HomeMy WebLinkAboutPermit Mechanical 1996-5-22
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED wo~~A1)%
ASSESSORS MAP' \ \lJ ("Y-J I ~ \
OWNER' >-t (\ r-.ro. y~,
ADDRESS: "':'~ f='., --!Jb.. OJL~ *" ct _
'- f)_~J\ l ~~ b9-(1 STATE: \ \L\ 0 ~Tr\
DESCRIBEWORK~ \.~~,~ \\
NEW, REMODEL - ~DDITION -=-v ~EMOllSH
LOT'
CITY'
CONTRACTOR'S NAME
GENERA' .
BLOCK'
OTHER
.
4\-\cnEY{'
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
I
[ J\-4ln
SUBDIVISION'
PHONE: \/\,,\ .0,?.L.:J4-
ZIP:
Gtr\-, I
ADDRESS
CONST.
CONTRACTOR'
PHONE
PLUMBING'
MECHANICAL"JlMrQ (\{\lei.. (b~
\ ~ .
ELECTRICAl'
~
EXPIRES
,~~ S{\.)//j
- OFFICE USE -
QUAD AREA: LAND US". FLOOD PLAIN'
. OF BLDGS' # OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: . OF BDRMS'
# OF STORIES: HEAT SOURCE' SECONDARY HEAT:
WATER HEATER: RANGE' SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This 15 a 24 hour recording. AI/Inspections rcquesled 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 Temporary Electric
o Site Inspection - To be mado
after excavatIon, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
exca~ated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Undorground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - 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 Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
~aUIRED INSPECTIONS
)kOU9h Mechanical - 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 Wail/Ceiling Insulntlon - Prior to
cover. ,
o Drywall - Prior to taping.
o Wood Slovo - Atter Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior 10
placemant of concrete.
D Sidewalk & Driveway - After
excavation Is complete. forms
and sub.base material In place.
o Fence - \Nhen completed.
o Street Treos - When all required
trees are planted.
o Final Plumbing - When 011
plumbing w9rl< Is complet.e,
D Final Electl'"icnl - Whon all
electrical work Is complete.
~nal Mechanical - When all
. ~~chanlcal work 15 complete.
o Final Building - Whep all
required Inspections have been
approved and building Is
completed.
,DOthor
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 - When
blocking, sel.up, and plumbing
Inspecllons have been approved
and the home Is connected to
the service panel. .
o Final - After all required
Inspections are approved and
porches, sklrllng, decks, and
ventln.g have been Installed.
Lot faces 'Lot TYP.
Lot sq. ltg, InterIor I P.L.
IN
Lot coverage Corner Is
Topography Panhandle Iw
Total height Cul.de.sac IE
BUILDING PERMIT
ITEM SQ, FT, X $/SQ. FT. = VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEIYIS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plu'mblng Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
l;j . l..{J"
I D.Lt)
1.20
Al W
.:..c..JO.
Issuance
State, Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Mlscetlaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) dJp. :10
(A, B, C, 0, and E Combined)
,I'"' .'
, .,~ '
,~ '
.IS THE PROPOSED WORK iN THE _
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be sIgned
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
HSE GAR
ACC I
APPROVED'
"
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 Developmen,t 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 certHy 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 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
are In compliance with CRS 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 prop~rty;and the approved set 0" lans will remain
r' / -
. (~he Sltte at al'.lmes during onstr !lon. .
~naiure'-- 2.t,,/ ('./ k
Date
VALIDATION: ^ll _ -.rJ
RECEIPT NUMBER N \O\~
DATE PAID '" P) r:lfJ.qw
AMOUNT REC~Vjp -f}\n ~d-.U
RECEIVED BY rf\ (A(). , -