HomeMy WebLinkAboutPermit Mechanical 1999-5-3
RESIDENTIAL
PERMIT APPLICATION
.
SPRINGFIELD
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
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ASSESSORS MAP'
LOT:
BLOCK:
OWNER'
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ADDITION
OTHER
CITY:
STATF' '
DESCRIBE WORK'
,*, '..4"tpA-r-JI.
NEW
REMODEL
DEMOLISH
.-
.J08 NUMBER, q'1tJ 57 Z--
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:
10 7dO
PHONE: _711C ~ l:::l6 7.&
ZIP:
CONTRACTOR'S NAME
41# ;(/.f/J~
/
ADDRESS
. CON ST.
CONTRACTOR'
EXPIRES ',-:- PHONE
GENERAl'
PLUMBING'
MECHANICAl'
ELECTRICAl'
- OFFICE USE',- .
QUAD AREA:
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:
LAND USE:_
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGF.:_
FLOOD I'LAIN'
ZONING CODE:_
. OF BDRMS'
SECONDARY HEAT:
SOUARE FOOTAGE:
To request an Inspection, you must call 726-3769. Tills Is a 24 hour record.lng, All Inspections requested before 7:00 a.m. wIll be
made the same working day. Inspections requested ofter 7:00 a.m. wlI,' '?~ made the following work day.
REQUIRED INSPECTioNS
o Temporary Electric
o Rough Mechanical -. prl~r to
cover. "" .
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Rough Electrical - Prior to
cover. . .
o Underslab Plumblng/Electricall
Mechanical - Prior to cover.
o Electrical Servlco - Must be
approved t~e!:tnln Rar~anent
elect~~19~15>>Jeo.Ul '
o Fooling - After trenches are .00'0'\ 'e\X\IO \'6U\\\'0'J 00
excavated, ,->oC1f~ JO~":"~~riQf;)\.oC'laJ<l8g
, '\'W f-\~ ~eiii?s' ~Iii~~~"'sp.
o Masonry - Steellocallon, b8\.~\O~ U\.,e~ UI'0\o'O 0r::r1F~ '001\\\0~.
beams, groulfng. UOI~'0 '6e\e\~~'~~ll1iYlPQ:~~1?6' q~\lP.\ .
eUO~ e\X\ \~1I0IW . Ie' se\1I1 \.'<1
o Foundallon - After lorms&f6l1 1Il0~ eSO\X~ ,009'0 \\~-:;~ .
erected but prior to con'.ge'lil,SO ~~~,iflJl:\l!l~~iillQallon _ Prior to
placement. .\OIJ esal,~@lIil~ uo'?! ' ,
1.\\10\ \ \\ uo'6e lI'Oel tl' \ , ,
o Underground Plumbing - F/<i'il~ of-S~ Drywall _ Prior to taping:.
to IlIlIng trench. 0\11 U
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stovo - After In,stall.nt/on.
o Post and Beam - Prior to floor
Insulation or decking.
o Insert - After fireplace approvlll
and installation of unit.
o Floor Insulation - PrIor to
decking.
o Curbcut & Approach - After
forms are crncled but. prIor to
placement of concrete. .
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to tilling
trench.
o Sidewall{ & DrivewaV ~ After
excavation Is complete, forlT!s
and sub.base material .in place,
o Water Line - Prior to filling
trench.
o Fence - When corrlpleted.
o Rough Plumbing - Prior to
cover.
o Streot Trees - Whu0 a!"l r.equlred
trees are planted. . .
o Final Plumbing - When all
plumbing W9rl{ Is complet.e.
D Final Electrical - When all
electrical work Is complete.
~ Mechanlca' - When all
nC(~hanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building is
completed.
.
DOthcr
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocl{jn~} Is complete.
o Plumbing Connections - When
home 11as been connected to
waleI' and sewer.
o Electrical Connection - When
blocking, set.up. and plumbing
Inspections have been approved
and the home Is connected to
the s.ervlce panel.
o Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been inslalled.
.....~
Lot faces ,
Lot sq. flg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
sa. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Lot Type .
Interior
Corner
Panhandle
Cul.dc.sac
X $/SQ. FT.
lA)
, ,
\';";
I, p.L.
IN
Is
Iw
I~
VALUE
'..
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
,
\
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
FT
FT.
FT.
(C)
Wood Stove/lnsert/Flreplace Unit
N'
c;e~ ve/~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DlIE (exclueJing clectrlcal)
(A, B, C, 0, and E C~mblnCd)
FEE
I (.()tJ
/(), tli)
l.{~~ !.#~
Jt.tiJ
Setbacks.
HSE GAR Accl
I
I
'e .HE PROPOSED WORK oN THE.
"'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVEq:
.,
BUilDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is gra.nted on the express condition that the said
construction shall,ln all respects, conform "to the Ordinance
adopted by thc 'City of Springfield, Including the
Development Code. regulating the constructIon and use of
Ouildings, and may be suspended or revoked at any tIme
upon violation of any provisions of said ordinances.
Plan Check Fee.
Dale Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systoms 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 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 Ordinances of the City of Springfield, and the Laws
of. the State of Oregon pertaining to tho work described
hcrcin, and thai 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.
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 will remaIn
on the site at all times during construction.
Signature ~ /~
<-: 7- "17
Oat.. .).
VAI.IDATION:
RECEIPT NUMBER
o P7'9'(
r(3/'i'f /)
J';,/!
DATE PAIr>
AMOUNT RECEIVED
RECEIVED BY