HomeMy WebLinkAboutPermit Mechanical 1992-7-13
RESIDENTIAL
PERMIT APPLICATION
Inspeclions: 7?6-3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP: /r.:>"'f- '3<(-- '2. "2
LOT:
I Lf I J
o 'F:'. ~q" ",a.
BLOCK:
OWNER:
ADDRESS:
Do. vi"
I L{ \ \
s;. p frJ1 _
GelIA It
o \( Sa. ",,-G\
CITY:_
DESCRIBE WORK:
:r; r-.s+" It
NEW
REMODEL
ADDITION
CONTflACrOll'S NAME
GENERAl.: _
Pl.lJMI3ING:
STAT~'
C'Ji2-
A;..- ~J..\'-th^,'^."
,-
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR N
MECHANICAl..
-- - -.--
!'\" (,shr (\'.s \-t "-a.t 1"'-9 4(3/
C+-S erl"ci r:c .
E. st,.,.c'l ~Rfcl.
. ---. . :::Z1(7-7lfl '..j
:l.S 7.Q(j \ % 2.
ELECTRICAl.:
QUAD AREA:
. OF Bl.DCS:
OCCY GROUI':
N OF STORIES:
WATER HEArER:
- OFFICE USE -
l.AND USF-
N OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:_
RANGE:
.
.JOB NUMBER ?;?&'9'~
F ,
225 Fifth Streol
Springfield, Oreyon 97477
TAX LOT'
~~-'-~
SUBDIVISION'
PHONE7'i 1.:3 '-IY 0 /72..6 - 3: 18o
/
C{llfl7
ZIP:
EXPlr~ES
PHONE
FLOOD PLAIN.
ZONING CODE:_
N OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you must call 726-3769. This Is a 24 hour recording. AtllnspGctions requested before 7:00 a.m, will be
made the salllC working day. inspections requested after 7:00 a.m. will be made the following work day.
I .'1 Tcmponll y Elcchi<:
l-I Sile In::.pcction - To be made
~ after cxt;avation, but prior to
stJllifl{j forms.
o Undcrslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footing - Afler trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o
Foundation - After forms are
erected but prior to concrete
placcmcnt.
o Underground Plumbing - Prior
to filling trench.
o
Underfloor Plumbing/ Mechanical
_ Prior to Insulation or decking.
o Post and Beam - Prior to floor
insulation or (jecking.
o Floor Insulation - Prior to
deckinu.
o
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench.
o Water Line - Plior to filling
trench, .
o Rough Plumbing - Prior to
cover, .
REQUIRED INSPECTIONS
I=:J Rough Mechanical - Prior to
cover.
!~ Rough Electrical - Prior to
-1 covor.
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 Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement 01 concrete.
o Sidewalk & Driveway - After
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 - When all
plumbing worl< is complete.
D Final Eleclrical - Wilen all
electrical woil{ is cOlllpletc.
rvt Final Mechanical - Wtwn all
~ mechanical work Is complete.
o Final Building - Wilen all
required inspections have been
approved and building is
completee!.
OOth.r
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - WIHHl
blocking, set-up, anel 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 faces
Lol Type.
Interior
Lot sq. Itg.
Lol coverage
Corner
Topography
Panhandle
Total height
Cul.de-sac
BUILDING PERMIT
ITEM SO, FT. X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furni1cc
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
.S THE PROPOSED WORI< IN THE
HISTORICAL DISTRICT, on ON
THE HISTORICAL REGtSTER?
If yes, Ihls apptlcalion mu~t bo slgnetj
and approved by the Historical
Coor<..Hnalor prior to permll Issuance.
Setbacks
I P.L. HSE GAR ACC I
IN
-L-___
W
IE
VALUE
FEE
/~ ,.a:.
Ie!:? .-:s_
- 75
,-
7. ')_ /"/
APPROVEO'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thai 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 arc being improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
tl1e completed application and do hereby certify th;)t all
Informallon hereon is trlle and correct, and I (Ilrlller certify
that any and all work performed shall be done in act:ordilncc
with the Ordinancus of the City of Springfield. and Ihe LilW5
of the Slilte of OrcfJon pcrlnlnlng to the work de~;clibed
herein, and that NO OCCUPANCY wltl be !"ade of any
structure without permiSSion of the Building Safely Divi:;ion.
I further certify that only contractors and employees who
are In compliance with OAS 701.055 will be Llsed on this
project.
I further agree to ensure thai 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~t II tImes during.construc..tlon.
Signature ~ 1A.lA~
- tI
Date ;-134L
VALIDATION;
RECEIPT NUMBER ~_.7 3' ~
7-? ?-"7'2-
~""::?5-
r:2~~
v/
DATE PAID
AMOUNT RECEIVED
RECEIVED BY