HomeMy WebLinkAboutPermit Mechanical 1993-9-24 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK: ')JIIJi'
ASSESSORS MAP: \~ l'{'( (')(.\
LOT
OWNER' mi/(L l11)h
ADDRESS: '-5J..b;?' l-!Jr::JfhJ~
CITY: (\!JrLlr;ftf Jrf
//KITi II
DESCRIBE WORK:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL:
ELECTRICAl'
IItlIl!f!f!-1Il.YJ
.
SPRINGFIELD ",.
· JOB NUMBE8 7)1~~-
225 Fifth Streel
Springlield, Oregon 97477
TAX LOT:
\ '1 (Y'"\
for<:.IJfh/(J .
<LV
BLOCK'
STATE: ()r~() n
:J -fDn A.Pcd P/.//YJ(J'
SUBOIVISION:
PHON..
ZIP:
971-/77,
DEMOLISH
OTHERJilsJ.fl.J.'! 1)1(1'
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Mu:;t be
approved to obtain permanent
electrlcC:11 power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to tapin9.
D Wood Stove - After installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete. forms
and sub-base material in place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
AODRESS
CONST.
CONTRACTOR'
I'HONE
EXPIRES
1(;; K Lf f()(;jIJ # f9 r'pEr/. 5,)~-.t1\lli~\.\
7Jlb.:.lltz? 7.
- OFFICE USE -
QUAD AREA' LANO US~' FLOOO PLAIN:
. OF BLOGS: . 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. This is a 24 hour recording. All inspections requested bClore 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
Final Plumbing - When all
plumbing work is comr,lctc.
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
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 fllling trench.
D
Underfloor Plumbing/Mechanical
- Prlor to Insulation or decking.
D
Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
.,
D
Sanitary Sewer - Prior to filling
trench.
D
Slorm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
o Rough Plumbing - Pri~r to
cover.
o Final Electrical - When all
'-----' 7lca' work is complete.
~i~~~~ M~chaniial.-f~n all
mecllanical 'work is complete.
D Final Building - WllOn all
required inspections h:tve been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
D Bloc~:ing and Sel.Up - When all
blocking is complete:
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, sct-up, and plurnbing
inspections have been approved
and the home is connected 10
the service panel.
D Final - After all required
inspe,:;t!ons are approved and
porches, skirting, decks, and
venting have been inst:1l1cd.
.....
~)
.
Lot (ar.cs
Lot Type
Lot sq. Ilg.
Interior
Lot coverage
Corner
Topograph'l
Panhandle
Total height
Cul.de.sac
.,
BUILDING P,ERMIT
ITEM SO, FT, X $/SQ. FT.
Main
Garage
Carport
--,~_._-
Totnt VarUI~
Building Permit Fec
State Surcharge
TOlar Fcc
(A)
(~
.HE 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.
____ S~~-:!cks _
P.L. IHSE GAR ACC I
N I
Is 1
Iw 1
LL_.-J
VALUE
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
Storm SeVier
FT. "
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
~V
F U pt'l':e-
EX~<rnst~
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
Slate Surcharge
Total Pemdt
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
CUlbCUI
It
Demolitioll
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electric;]l)
(A, S, C. D, an(j E Combined)
FEE
~
\S,
\~~
\D~cm
. .1;5
'1~.I~
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shal', in all respects, conform to the Ordinance
adopted by the Cily of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon vlo!ation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number.
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
propertles 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 certlfy
that any and all work performed shall be done in accordance
with the Ordinanct;:s 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.
1 further certify thaI 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
"" '"" "j'i:A7'""'" '"""'P""'
Signature / t . I
Oat" -Ji/)
VALIDATION: \r---0......C'/51
RECEIPT NUM~~ 1l 1 U 1)
DATE PAir '--\.- :,.J<'",\ ~~
AMOUNT RECEIVED \~~~
RECEIVED BY ___.0 '" ~
"