HomeMy WebLinkAboutPermit Mechanical 1994-10-6
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP:
LOT:
SPRINGFIELD
BLOCK:
OWNER:
ADDRESS:
CITY'
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JOB NUMBER
2,25 Fifth Street
Spi-lngfleld, Oregon 97477
TAX LOT:
SUBDIVISION'
--
l)5 <;<[)( )
PHONE:
7 Cf.-I... /5 tf.3
ZIP: 77 <oJ
DESCRIBE WORK:
IN, ftt lL A-'l-lo'l\)(j F t::t tEe (-,(.!c. FUll-Ai Ace
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
G EN ERAL:
PLUMBING:
MECHANICAL:
~VIE:V ~ P~fc€' Co~
,
S i.o F/&. /4
ELECTRICAl'
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR #
EXPIRES
PHONE
REQUIRED INSPECTIONS
f91' Rough Mechanical - Prior to
~over.
ough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtai n 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 taping.
o Wood Stove - After lristallatlon..
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
. forms ar~ 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 'cill'requifed;
trees are planted. ,...
(JO()77 '
10 -JJ;..'H . '7 S'6 .../ (;,;z. J
~O, 5' NUo-l5-TW4'(
s=: (/ v-cAlE: 9 7 fA) '3 .
- OFFICE USE -
QUAD AREA' LAN D USE: FLOOD PLAIN'
# OF BLDGS: # OF UNITS' ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG~' 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.
o Temporary Electric
o Site Inspection - To be made
after excavation, but priorto
setting forms.
o Underslab Plumbing/Electrical/
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 filling trench.
o Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
o Post and Beam - Prior to floor
. insulation ?r decking.
o Floor Insulation - Prior to '
decking. .
'.' .
-
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.. .
o Water Line - Prior to filling
trench. .
o Rough Plumbing - Prior to
cover.
I
o Final Plumbing - When all
plumbing work Is complete.
. ~inal Electrical-When all .
~ electrical work is ?omplete. .
o Final Mechanical - When all
mechanical work Is complete.
rt-1 0-al Building - When all
~ulred 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 c.onnected to
the service panel.
o Final - After all required .
insp~ctlons.are 'approved and
. porches, sklrtln'g, decks, and
.ventl.nghave been.installed.
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT.
Main
". ..... \,
... o. ~
Garage
Carport. . . \ ';
.' i.
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
o:i'
,
.I
Setbacks
I P.L. HSE GAR ACC I
IN
Is
Iw-.
IE
VALUE
. SYSTEMS DEVELOPMENTcCHARGE ($.DP) '.'
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO .
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
FEE
Total Miscellaneous Permits' (E) . . .,
TOTAL AMOUNT DUE (excluding electrical) ~"'d-LJ
(A, B, C,D, and E Combined)
\... . ..HE PROPOSED WORK IN THE
"'.HHISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is'granted on the express.condition that the said
construction shall;' in all respects, co~form.to the Ordinance
adopfed; by ',the City.. of Sprihgfi.eld, including the
Development Code, regulatiQg the construction and use of
buildings, and may be;sus'pen.ded:o(r.evo.ked at any time
upon violation of any provisions of said ordinances.
'Plan Check Fee:
, ,.
... I _. $
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
1'-, .....
: Sys't'~~~' Devel9pmenf-Charge is:ifu~..on all undeveloped
properties within the<?i~y.Jimi~s which are being improved.
~ \.. , .. ..
ADDITIONAL COMMENTS
By slgnature,.1 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 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
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
on the site at f\1 ~imes~ dur~cJ~c.ti.on. ~
Sign~, ~-LAA," L a:- p~ ~.
\ - , I ~ ~
Date . I <:J -b - 'It{
VALIDATION: \A.f1~(~
RECEIPT NUMBER _ \ \ ~ _,
DATE PAID \D '\Ol~f
AMOUNT RECEIV\E~ , ~ t! \,'
RECEIVED BY L1l\1~::( ~ )