HomeMy WebLinkAboutPermit Mechanical 1993-9-29
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726-3769
Office: 726-3759
SPRINGFIELD
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LOCATION OF PROPOSED WORK: JCEq \U1Jro,,1
ASSESSORS MAP- /1 O~::l/:;};:>
LOT-
OWNER: Gnb + 5uQ j51lt~
ADDRESS~l('{'l~
CITY- ~("w5+i'.e..ld
L
CL*, _
,
JOB NUMBER O]?-.LSoo
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: ~ lo L.. n I'l
BLOCK-
SUBDIVISION-
STATE:
02
NEW
DESCRIBE WORK:
OTHER
REMODEL
ADDITION
CONTRACTOR'S NAME
DEMOLISH
ADDRESS
CONST_
CONTRACTOR'
GENERAl -
PLUMBING-
MECHANICAL{lrvnf:Oll(:ID~{ID1"~ J5J'r..J. 1st
ELECTRICAl -
OUAD AREA:
\ IZ--Nw
. OF BLDGS:
OCCY GROUP-
. OF STORIES:
WATER HEATER-
ffiLlloO
- OFFICE USE -
LAND USE:
. OF UNITS-
CONSTR. TYPE:
HEAT SOURCE:
1=&
PHONE:~ql
ZIP: Cf-=tl/-n-
EXPIRES
PHONE
RANGE:
34d--~ {ol
FLOOD PLAIN-
ZONING CODE:
. OF BDRMS:
SECONDARY HEAT:
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/Electrical!
Mechanical - Prior to cover.
D
Footing - After trenches are
excavated.
D
Masonry - Slcel location. bond
beams. groutIng.
D
Foundation - After forms arc
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 floor
insulation or decking.
D Floor Insulation - Prior to
decking.
D
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - Prior to filling
trench.
D Waler Line - Prior to 111l1ng
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - 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.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After installation.
D Insert - After fireplace approval
and installation of unit.
D
Curbcut & Approach - Afler
forms arc erected but prior to
placement of concrete.
Q Sidewalk & Driveway - After
-- excavation is comolete, forms
and sub.base material in piace.
D Fence - When completed.
D Street Trees - V.,Jhcn a.1I roqLlircd
trees arc ptr.\ni,;d.
D
Final Plumbing - When all
plumbing work is complete_
D
Final Electrical - When all
electrical work Is complete.
~inal Mechanical - Whon all
mechanical work Is complete.
D
Final Building - When all
required Inspections have beon
approved and building is
completed.
gOther GAo:... -!;.M~
MOBILE HOME INSPECTIONS
D Blocking and Sel.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - \^Jhen
bllJcklngj set-up. nnd plumbIng
inspections have been approved
and the home is cQnnected to
the service panel.
D Final - After all required
inspections are approved and
porches, skirtIng, decks, and
venting have bel:n Installed.
"
;
Lot Type , Setbacks
Interior I P.L. HSE GAR ACC I
IN I
Corner
Is I
Panhandle
Iw I
Cul-de-sac I
IE I
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
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
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
l<s'DO
I C"\ .(')0
-:7c:;
'cl<:;'j,
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
':)'./5
'&E PROPOSED WORK IN THE
..HISTORICAL DISTRiCT, OR ON
THE HISTORICAL REGISTER?
It yes, this application must be signed
and approved by the Hlstorlcai
Coordinator prior to permit issuance.
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 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
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 certlfy
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)' nt
of the property, and the approved set of plans will rem in
on the s,e at all tim)/ies during constr~in.
Slgnat~ ~
Date "'J / :::;,q 1
VALIDATION:
RECEIPT NUMBER I bY ~<3
q bql93
:2> ::;)c:;, -"),
6:).9
DATE PAIf'
AMOUNT RECEIV''''
RECEIVED BY