HomeMy WebLinkAboutPermit Mechanical 1998-6-30
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
ASSESSORS MAP:
LOT:
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OWNER:
ADDRESS:
CITY:
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DESCRIBE WORK:
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.
NEW
REMODEL,
CONTRACTOR'S NAME
GENERAL:
,PLUMBING:
MECHANICAL: ~4 {", ~ \ tu
ELECTRICAL:
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER:
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SPRINGFIELD
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JOB NUMBER Cf<t' 0 r 0 s
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: 63 7o---rJ
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BLOCK:
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STATE:
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SUBDIVISION:
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PHONE:
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ADDITION
DEMOLISH
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ZIP:
'\)\{77
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OTHER
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ADDRESS
CONST.
CONTRACTOR #
EXPIRES '::'> PHONE
D Rough Mechanical -..:. Prior to
cover.
~UghElectrlcal - Prior to
cover. .
o 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 Wail/Ceiling Insulation - Prior to
cover. '
D Drywall - Prior to taping.
D Wood Stovo - Arter Installation.
D Insert - Arter fireplace approvlll
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is compie!e, forms
and sub-base materiaI' In' place.
o Fence - When completed.
D Street Trees - When all required
trees are planted.
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FLOOD PLAIN:
tONING 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.
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REQUIRED INSPECTIONS '] ,.,' ,~.', ,
,.'
D Final Plumbing - When all
plumbing worl< Is complete.
\.
~Inal Electrical .,- When all
\ .' el~ctr~cal ""'.:O~k ;1~::comPlete.
~ MechanIcal - When all
mechanical work Is complete.
NOTICE: - OFFICE USE -
THIS PF8M/r SHAltre'XPlAE=
AUTHORIZED UNriERIjN~I~~~HE WORK
COMMENCED OR ~01(J~I' It) NOT
ANY 180 DAY p' FOR
. I ER/Q~AT SOURCE:
RANGE: __
D Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab Plumbing/ Electrical!
MechanIcal - Prior to cover.
o 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 Underfloor Plumbing/Mechanical
-,Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
, decking.
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.
D FInal Building - When all
required Inspections have been
approved and building Is
completed.
D Other
, 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
porches, skirting, decks, and
venting have been Installed.'
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
'"
Panhandle "
Total height
Cul-de-sac
BUILDING PERMIT
ITEM SO. FT.
. ~{
X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
;,
State Surcharge
Total Charge
(G)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
"
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
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 el,
(A, B, C, D, and E Combined)
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Setbacks
I P.L HSE GAR ACC I
N
S
W
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E
VALUE
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FEE
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IS THE PROPOSED WORK tN 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.
APPROVED:
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BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
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 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 Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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By slgnature,l state and agree, ,that I hav~ carefully examined
the completed application and'db hereby certify that all
Informatlol,1 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 employe~s who
are In compliance wlth ORS.701,055"wIII 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 during construction.
Signa,"," ~ 11.1 ~
b - ) D .-<( ~
Date
VALIDATION:
RECEIPT NUMBER '"36'" { ~
'I-(-g <(
AMOUNT RECF' \ . ) $' d-lo _ J-6
l:iLJ
DATE PAID
RECEIVED BY