HomeMy WebLinkAboutPermit Mechanical 1993-7-19 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
LA G-e,
.
SPRINGFIELD
.~
JOB NUMBER
C1~JO~L../-
225 Fifth Street
Sprlnglield, Oregon 97477
LOCATION OF PROPOSED,WORK:
ASSESSORS MAP:
LOT:
3~~":l l!n__~2lf'-f\",,^'~-
\ ., 0 ~ d :l.t ::l. TAX LOT:
o ,-,00
\A)f) V:..t^) ~ \.,.. ",e.,. ,
~~~~ ~~^~~~~
CITY: ,6p1r",^~ ' STATE:
DESCRIBE WORK: ~.P" A1J1. ~ /l t A ^ "''''' (" 0 , '
NEW REMODEL ADDITION DEMOLISH
OWNER:
ADDRESS:
CONTRACTOR'S NAME
BLOCK'
oIQ
OTHER
SUBDIVISION:
PHONE: I :lh- i'ilOq
_ ZIP:
CJJU-~
ADDRESS
CONST.
CONTRACTOR #
EXPIRES
PHONE
- OFFICE USE -
LAND USE:
# OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrIcal p~wer.
o
Fireplace - Prior to facing
materials and framing Ir'lsp.
GENERA' '
PLUMBING'
MECHANICAL: JJ.I)^'IJ~OV'\ l.-/~ vY\"',,,,,-,<:...+ ':9" ~n? ttSC:; /....5:')
ELECTRICA' .
QUAD AREA:
c;
. OF BLDGS:
OCCY GROUP'
. OF STORIES'
WATER HEATER:
')b../'14 74t.-.-7t....r;
FLOOD PLAIN:
ZONING CODE:_
# OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspectlon, 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 foliowing work day.
,0 Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbingl Electricall
Mechanical' - Prior to cover.
o
Footing - After trenches an~'
excavated. .
o
Masonry - Steel location, bond
beams. grouting.
o
Foundation - After forms arc
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench. .
o
Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
'D
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. .
o
Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
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.
D Sidewalk & Driveway - Alter
excavation is complete, forms
and sub.vase materia! in place.
D Fence - When completed.
o Street Trees - When all required
trees arc planted.
o Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
~inal Mechanical - When all
mechanical work is complete.
o Final Building - When all
required inspections have been
approved and building is
completed.
I-I Other
()~ JA~~Q..
\
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.
I'
. .
Lot faces Lot Type Setbacks IS THE PROPOSED WORK IN THE
I P.L. , , , ACC I HISTORICAL DISTRICT, OR ON
Lot sq. ftg, Interior HSE GAR
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by, the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height Cul.dc.sac IE I
APPROVED'
BUILDING PERMIT
ITEM SO. FT. X $/SO, FT.
VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/ Fireplace Unit
Dryer Vent
~
Mechanical Permit
IS,OO
looD
is...
ciS./S
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrICal)$;:)c:;,.i5
(A, B. C, D. and E Combined) ,
BU!LDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thai the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield,' including the
Development Code, regulating the co~struction and use of
buildings, and may be suspended or revoked at any time
upo~ violation of any provisions of said ordina~ces.
Plan Check Fcc: ~_
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems ~evelopmcnt Charge is due'on all undeveloped
properties within the City limit~ which are being improved.
ADDITIONAL COMMENTS
By signatu,re, I state and .agree, that I have carefully examined
the completed application and do hereby certify that all
I.nformation hereon is Irue 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 pcrtai,nlng 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'
are in compliance with ORS.701.055 will be used on this
project.
I further agree to ensure Ihat'all required inspectio(1s 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 tlrttes during constru tion.
SignaturP'.fd;~/; ,
'!lo.,la"',
DatI'"
VALIDATION:
RECEIPT NUMBER O}SlpO
7 J,'1 Ict:>,
$ :>c:, -:7"
~g
DATE PAID
AMOUNT RECEIVEP
RECEIVED BY