HomeMy WebLinkAboutPermit Mechanical 1993-9-17
RESIDENTIAL
~APPLlCATlON
_Inspections: 726.376.0
Olllce: Ilb'JI~~
LOT:
e
BLOCi'"'
.
'.
q3t43t
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
SUBDIVISION:
OWNER: \Jf'\l.. C) \ [:\\I.IDOo P,i 8_ _ --- PHON~,\\L\tO-4C\<?" 1
ADDRE~ ~l ~ {\.~~Q, ~Lf' ':\. \< C"Cu \J
CITY""- ,\J\ J i\C\fo 0 rq STATE:_~ C~nY\
DESCRIBE WORK: ~Q C\} + - V. \ ~..JYi:r ~
NEW REMODEL ADDI~ON DEMOLISH
CONTRACTOR'S NAME
GENERA' .
PLUMBING' /
MECHANICAL: L\h 1 "JY\..QJ2./
ELECTRICAl'
OUAD AREA:~.e.n..W
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER'
OTHER
ADDRESS
CON ST.
CONTRACTOR'
ZIP:~. Y\4f) / )
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANG~'
EXPI RES
PHONE
FLOOD PLAIN'
ZONING CODE:
L
. OF BDRMS'
SECONDARY HEAT:
SOUARE 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
o Site Inspection - To be made
after excavation, t)ut prior to
setting forms.
o
Underslab Plumblng/ Electricalf
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 fllting trench.
o
Underlloor PlumblngJ 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
trenctl.
O Storm Sewer - Prior to filling
trench. . .
o Water Line - Prior to filling
trench.
o
Rough Plumbing - Prior to
cover. ~
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
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 la~ing. '
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
Street Trees - When all ~f)quired
trees are planted.'
o
Final Plumbing - When all
plumbing work is comptet.e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is comptete.
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.
o 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
Lot sq. fig.
Interior
Lot coverage
Corne r
Topography
Total height
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM
sa. FT.
X $/sa. FT.
Main
Garage
Carport
Total Val ue
Bullding Permit Fee
State Surcharge
Total Fee
(A)
.
I P.L.
IN
Is
Iw
IE
VALUE
\ ~THE 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.
So I bac ks
'HSE'GAR'ACcl
I
I
I
I
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
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/lnsert/Flreplace Unit
Dl\~e~~A~Q~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
State Surcharge
J~~
FEE
~CD
I '7 .50
10.00
.'t)(1;
C)O.~~
Total Miscellaneous Permi ts (E)
TOTAL AMOUNT DUE (excluding Clectrlca&B-~
(A, B, C, D, and E Combined)
APPROVED:
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 Cily limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stale 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 certtfy
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 perlaining to the work described
herein, and thaI 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 compllance with QAS 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
on the site at ~mes during co~struct,"/J
SignaturfTf;f;uA/ 7?1~
Datp /'
VALIDATION: t()~l\n
RECEIPT NUME!~g .....JJ. }
DATE PAID ({'-f /'), ~CS
AMOUNT~D&R'W/
RECEIVE'\. BY .J{m__) .