HomeMy WebLinkAboutPermit Mechanical 1995-12-1
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
>--LOT'
.
SPRINGFIELD
BLOCK:
OWNER: J20J?0Y.../-- L-I-l't _
ADDRESS: ' . ~~ f1-3:{;1'vU1\() -
CITY:~' 8' Alt1i~O~)ATE:~
f'ifdt' -
DESCRIBE WORK' 11~<
J
REMODEL
NEW
CONTRACTOR'S NAME
GENERA' '
PLUMBING-
"MECHANICA"
17/),) V1hV
ELECTRICAl -
ADDITION
DEMOLISH
OTHER
~B NUMBER 7' 5"/.&> S
225 Fifth Street
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION'
//- 7 ffT)
PHON'"
~-:t -43qg
ZIP:
'1-:t4--+i-
.?' ~-kvzs,' (J1/\..
ADDRESS
CONST,
CONTRACTOR'
EXPIRES ',,=, PHONE
- OFFICE USE -
QUAD AREA- LAND US'" FLOOD PLAIN:
. OF SLOGS: . OF UNITS' ZONING CODE:_
OCCY GROUP: ' ,CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. AlllnspectJons 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical I
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 I Mechanical
- Prior to Insulation or decking.
D
Post and Beam - Prior to floor
Insulation or decking.
,
D Floor Insulatio~ ~ Prior to
deckl ng.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to fillIng
trench,
D Water Line - Prior to filling
trench.
^
. D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover,
D 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/e"alllng Insulation':"" ,Prior to
cover, .
D Drywall - Prior to taping.. ,
o Wood Stove - After In5tallatl'o,1.
D Insert - After fireplace approvlll
and Installation of unit.
,
D Curbcut & Approach - After
(orms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavatIon Is compiete, forms
and sub.base material In place.
D Fence - When completed,
D Street Trees - When all required
trees are planted,
D Final Plumbing - When ali
plumbing w9rk Is complet.e.
D Final Electrical - When all
electrical work is complete,
D Final Mechanical - When all
mechanical work Is complete.
.
o Final Building - When ali
required Inspections have been
approved and bulidlng Is
completed.
;gr Other
&~ 4//C
r/"vA"'C 6~
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D 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.
D Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed. .
~-
Lot sq, Itg.
-.'J'< ...,:;' - N~ ..
L~t ~ype. ',! "
Setbacks
Interior I P.L HSE GAR ACC I
IN I
Corner
Is I
Panhandle
Iw I
Cul-de.sac
IE I
.S TI;lE PROPOSED WORK IN THE.
HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
" yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Lot faces
Lot coverage
Topography
Total hel ghl
APPROVED:
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
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 Springfiell!, Including the
Development Code, regulating the constructlCJn and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Carport
Plan Check Fee: .
Date Paid:
Total Value
Receipt Number'
Building Permit Fee
Received By:
Slate Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
FT,
FT,
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Dryer Vent
/':.,#' , / ~ .{. /~#
J
J'H/,,';,
/ &; ()O
J -.
//J.po
/,:;"'0
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By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify thaI 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
arc In compliance with OAS 701.055 will be used on this
project.
Exhaust Hood
Vent Fan
N'
Wood Stove/lnserl/Flreplace Unit
Mechanical,Permlt.. '.
Issuance
State Surcharge
Total Permit
17r+,.fJ'
(D)
I further agree to ensuro 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 l~tir;es durl~g on tructlon,
Signature J..<::xiMtlr:-,
. - .
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Date
12-{I/QCY
Curbcut
fl
Demolition
State Surcharge
VALIDATION:
/'J 7/5
/2h/J'.F
, /- . 2.12
AMOUNT RECEIVED ~2f~ _
RECEIVED BY A'P"...iJlL----Z..
DATE PAin
RECEIPT NUMBER
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
2/.::; ?- 0
. .