HomeMy WebLinkAboutPermit Mechanical 1994-8-4
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RESIDENTIAL
PERMIT APPLICATION
90./)'c!
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JOB NUMBER
Inspections: 726.3769
Office: 726.3759
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: /) 1'" /~ / :2,
SUBDIVISION'
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LOCATION OF PROPOSED WORK:
ASSESSORS MAP' 1'7/}/,
LOT:
BLOCK'
OWNER: CarQ-/ Aa-,,,., Lt.<('J'1ukl
ADDRESS' /- 7'9 :2...., .f'n Q / Yl
CITY:~"";'''' / -,tJ'I"..I d
DESCRIBE WORK: --.?~ I IA ~F7~ A.<VIVr.
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ADDITION
DEMOliSH
OTHER
CONST.
CONTRACTOR'
CONTRACTOR'S NAME
ADDRESS
EXPIRES
PHONE
GENERA' .
PLUMBING'
MECHANICAt
ELECTRICAl'
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3(;-757'5'
- OFFICE USE -
QUAD AREA' LAND US". FLOOD PLAIN'
. OF BLDGS' . OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: 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.
REQUIRED INSPECTIONS
C)v1 Rough MechanIcal - PrIor to
~cover.
D Temporary ElectrIc
D Final Plumbing - When all
plumbing work Is camp/et.e.
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Rough Electrical - Prior to
cover.
o Final Electrical - When all
electrical work Is complete. ~
D Underslab PlumbIng/Electrical!
MechanIcal - Prior to cover.
'f";:7( Final Mechanical - When all
~mechan'cal work Is complete.
D Electrical Service - Must be
approved to obtain permaflent
electrical power.
D Footing - After trenches are
excavated.
D Final Building - When all
required Inspections have been
approvad and building Is
com plated.
o Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting.
D Framing - Prior to cover.
gOth~r C~JIN1J='
o Foundation - After forms are
erected but prior to concrete
placement.
D Wail/Ceiling Insulation - Prior to
cover.
D Undarground Plumbing - Prior
to filling trench,
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stovo - After Installation.
D BlockIng and Set.Up - When all
blocking Is complete.
D Post and Beam - Prior to floor
Insulation or decking.
D Insert - After fireplace approvel
and Installation of unll.
D Floor Insulation - Prior to
decking.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
D Sanitary Sewer - Prior to filling
trench.
D Electrical Connection - When
blocking, set.up, and plurQblng
Inspections have been approved
and the home Is connected to
the service panel.
D Sidewalk & DrIveway - After
excavation Is complete, forms
and sub-base material In place.
D Storm Sewer - Prior to filling
trench.
D Waler Line - PrIor to filling
trench.
o Fence - When completed.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
o Rough Plumbing - PrIor to
cover.
o Street Trees - When all required
trees are planted. . _
Lot faces
'.
lot Type
lot sq. fig.
Interior
Lot coverage
Corner
Topography
Total hplght
Panhandle
Cul.de.sac
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(" THE PROPOSED WORK IN THE.
--"HISTOI'lICAl DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Hlstorlcai
Coordinator prior to permit Issuance.
Setbacks '
L P,l, I HSE GAR I ACe' I
IN
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BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT, - VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fix~ures
Residential Bath(s)
N'
Sanitary Sewer
Water
FT.
FT.
Storm Sewer
FT,
Mobile Home
Plumbing Permit
Stat~. Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
.h.A< laE f ,.PI'1lJ~
Mechanical Permit
Issuahce
State .Surcharge
Total Permit
3P> ~A".v,
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
fI
Curbcul
Demolition
State Surcharge
Total Miscellaneous Permits (El
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
PJ/v
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tfr"
~0 z.D
~.20
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition thalthe said
construction shall, in all respects, conform to the Ordinance
adopted 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:
Pians 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 pertaining 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 further agree 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 wlli remain
on the site at all times during construction.
~nature
Date
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VALIDATION:
RECEIPT NUMBER
DATE PAir'
AMOUNT RECEIVED
RECEIVED BY
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