HomeMy WebLinkAboutPermit Mechanical 1996-10-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ottice: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED,\;VORK' L(i..~
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LOT'
OWNER'
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DESCRIBE WORK,1:- tI..,d--<l \ \
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICA' '
M If" (oS J".a \l fJ
ELECTRICAl'
QUAD AREA:
. OF BLDGS:
OCCY GROUP'
· OF STORIES:__
WATER HEATER:
na..""';~Q"'"
.
BLOCK'
STATE:
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JOB NUMBER o.lo \~~
225 Filth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
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'Dr., _ cr- N;.r..t GcU
PHONE: _
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ZIP:
97'17;
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ADDITION
DEMOLISH
OTHER
ADDRESS
CONST,
CONTRACTOR'
PHONE
REQUIRED INSPECTIONS
;:"
~ Rough Mochanlcal - PrIor to
cover.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtaIn permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/C.olllng Insul<ltlon - Prior to
cover.
D Drywall - Prior to taping,
D Wood Slovo - Alter Installation,
D Insert - After fireplace approval
and Installation 01 unit.
D
Curbcut & Approach - Alter
forms are erected but prIor to
placemont of concrete.
11 (Cl-TI_;
EXPIRES .-
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- 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 ~4 hour recording. All Inspections reqUeSied 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.
D Temporary Electric
o
Site Inspoctlon - To be mado
after excavation, but prior to
setting forms.
D
Underslab Plumbing/ Electricall
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing/Mechanical
- Prior to Insulatlon or decking.
o
Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior 10 filling
trench.
o Storm Sewer - Prior to filling
trench. Ii
D Water LIne - Prior to filling
'. trench.
o Rough Plumbing - Prior to
cover.
D Sidewalk & Drlvew.w - After
excavation 15 compietc, forms
and sub. base material In place.
D Fence - \OVhen completed.
D Street Troos - Wh~n all required
trees are planted.
D Final Plumbing - When all
plumbing w9rl< Is complel,e.
o Final Electrical - When all
electrical work Is complete.
~nal Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
DO'hor
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connoctlons - 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.
D Final - After all required
Inspectlons afe approved and
porches, sklrllng, decks, and
venting have been Installed.
Lot (aces
Lot Type .
Lot sq, fig,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
I ( 'THE PROPOSED WORK IN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed'
and approved by the Historical
CoordInator prior to p~rmlt issuance.
I P,L.
IN
Is
Iw
IE
Setb,cks
HSE GAR Accl
I
I
I
I
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT, = VALUE
Main
Garage
Carport
Tolal Value
"
Building Permit Fee
State Surcharge
Total Fee
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
Water
FT,
FT,
Storm Sewer
FT,
Mobtle Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
Stale Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
fI
Demolition
State Surchargft
FEE
-
I~O~
J.UU
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrlCal'&.I.0 .tJf' )
(A, B, C, 0, and E Combined)
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition Ihalthe said
construction shall, In all respects, conform to the Ordinance
adopled by the Clty.ol Springfield, Including the
Oevelopment 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 Development Charge Is duo on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carofully examined
lhe completed appllcallon 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
wllh Ihe Ordinances 01 the City of Springfield, and the Laws
01 the State 01 Oregon pertaining to the work described
herein, and thai NO OCCUPANCY will be made 01 any
structure without permissIon of the Building Safety Division.
I further certlty that only contractors and employees who
are In compliance wllh 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 streel, that the permit card Is located at the fronl
of the property, (lnd the approved set of plans will remain
on the site at all Urn during construction.
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6 ,'2.--Cf (;
Signa lure
Date
VALIDATION: ~ /1..'21 "..)
RECEIPT NUMBEro. .J 1~
DATE PAID 1.-1/7 _
AMOUNT REC(-IVr} -:-.cfJ fo .!J.IJ
RECEIVED BY~~