HomeMy WebLinkAboutPermit Mechanical 1995-11-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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SPRINGFIELD
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LOCATION OF' PROPOSED WORK: ~~5" ..@A"p~~
ASSESSORS MAP' /'/"'cP"5-=<5--/t7/
LOT:
BLOCI<"
OWNER'
ADDRESS'
CITY'
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JOB NUMBER
"95' ~ /3
225 Fifth Street
Sprlnglleld, Oregon 97477
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.TAX LOT'
SUBDIVISION'
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PHON'"
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ZIP: 9/~ "::>
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DESCRIBE WORK: / ~~7?1'.!L ~ ~A~
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NEW
REMODEL
ADDITION
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR'
PHONE
CONTRACTOR'S NAME
GENERA' .
PLUMBING:
MECHANICAL~4/?;?/?~ ,~"3';.
ELECTRICAl'
EXPI RES
"Y~:..<:q-;.~~.... ~ I'/.
~.~.7.r7.r./ /~-,: 5'-"'!!? ?7~
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. - 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 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. Inspections requested after 7:00 a.m. wIll be made the following work day.
D Temporary ElectrIc
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D
Underslab Plumbing I Electrlcall
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
to filling trench.
o 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 tilling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line :- Prior to filling
trench.
0, Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
rn Rough Mechanical - Prior to
cover. 64-5
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/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After InstallatIon.
o Insert - After fireplace approv~l
and Installatlon of unit. .
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Drlvewav - After
excavation Is complete, forms
and sub. base material In place.
o Fence - When completed.
o Street Treos - When all required
trees are planted.
o Final Plumbing - When all
plumbing work Is complete.
. .
D Final Electrical - When all
electrical work is complete.
rl/1 Final Mech:mlcal - When all
.~ mechanical work Is complete.
"~5
o Final BUilding - When all
required Inspections have been
approved and building is
completed.
(.'0 Other
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MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
waler 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.
Lot faces Lot Type.
., I P.L.
LoJ_sq. Itg. Interior IN
Lot coverage Corner Is
Topography Panhandle Iw
Total height Cul.de'sa~ I'E
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT. b VALUE
Main
Garage
. Carport
Total Value
Building Permi t Fee
State Surcharge
Total Fee
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
L3:9-5 .7h~_ <"'~ fl?
Mechanical Permit ~~
Issuance
....f?
State Surcharge
Total Permit
(D)
"
'.
MISCELLANEOUS PERMITS
Mobile Home'
!
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
Slate Surcharge
Total Mlsceilaneous Permits (E)
TOTAL AMOUNT DUE (excluding clecl!lcal)
(A. B, C. D. and E Combined) .
FEE
/?; cr'
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/tP. .
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2~p
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_STHE 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.
Setbacks
HSE GAR ACC
I
'~.-l
APPROVED'
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 o~ any provisions of said ordinances.
Plan Check Fee'
'-
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Syste~~ Developmen.l Charge IS,due on all undeveloped
properlies within tll0 City limits which are being Improved.
ADDITIONAL COMMENTS
. .
By signature, I state and agree, that I have carefully examined
the completed appficatlon and do hereby certify that ali
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Orqinanccs of lhe City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY wlil be made of any
structure without permission of lhe BuildIng Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 wili be used on thfs
project.
I further agreo to 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 approved set of plans will remain
on the site at all times durl~constructlon.
Signature ~.Lf~~~
Date -/ / -.2.. 0 - QS
VAliDATION:
RECEIPT NUMBER
DATE PAIr>
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7.6. ,:=?e:>
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AMOUNT RECEIVED
RECEIVED BY