HomeMy WebLinkAboutPermit Mechanical 1995-1-27
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REMODEL ....----- ADDITION ~DEMOLlSH
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT:
/7/77
OWNER:
ADOR~CC'
CITY'
DESCRIBE WORK:
NEW
CONTRACTOR'S NAME
GENERAl'
PLUMBINC"
MECHANICAl'
ELECTRICAl'
/"\ u),a.//M
:.
SPRINGFIELD
..
910/01
2;;/'5" ~AP~Jr'/..+
2-6 /.,; C)&5c1h:;
BLOCK'
4f?1
STATE:
to?
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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---
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TAX LOT:
SUBDIVISION'
PHONE:
74/-? J/?
.
ZIP'
97<7'77
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OTHER
~
EXPIRES "'--;:;NE
ADDRESS
CON ST.
CONTRACTOR'
- 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' RANG"' SQUARE FOOTAGE:
To requesl 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, Inspections requested after 7:00 a.m. wIll be made the following work day,
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
,beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
10 filling trench.
. 0 Underlloor Plumbing/Mechanical
, - Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking. - '.
O Sanitary Sewer - Prior to flll"lng
trench.
o Storm Sewer - Prior to fillIng
trench.
o Waler Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~over.
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 to cover.
o Wall/e"elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approv~1
and Installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing work Is complet.e.
D Final Electrical - When all
electrical work Is complete.
1'7f Final Mechanical - When all
~hanical 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 - After all required
inspections are approved and
porches, skirting, decks, and
venting have been Installed.
,.... ,';~. .. , , 'IS THE PROPOSED WORK IN THE.
....,.
Lo' Type ..
Lot faces Selbacks
~ot sq. fig. Interior I PL. I HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN THE HISTORICAL REGISTER?
Lot coverage Corner II yes, Ihls application musl be signed
Topography Panhandle Is I I I and approved by the Hlslorlcal
Iw I. I I Coordinator prior to permit Issuance.
Total heigh I Cul-d.e.sac lLLLLJ
APPROVED: ,
BUILDING PERMIT
ITEM SO. FT. X $/SO, FT.
VALUE
Main
Garage
"
Ca~porl
,~
Total Value
Building Permi I Fee
Slate Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHAHGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Resldenllal 8ath(s) NO
Sanllary Sewer FT.
Waler FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
4.5"0
r,-, .CH>
Ven t Fan
2...
N'
Wood SloveilnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
5-""'0
I ,
leO. or.>
IltJ
2...&,)., .c
/'1l'oV,
Issuance
State Surcharge ( 7 r -t, -fJ-
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
,'7/-,2..0
TOTAL AMOUNT DUE (excluding electrical) "
(A, B, C, D, and' E' Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pelmlt Is granled on Ihe express condition thallhe said
construction shall, In all respects, conform to the Ordinance
adopled 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 Check Fee:
Date Paid: ,
Receipt Number:
Received By:
Plans Reviewed By
Dale
Systems Developmenl'Charge Is due on all undeveloped
properlles wllhln Ihe Cily limits which are being Improved.
ADDITIONAL COMMENTS
By slgnalure, I stale and agree, Ihat I have carefully examined
the completed appllcallon and do hereby certify Ihal 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 Ihe City of Springfield, and Ihe Laws
of the Slale of Oregon perlalnlng to Ihe work described
herein, and tha' NO OCCUPANCY will be made of any
slructure wlthoul permission of Ihe Building Safely Division.
I further certify Ihal only contractors and employees who
are In compliance wllh ORS 701.0S5 will be used on Ihls
project.
I further agree to ensure that all re~ulred Inspections are
requested at the proper time, that each address Is readable
from the slreel, that the permit card Is located al the front
of the property, and Ihe approved sel of plans will remain
on the site at all times during constluctlon.
~nature ".q y ~ ~~__
Date /-~7-q5
VALIDATION:
/~/2 7
DATE PAID ~27/'J'S
/' 2.0
AMOUNT RECEIVED ---;;..<0 .
W~
RECEIPT NUMBER
RECEIVED BY