HomeMy WebLinkAboutPermit Mechanical 2001-1-2
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RESIl)ENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759 i
LOCATION OF ~ROPOSED WORK: \f)Q \
ASSESSORS MAP'
.
SPRINGFIELD
.
JOB NUMBER
(v\ t-\ I ~ I 2-01
225 Fifti> Slreet
Sprlnglleld, Oregon 97477
If) 1,'),0-.. V \ ,
Q. '\ '-\ "l.B
TAX LOT'
LOT' BLOCK: SUBDIVISION'
OWNER:',\\, n.f:..e:i"Y'"\ C\,\V"\0t-\ ~ \-f')v~.s.~\'''''UC.PHONE: 3l..\S -7~'~
ADDRESS' '\OQ... \ f) O-*' ~J\^Du.<") s., 'V \
CITY: s~t~~ \ f"\~ STAT'" n k ZIP: C) -, '-ll_9-
DESCRIBE WORK\\("\c...,~t-^ \ \ ?--' \ ~ -\,~.----." ~ I,) n. -\- \' u. \N\Y
NEW _/ REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME
ADDRESS
CONST,
CONTRACTOR ·
EXPIRES '," PHONE
GENERAL'
PLUMBING'
MECHANICAL~(> rf'l\,,^D..\-~~.'lDlnf:&Av~ \':.\"'\". (\'140')
ELECTRIC!> I '
't:-,'-\\lo'-~ ND''''I r ""4~'-\""-2R.~
- OFFICE USE -
QUAD AREA: LAND USE:_ FLOOD PLAIN'
. OF BLDGS: . OF UNIT:'" ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: . SECONOARY HEAT:
WATER HEATER' RANGE: _ 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 aflcr '1:00 a.m. will bo made the following work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, bul prior to
setting forms.
o Underslab Plumblngl Electricall
MechanIcal - PrIor to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground PlumbIng - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
_ Prior to Insulation or decl<lng.
D Post and Boam - 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 Mochanlcal - Prior to
cover.
D 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/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After Installallon.
o Insert - After fireplace approvl!ll
and Installation 01 unit.
o Curbcut & Approach - After
forms are cmcted but prIor to
placomont of concrete.
o Sidewallt & Driveway - After
excavation Is complete. (orms
and sub-base malerlal In place.
o Fence - "Vhcn cOi....'pleted.
o Streot Troos - When all required
trees are planted.
D Final Plumbing - When all
plumbing wC;>rlt Is complet.c.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building -, When all
required Inspections have been
approved and building is
com pie lcd,
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Set' Up - When all
blocking Is complete.
o Plumbing Connccllons - When
home 1)3S been connected to
water .1.nd sewer.
o Electrical Connection - When
blocklnn. set-up, and plumbing
Inspections have been approved
and the home Is connocted to
the service panel.
o Final - After all required
Inspections are approved and
porches, sklrtlng, decks, and
ventlng have been Installed.
("
Lot faces
Lot sq. ftg,
Lot coverage
Topography
Total height
BUILDING PERMIT'
ITEM
SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fcc
Lot Type ..
Inlerlor
Corner
,
Panhandle'
Cul-de-sac
;; t
X $/SQ, FT,
(A)
,',' . . I: ~,~ ,./ \:It
..' " '"l\~;'"'
, .. . J
.,
'(eTHEPROPOSED WORK IN 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,
-~
Setbacks .
HSE GAR Acc'l
I P,L,
IN
Is
t~ _1-1
VALUE
'.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT,
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
FT,
(C)
Dryer Vent
Wood Stove/lnserl/Flreplace Unit
N'
Mechanical Permit
Issuance
St3tC Surchar{Jt:!
Total Permit
(D)
Mobile Home
MISCELLANEOUS PERMITS
State Issuance
State Surcharge
Sldewa1"k
ft
Curbcut
It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
APPROVED:
BUILDING "ALOE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition tl1at the said
construction shall, In all respects, conform to the Ordinance
adopted by thc City, of Springfield, Including the
Dovelopment 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 '1
properties within the City limits which are being Improved,
1
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certlly thai 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 01 Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thai NO OCCUPANCY will be mado of any
structure without permission of the Building Safely Division.
I further certify that only contractors a.nd employees who
aro In compliance with ORS 701.055 will bo used on this
project. '
I further agree to ensure that all rOQulred Inspections are
requested at tho proper time, that oach address Is readable
from tho street, that the permit card Is located at the fronl
of the properly, and the approved set of plans will remain
:~g~ha:u:~e 7~ du g cons ~
Date / - Z. - ",T
CJ
VALIDATION:
RECEIPT NUMBER
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DATE PAIl""
AMOUNT RECEIVED
RECEIVED BY