HomeMy WebLinkAboutPermit Mechanical 1992-7-13
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RESIDENTIAL
PERMIT APPLICATION
Inspeclions: 72().37G9
Ollice: 72().37t,9
LOCATION OF PROPOSED WORt<.
ASSESSORS MAP:
LOT'
OWNER'
ADDRESS:
CITY'
DESCRIBE WORK'
NEW REMODEL _..L
ADDITION
CONTRACTOR'S NAME
CENERAI'
PLUMQING: __~___.
MECHANICAL .rn-N\~\)t..t t:-\I)U)
ELECTRICA' .
"2(""
BLOCi<'
STATF'
or-"
.
JOB NUMBER
9'k; 7~1
225 Fifth Stroet
Sprtnglleld. Oregon 97477
TAX LOT:
SUBDIVISION:
C"J1- ?IJh
PHONE: f] L/ to - "37 g, '1
ZIP: .1..(]Lj f1 '7
f VM 'P,
A\fZ r\MJ}) ~bR
T r\ ~ {<,fV\ USIA Y
DEMOLiSH
OTHER
ADDRESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
'b SS Lll> \ ~;\- E:u.q.
o()l./~o
~Jt}I"]J93 8!j.~-gIOI
. I
- OFFICE USE -
OUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS: . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYP'" . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANG'" SOUARE 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
m:l(lc the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Tcmpornry Electric
o Site Inspcclion - To be made
CiHer excavation, hut prior to
selling forms.
o
Underslab PlumbingJ Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms arc
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumblngl Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water L1no - Prior to filling
trench.
o
Rough Plumbing - Prior to
cover. _
'\
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o 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/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
>
o Wood Stove - After Installatiof!.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - Alter
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 - Wilen all
plumbing work is complete.
o Final Electrical - Wilen all
electrical work is complete.
/
kA Final Mechanical - When all
~ mechanical 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.
Lot' (aces Lol Type. Setbacks .S THE PROPOSED WORK IN THE
\ I P.L.
- HSE GAR ACC I HISTORICAL DISTRICT, OR ON
Lot sq. IIg. Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total helghl Cui-dc-sac IE I
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Gamoe
Carport
Total Value
Building Permi t Fcc
State Surcharge
Total Fcc
(A)
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanilary Sewer FT.
Walcr FT.
Storm Sewer FT.
Mobile Horne
Plumbing PermIt
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
~ &//??ftl.
Mechanical Permit
//4/4/,
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Stale Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
~~
;;.,cO
15t22
/t'? ()O
7J
-~s: 7S
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is ~lranted on the express condition ttlatthe 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 ill any limo
upon violation of any provisions of 5ilid ordinances.
Plan Check Fcc'
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 stale and agree, that I have carefully examined
the completed applicalion and do hereby certify that all
Information hereon Is true and correct, and I furlher 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 cerlify thai only contractors and employees who
are In compliance wittl ORS 701.055 will be used on this
project.
I further agree to ensure that all requircd inspcclions arc
requested at the proper time, that each addre5S is readable
from the street, that the permit card Is locatod at the fronl
of the properly, and the npproved set of pJan~. will rel1lain
on the site at all times duri g constru Ion.
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VALiDATION:
RECEIPT NUMBER 55"19
'7 //1, /-=, 2-
, I i "..-7S--
AMOUNT RECElv"n, 2 ;J "
.~
DATE PAl'"
RECEIVED BY