HomeMy WebLinkAboutPermit Mechanical 7-3-11
SPRINGFIELD~ .;
~~_~~ JOB NUMBER ~,~~,,',---5>;:>
225 Fifth Street
Springfield. Oregon 97477
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17~c73 ,,~? !' t::'O
OWNER: R..cxJ r1E. (I t- J(orrn StUve'
ADDRESS:' q In .JI;~n1-, M~Ao(.J lVct '
~.p'in5R~1cI STAT 1=. 0((
DESCRIBE WORK' Comptdr {ArrFlnJOjned Ecnu.~ RootY\. (2nd fUx)(-)
ADDITION 1/
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
~ASSESSORS MAP'
LOT:
CITY'
NEW
REMODEL
CONTRACTOR'S NAME
~GENERAI ' RcdnLv 'Jt1;.Ve'
l"
PLUMBING:
II '/
~ MECHANICAL:
i II /I
_ ELECTRICAL:
QUAD AREA:
# OF BLDGS'
OCCY GROU~:
# OF STORIES:
WATER HEATER:
BLOCK:
DEMOLISH
OTHER
TAX LOT:
t:/ /~ ~
SUBDIVISION:
PHONE:
746 'Z/{X>
ZIP:,
q7477
CON ST.
ADDRESS' CONTRACTOR # EXPIRES , .~ PHONE
, <Atbve " (\Ort:. 746-1l/XJ
/, /f II
/I /) "
- OFFICE USE ..:...
LAND USE:
# OF UNITS'
CONSTR, TYPE:
HEAT SOURCE:-
RANGE:
FLOOD PLAIN:
ZONING CODE:
# OF BDRMS:
SECONDARY HEAT:
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 after 7:00 a.m. will be made the following work day.
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.,
o Underslab Plumbing 1 Electrical/'
Mechanical - Prior to cover.
o Footing - After trenches are
excavated, '
o Masonry - Steel location, bond
beams, groutlng.-
D Foundatlon- After forms are'
erected but prior to 'concrete "
placement.
o Underground Plumbing - Prior ,
to filling trench. .
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
, ,
REQUIRED INSPECTIONS
IVl Rough Mechanical - Prior to'
, I,.6.:J cover. .
IYl 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.
.. .~.
D Framing - Prior to cover.
rn Wail/Ceiling Insulation....,. Prior tq
cove~ ,
I2tJ DryW~1I - Prior ,to tapl"I1.g. ,
o Wood Stove - After Installation.
O. Post and Beam - Prior to floor
I I tl d kl' D'" Insert - After fireplace approval
nsu a, on or ec n9. .. .- ,', ., and Installation of unit.
o Floor Insulation - Prior to
decking. '
o .Sanitary Sewer - Prior to filling
trench.
D Storm Sewer ~ Prior to filling
trench. ,
1 ':'.
D Water Line - Prior ,to filling ,
trench. ...... ' , '
o .Rough Plumbing' -: Prlo; to,
cover., ,:~ ,
'0 Curbcut & Approach - Afte'r
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. '
~
, '-
D
Final Plumbing - When all
plumbing W9rl< Is complete.
rn Final Electrical - When all
. electrical worl< is complete.
ffiFlnal Mechanical - When all
mechanical work Is complete.
IJt Final Building - When all
~ required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete,
o Plumbing Connections - When
home has been connected to
water and sewer,
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home is connected to
'the service panel.
o Final - After all required
. inspections are approved and
porchcs,skl rii ng, decks, and
venting have been installed,
BUILDING PERMIT!
;~ "t
ITEM
SQ, FT.
X $/SQ, FT.
Main
Garage
Carport
~dJ.P~t.'li:.1- ~~~~~
'--:::?~ /2 ~~
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
(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
Wood Stove/lnsert/Flreplace Unit,
Dryer Vent
~~~~ ~Vc;,C?
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
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, 8, C, 0, and E Combined)
':;';" "
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THEPROPOSEO WORK iN'THE -
PHIST081CAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by', the Historical
, Coordinator prior to permit issuance.
P.L.
Setbacks
HSE GAR ACe' I
I
N
S
\W
IE
VALUE
"
~~, $liI/#,
FEE
~~
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SYSTEMS DEVELOPMENT CHARGE (SDC)
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APPROVED:
-: '..... - q,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the 'e~press 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 said ordinances.
Plan Check Fee:
?-g .",. '3
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 COMMENTS
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 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 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 d~1F construction.
Signature ~/.~
Date ~~ /1- or!
VALIDATION:
RECEIPT NUMBER ? '-/ g~
DATE PAID ? Y /~ ?
AMOUNT RECEIVED / P ':! .=:? c:::>
RECEIVED BY ~~ "
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