HomeMy WebLinkAboutPermit Mechanical 1995-12-22
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ADDITION
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ottice: 726.3759
ASSESSORS MAP'
LOT'
OWNER:
ADDRESS:
CITY'
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING-
MECHANICAl' >4tv;,'~ ti41
ELECTRICAL' c::-J:i5 I
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BLOCK:
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STAT'"
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jJ DEMOLISH
OTHER
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JOB NUMBER 9~/~~
225 Fifth Street
Springfield, Oregon 97477
,
TAX LOT'
SUBDIVISION'
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. PHONE:
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/JIZ
ZIP: '9 7(,/ R'7 It
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ADDRESS
CON ST.
CONTRACTOR'
PHONE
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EXPIRES
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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: RANGE: _ SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons requested before 7:00 a.m. will be
made the same working day, InspectIons rOQuested 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 Plumblng/Electrlcal/
MechanIcal - PrIor to cover.
o Footing - Atter trenches Bfe
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
. 0 Underground Plumbing - Prior.
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
I
o Floor Insulation - Prior to
decking.
.0 Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench.
. 0 Rough Plumbing -.:.. Prior to
cover. .
REQUIRED INSPECTIONS
rT7l Rough Mechanical - Prior to
L..4J cover.
o Rough'Electrlcal - Prior to
cover,
o Eleclrlcal Service - Must be
approved to obtaIn permanent
electrIcal power.
o FIreplace - Prior to facing
materials and framing Insp.
o FramIng - Prior to cover.
o WalJ/Ceflfng Insulation - Prior to
cover.
o Drywall - Prior to taping.
[] Wood Stovo - After Installation.
o Insert - After fireplace approvlll
and Installation of unit.
o Curbcut & Approach - After
'. forms are erected but prior to
placemont of concrete.f.,
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 Bre planted.
o Final Plumbing '- When all
plumbing work Is complet.e.
o Final Electrical - When all
electrical work Is complete.
rv1 Final Mechanical - When all
I4-J mechanical wol1< Is complete.
o Final Building - When all
required InspectIons have been
approved and building Is
completed.
OOthsr
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.
Lot faces Lot Type. Setbacks . TI;IE PROPOSED WORK IN THE.
I P.L. HSE GAR ACC I HtSTORICAL DISTRICT, OR ON
Lot sq. Itg. Interior IN 1 THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle \W I Coordinator prior to permit issuance.
Total height Cui-dc-sac IE I
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
'.\
."
VALUE
Main
Garage
"
Carport
Total Value
, Building Permi t Fee
State Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
Stato Surcharge
Total Charge
(C)
MECHANICAL PERMIT
F~rnacc ~
Exhaust Hood
Vent Fan
N'
WOOd Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
fi1;W. /;;-- #,
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Issuance
,
State Surcharge
, Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance,
State Surcharge
Sidewalk It
Curbcut It
" Demolition
State Surcharge
,
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excludlQg electrical)
(A, B, C, 0, and E Combined)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thallhe said
construction shall. In all respects, conform to the Ordinance
adopted by the City of Sprlngflelll, including the
Development Code, regulating the constructl()n 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
Date
Systems Development Charge Is due on all undeveloped
properties within tho Cily limits which are being Improved.
ADDITIONAL COMMENTS
By signature. I state and agree, that I have carofully 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 Ordinanc~s of the City 01 Springfield, and Ihe Laws
of the State of Oregon pertaining to tho work described
herein, and that NO OCCUPANCY will be made of any
structure wlthoyt 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 agreo Lo 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 al the front
01 the property, and the approved set of plans will remain
on the site at ail times during constructIon.
Signature ~.LU ~rr1
,
Date
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VALIDATION:
RECEIPT NUMBER /""')89 '3"
/<,-77,95-
26,~
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY