HomeMy WebLinkAboutPermit Mechanical 6-10-7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
-.
SPRINGFIELD
OWNER: Pe 0l(Ca "Jnhn~
i ADDRESS:13L~ ttOd!J0
CITY- Z'f>yr1'Ud STATE tJ 'Z- ZIP,!3 7'177
DESCRIBE WO:K' ~0 p'pilw .c- -ff~ due. U:2D fyI--r
REMODe0 . ADD)~JN . . DEMOLl~ OTHER .
LOT:
NEW
CONTRACTOR'S NAME
GENERAl'
BLOCK:
""
'"
JOB NUMBER
cr rpDS~ L I
225 Fi fttl Street
Sprin.gfleld. Oregon 97477
TAX LOT: () :l5(){j ,
SUBDIVISION:
PHONE:
7tfl-Of)'1~
ADDRESS
CaNST.
CONTRACTOR #
EXPIRES ""-. PHONE
PLUMBING: I
MECHANICAL: PAJ.)QAM./'JAA l fY1A f5hwj-tlJrV\,--
ELECTRICAL:
CJ2<6Jlf
7/17 '-1&5'- 39tJO
- OFFICE USE -
QUAD AREA: LAND USE: 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. Ttlls Is a 24 hour recording. All inspections requested 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 Te~porary Electric
'.
,0
Site Inspection - To be made
after excavation. but prior to
selling f,orms.
o
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
D
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 decking.
o
Post and Beam - Prior to floor
Insulation or decking.
D Floor I'nsulatiori ....:; Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
~ROU9h ~haniGal~" Prior to
~ ~over. ~.7
D RoU9hE~t'rical - 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/Ceiling Insulation' -. Prior to
, cover.
o Drywall - Prior to taping.
o Wood Stovo - After I~stallatlon.
o Insert - After fireplace approval
.. and installation of unit.
o
Curbcut & Approach - After
forms are erected but. prior to
placement of 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.
o Final Electrical ,- When all
electrical work is complete.
AA Final M.~"~l~~- When all
~ mechanical work Is complete.
o Final Building..,.. When al/
required Inspections have been
approved and building is
completed. .
~h",~'f ~
, '-J
MOBilE HOME INSPECTIONS
o Blocking and Set-Up - When al/
blqcking is complete.
o
Plumbing Connections - Wher:l
home has been connected to
water and sewer.
o
Electrical Connection - When
blocking, set-up. and plumbing
inspections have been approved
and tile home is connected to
the service panel.
o
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been Installed.
:;0
Lot faces Lot Type
Lot sq. fig. Interior I Pl.
IN
Lot coverage Corner. Is
Topography Panhandle Iw
Total height Cul-de-sac IE
BUILDING PERMIT'
f
ITEM
SQ, FT.
X $/SQ. FT.
Main. ..
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
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
NO
I i
Wood Stove/lnserl/ Fireplace Unit
;~V~pIVl~1 afPl~
WChanical pe,dt .' .
Issuance
State Surcharge 1310 Ci.Jy Ad~; 1'\
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, D. and E Combined)
FEE
IS .(1)
to .07)
- _I. ~_
:2~1fJ
,:'"';'.,
.\,;.t
Setbacks
HSE GAR ACe'
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.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that 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 s~(d 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 are being improved.
ADDITIONAL C,OMMENTS
By signature, I state and agree. that I have carefully 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 Ordinancl;ls 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 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.
Slgnatum"/{" ~2tl5.-r L3.~
Date r I,D - .., - a. /- .
VALIDATION:
RECEIPT NUMBER 1~ '3 '61-
DATE PAID In -7 -q ~
AMOUNT RECE~VED ;J.tJ .J-O
~/
RECEIVED BY
FENCE PERMIT APPLICATION
CrTY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office:
INSPECTION LINE:
726-3759
726-3769
, Job Location: 't3/3 mo~c- J-I. .!So+J I>P. 97<177
; .
Assessors Map #: \C)O~?io~~
----
Tax Lot #:~~
Owner: ~_J'1J'n \7Qhn~on
Address:--L3J~ mDcU,(._ s./-.
Phone #: 1tf/~O,f(/-<.-
Ci ty: . Sfl""'/'nJ :t,I,J} Jt/, State: t0R _
Value of 'Fence: c!Afl)~ Fence Permit is
contractor/Install:r: n JJMi)
Zip:
q 7l/7 7
$5.00
",
'.
"'---"'
, Address:
Phone it:
Ci ty:
.State:
Zip:
Construction Contractors Registration it:
Expires:
lly signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
this application/permit is correct and that I was provided with the Springfield
Development code requirements for fence standards.
.CJt-'
. . .' 7J II .J ./ A '....-fh.-..
Sign::a .
'1-/ - 9~
Date
FOR OFFICE USE
Date of Application: r; . / . q 0 ~OB #: Q{oOSK1
Receipt # A ~rm J Issued By: / J')/)' )
Total Amount ~O~l~C:d: ~l::)<<J LX-X_ ~
Checked [or Delinquencies:
Checked [or Historical Status: