HomeMy WebLinkAboutPermit Mechanical 1993-5-20
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RESIDENTIAL
PERMIT APPLICATION
Inspections 726.3769
Office: 726<1759
LOC/,nON OF PROPOSED WORK:.
ASSESSOR:; MAP: _/70.3.
LOT:
OWNER _,8A-/A1 .J:Yl1'7//'Y?
ADDRESS ~25 (A.eI A.~<) // ft
CITY r'?..r.7 ~
,
DESCRIBE WORK:
"/_ ro7tJ
NEW __' REMODEL
CON rRACTOR'S NAME
SPRINGFIELD
JOB NUMBER 9".36-7 rY(-
225 Fifth Street
Springfield, Oregon 97477
BLOCK:
TAX LOT:
SUBDIVISION'
~/Ad
STATE:
~
&-r.t - ~h?P:>
I /_U;
ADDITION
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR'
GENERAL: .
PLUMBING:
MECHANICAL: -_tW//r.;-L-.RAI?/f'..I;
ELECTRICAl'
OUAD AREA:
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:__
1/0077
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
PHONe'
ZIP:
<77~7?
EXPIRES
PHONE
/tfAt/9 < ~ -/?-2./
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
.. ,
To request an inspection, you must calt 72G.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.
o Tcmpormy Electric
D Sitc Inspection - To be made
after ,~xcavation. but prior to
setting forms.
D
Underslab PlumbingJEleclricalJ
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams. grouling.
CI
Foundation - After forms atC
ercct,:d but prior to concrete
placement.
D
Undcrground Plumbing - Prior
to filling trench.
D
Underlloor Plumbingl Mechanical
_ PrIor 10 insulation or decking.
o
Post and Beam - Prior to floor
insulalipn or decking.
o
Floor Insulation - Prior to
decking.
D
Sanitary Sewer - Prior to filling
Irencn.
o
Storm Sewer - Prior to filling
Ironen.
D Watcr Lino - Prior to filling
trench.
D Rough Plumbing - Prior to
cover
REQUIRED INSPECTIONS
1V'(Rough Mechanical - Prior to
~cover.
\("7f" Rough Electrical - Prior to
~ cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prior to facing
malerlals and framing Insp.
o
Framing - Prior to cover.
D WalllCciling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stova - After Installation.
o Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - Aller
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
o Fence - When completed.
o Slreet Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing worl( Is complete.
r'V(Flnal Electrical - When all
~electrlcal work Is complete.
~Final Mechanical - Wtlcn all
mcchanical work Is complete.
o Final Building - When all
rCQulred 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
waler and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections tl<lVe 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
Lol Type . Setbacks
Interior I P.L. HSE GAR ACC I
IN I
Corner
Is I
Panhandle
Cul-de-sac W I
E I
.
IS THE PROPOSED WORK IN THE
.. HISTORICAL DISTRICT, OR ON
THE HISmRICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Lot sq. fig.
Lot coverage
Topography
Total height
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
This permit is granted on the express condition Olat 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 al any lime
upon violation of any provisions of said ordinances.
Garage
Carport
Plan Check Fee:
Date Paid:
Total Value
Receipl Number:
Building Permit Fee
Received By:
State Surcharge
Total Fcc
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due On all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Residential Bath(s)
N'
-5~~ E~ /CW/77t'/
/<; ~C(j:tJ~~
Fixtures
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
.1.-,.
I'" ~ JI#,
//JU/n//
m/,U -
Total Permit
(D)
/<:;: CO
/ t) pO
,?j-
2.~ 7 J-
By signature, I state and agree, that I tlave 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 Ordlnanct:s 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
arc In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vont
Mechanical Permit
Issuance
State Surcharge
Sidewalk
It
I further agree to enSUIC that all required Inspcctione are
requested at the proper time, that each address is readable
from the street, that the permit card is located <It the front
of the property. and the approved set of plans will remain
on the site i1 all times ~ring construction. . 0 /
/ /(Slgnature~ P J(i'1t1\1 ,--tf /~ y. fJ/WR 4,
Datp ~- ;:Ki -? J
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Curbcut
It
Demolition
State Surcharge
VALIDATION:
RECEIPT NUMBER
~S-7 <j
S-/;;4)
.~~
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
?<:".7.s-
DATE PAIl'
AMOUNT RECEIVED
RECEIVED BY
Total Miscellaneous Permits (E)