEIPT NUMBER /~~e"3
~
$/.-/:::>.'95
2&:. ':;>~
DATE PAID
AMOUNT RECElv"n,
RECEIVED BY -4-....:> 111_ ~