HomeMy WebLinkAboutPermit Mechanical 1996-8-19
RESIDENTIAL ,.
PERMIT APPLICATION
Inspecllons: 726.3769
Office: 726,3759
LOT'
SPRINGFIELD
BLOCK'
.. JOB NUMBER qlo \ I~i
225 Fifth Streel
Springfield. Oregon 97477
TAX LOT:
(W.:!D)
SUBDIVISION'
OWNE~1. \.QAQ. \:\ o..fCl.n..O.r" PHONE: 14\0 I LrJ:S
ADOR :' _ '"E1-,{,-)\ I ~fi\ ~\ {' .J ,,~+ _
CITY: ,1~~O f'{\: STATE: (lJ.\ a~oc--_ ZfP: l.\\~ll
DESCRIBEWOR0~S-\r\OO \tJ'\Qf\1 1.)LUYVO< 4. f(l)
NEW REMODEL - ADDITION -XEMOLlS~ OTJER
CONTRACTOR'S NAME
ADDRESS
CONST.
CONTRACTOR'
EXPIRES '. PHONE
GENERAl'
PLUMBING'
MECHANICA" ~ 1 V~D ~_~ nic..oU.
ELECTRICA' .
QUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES:__
WATER HEATER'
\()\L~(n
- OFFICE USE -
LAND USE:_
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE: _
c{.?D~(~
~
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you musl call 726,3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day. Inspectlons requested after 7:00 a.m. wIll be made the following work day.
o Temporary Electric
o Silo Inspection - To be mado
after excavation, but prIor to
setting forms.
o
Underslab Plumbing I Electricall
Mechanical - Prior to cover.
o
Fooling - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o
Foundation -- Afler forms are
erected but prior to concrete
placemont.
o Underground Plumbing - Prior
. to filling trench.
O Underlloor Plumblng/Mechanlcel
- Prior to Insulation or decking.
o 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 Waler LIne - Prior to filling
. trench.
o Rough Plumbing - PrIor 10
cover.
REQUIRED INSPECTIONS
~U9h Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Servlco - Must be
approved to obtaIn permanent
electrical power.
o
Fireplace - Prior to facing
materials and framing lnsp.
o
Framing - Prior to cover.
o Wail/Coiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
(arms are erected but prIor to
placement of concrete.
o Sidewalk & Driveway - Afler
excavation Is compietc, forms
and sub.base material In place.
o Fenco - "'Vtlen completed.
o Slreet Troos - Whan all required
trees are planted.
o
Final Plumbing - When all
plumbing worl' Is complet,e.
D
Final Electrical - When all
electrical work Is complete.
~al Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
complelod.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
bloeklng Is complele.
o
Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel-up. and plumbIng
Inspections have beon approved
and the home Is connected to
the service panel.
o
Final - After alt requIred
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces Lot Type .
Lot sq. flg, Interior I P.L.
IN
Lot coverage Corner Is
Topography Panhandle Iw
Total height Cul.dc.sac IE
BUILDING PERMIT
ITEM SO. FT. X $/50, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
Stale Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
tTEM
Fixtures
Residential Beth(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flrcplace UnIt
AjV
Mechanical Permit
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharg~
\'."
(_HE PROPOSED WORK IN THE.
HISTORICAL DISTRICT, OR ON
THE HtSTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
HSE GAR ACC
VALUE
"
FEE
{j!!
~'O~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrICal)c:{l/ O.!JJJ
(A. B. C, D. and E Combined)
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
constructlon shall, In all respects, conform to the Ordinance
adopted by the Cily 01 Springfield. including the
Development Code, regulating the constructlon 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:
Rccel pt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is duo on all undeveloped
properties within tho City limits which are being Improved.
ADDITIONAL COMMENTS
By slgnalure, I stato end agreo. thai I have carofully examined
the completed application and do hereby cerllly thet all
Informatlon hereon Is true and correct, and I further certify
that any and all work pcdormed shall be done In accordance
with the Ordinances or the City of Springfield, and the Laws
of the Stelte of Oregon pertaining to the work described
herein, and thai NO OCCUPANCY will be made 01 any
structure wllhout 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 10 ensuro 1hat all required Inspections are
requested at the proper time, that oach address Is readable
from tho slreet, that the pormlt card Is located at the front
of the property. and the approved set of plans will remain
on the slle at all times during construction.
L2nature~~d/ ,&f'~ - d/
/
Oato
VALIDATION: Lt
RECEIPT NUM~. ,;'\98\\
DATE PAID ~ ~
AMOUNT RE~VE ;~(lJ)
RECEIVED BY' 1\)
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