HomeMy WebLinkAboutPermit Mechanical 1993-7-8
RESIDENTIAL
PERMIT APPLICATION
..
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK' ,!) \ \ '7
ASSESSORS MAP: fl{) ~;;)':=::~\ J 9.
LOT'
ADDRESS:
P.llTH
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SPRlnJ6J='/ GUJ'
OWNER' J)C(\
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CITY'
BLOCI<"
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Sr.
STAT'"
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JOB NUMBER
q?iA~
TAX LQT:
SUBDIVISION-
OS'r({X)
PHON'"
'74~-1'7&q
ZIP:
97<17rJ
DESCRIBE WORK: I ft)S7fi JJ.., 8000013rtJ AJRI/Jf!{!.,l{ Atl{)
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OTHER ,(
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL:
DEMOLISH
ADDRESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
PLUMBING'
MEeHAN ICAI' Canfart FJ.o..i t-mtin:1 855 W. First ElXIere 97402 004ffi
ELECTRICAl'
6/Zl/94
"4?-R1n1
QUAD AREA0 - OFFICE USE -
LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF UNITS- ZONING CODE:
OCCY GROUP' CONSTR. TYPE: # OF BDRMS'
. OF STORIES: HEAT SQURCE: SECONDARY HEAT:
WATER HEATER- RANGF' 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
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o
Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbingl 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 f1Illng
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
.KZ:J7ROU9h Mechanical - Prior to
T 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 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 of concrete.
o
Sidewalk & Driveway - After
excavation is complete, forms
and sub.base material in place.
o Fence - When completed.
o Streot Trees - When all required
trees are planted.
o
Final Plumbing - When all
plumbing work is complet.e.
D Final Electrical - When all
electrical work is complete.
(f74)Final Mechanical - When all
I mechanical work is complete.
o 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.
D 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
porches, skirting, decks, and
venting have been Installed.
Lot faces Lot Type .. Setbacks .PROPOSED WORK IN THE
Lot sq. ftg. Interior I PL. I HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Topography Panhandle Is I .1 I and approved by the Historical
Iw I i Coordinator prior to permit issuance.
Total height Cul.de.sac IE I I
APPROVED'
BUILDING PERMIT
ITEM SQ. FT.. X $/SQ. FT.
VALUE
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFireplace Unit
Dryer Vent
Mechanical Permit
1~.Oq
I () .oU
. ,)'S
CJ5'5
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) C'(,<)' TI
(A, B, C, D, and E Con:blned)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on Ole express condition that the said
construction shall, in all respects, conf9rm to the Ordinance
adopted by the City 01 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 Developmenl 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 QRS 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 o:'t;~ts will remain
on the slle at all . es uring nstru,...
Signature :i
Date
VALIDATION: IJ .!Jd..-
RECEIPT NUMB? q-n-"1
DATE PAin ) LP-, .Cf ":2.,
AMOUNT R~CEIV -cQ$ :J;5
RECEIVED v. 1)6':' /
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