HomeMy WebLinkAboutPermit Mechanical 1996-2-7
RESIDENTIAL
PERMIT APPLlCATIO~
Inspections: 726.3769
Office: 726.3759
.
LOCATION OF PROPOSED WORK' '2.C)OS'"
ASSESSOR~ MAP' Vi n:-)~'3: .i) ,
LOT: BLOCK'
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C\ wOlll
JOB NUMBER
225 Flflh Street
Springfield, Oregon 97477
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TAX LOT:
SUBDIVISION:
(Y)')(YJ
OWNER: J,' I \ a..~ e
'200 S'
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1'Y\4 ( ("0 \"
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ADDRESS'
CITY'
STATF' '
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PHONE:
( I..( I - '2Sf; ?..
ZIP:37l.f7g
DESCRIBE WORK:.::r n\ h II: "t. 1-\ ~<t+ - N - G; 10 G, Cd
NEW REMODEL ADDITION DEMOLISH
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OTH;R If)' r;..s
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CONTRACTOR'S NAME
GENERAL'
PLUMBING:
MECHANICAL:./VI. << (~~ \ \[,r
ELECTRICAL:
ADDRESS'
CONST.
CONTRACTOR .
~
EXPIRES
PHONE
r
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I.f {tD 0 (7- fiL Sf' CJ.
r CB*? _ T:: 7:; t'J
He",t~
q7'{7~
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{Y 7- 7VI.{'S:
QUAD AREA'
· OF BLDGS'
OCCY GROUP'
· OF STORIES:
WATER HEATER'
- OFFICE USE -
LAND USE:
· OF. UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE'
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE: _
To request an Inspecllon, you must call 726.3769, This Is a 24 hour recording, All Inspections requeSled before 7:00 a,m, wlfl be
made the same working day, Inspections requested ofter 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
g~OU9h ~I ~ Prior to
cover. ,,\'-'LJ
D Rough Eleclrlcal - Prior to
cover.
D Temporary Electric
D SlIe Inspection - To be made
after excavation. but prior to
seltlng forms.
D Underalab Plumbing/Electrlca"
Mechanical - Prior to cover.
D Footing - After trenches are
excavated. ~
D Mesonry - Steel locallon, bond
.beams. grouting.
D Foundation - After forms are
erected but prior to 'concrete
placement.
D Underground Plumbing - Prior
to filling trench,
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam - Prior to 1I00r
Insulallon or decking,
D Floor Insulation - Prior to
decking,
D Sanitary Sewer - Prior to filling
trench,
D Slorm Sewer - Prior to filling
trench. .
D Waler Line - Prior 10 filling
trench.
D Rough Plumbing"': 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.
I
D Wail/Ceiling InsJlatlon - Prior to
cover.
D Drywall - Prior to taping,
D Wood Slove - After Installation,
D Inserl - Aller lire place approval
and Installallon 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 Fence - When completed.
. .
D Street Trees - When all required
trees are planted. . .
D Flnsl Plumbing - When all
plumbing work Is complet,e,
D FInal Electrical - \N.hen all
electrical work Is complete. C
6~lnal ~.~,".1 - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
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MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete,
D Plumbing Connections - When
home has been connected to .
water and sewer.
D Electrical ConnectJ9" - When
blocking, set.up, and plufTIblng
Inspections have been approved
and the home Is connected to
the servIce panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
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Lot faces lot Type
lot sq, flg. Interior I:L.
Lot coverage Corner Is
Topography Panhandle
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Total ~elght Cul.do.sac IE
BUILDING PERMIT
ITEM SQ, FT,
X $/SQ, FT, -
VALUE
Main
Ga(ag~
Carporl
Total Value
Building Permit Fee
State Surcharge
TotaJ Fee
'.
-,
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC) ,
(B)
PLUMBING PERMIT
ITEM
Fixtures
,
Residential Bath(s) N'
Sanitary Sewer FT,
, Water FT,
Storm Sewer FT,
I Mobile Home
Plumbing Permit
Slate Surcharge
..
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State :Surcharge
Total Permit
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
FEE
(0)
'-(XJ
, j- lJO
~l._ .""1,
.d-t )
tloJW
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
rO{p.~
,"; :.,l;'~l~rl'H,:~I'
";" L..
Setbacks
, ,
HSE GAR ACC
-'IS THE PROPOSED WORK, IN THE - '
--HISTOI;lICAl DISTRICT, OR ON
"THE HISTORICAL REGISTER?
If yes, this application musl be signed
and approved by the Historical
Coordinator prior to permit Issuance"
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls-"permlt Is granted on the express condition thai the said
construction shall, In all respects, conform to the Ordinance
adopted by the City ,of Sprlngfleld, Including the
Development Code, regulating the construction and usa of
buildings, and may be suspended or ravoked at any time
upon violation of any provisions of said ordinances,
Plan Check Fee'
Dale 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
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By signature, I stale 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 law.
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 Salety Olvlslon,
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 to ensure that all required Inspections are
requested at the proper time, that each address la readable
from the street, that the permit card I. located at the fronl
of the property, and the approved set of plans will remain
on the site at all tI as during construction.
,A~.H
Signature r'
Date
1.-1
VALIDATION: 1J()1'11
RECEIPT NUMBER _0<. U q
DATE PAID rl - 'l.!-i1fJ .
AMOUNT REC~IV~ r1 to.J.{)
RECEIVED BY ^
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