HomeMy WebLinkAboutPermit Mechanical 1995-6-20
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP:
LOT-
OWNER'
ADDRESS'
CITY:
DESCRIBE WORt<'
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA' '
PLUMBING:
.
SPRINGFIELD
BLOCt<'
STATF'
(J k,
.
CftJOqq~
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
fllh100
PHON~'
7.)...(,- J-37J-
ZIP:
'77lf.77
of
h F'14-f- r iJ #1.('
OTHER
S'-lS~
,
DEMOLISH
ADDRESS
CONST,
CONTRACTOR #
PHONE
MECHANICAL:
ELECTRICAl'
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,
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(?Of;:' IVV~r;;:-, VV~
~6-6VE "1710<0'1
EXPIRES
{JDon
(0- ~ {-T-S
7 '{..b-/6:J-1
- OFFICE USE -
OUAD AREA: LAND 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
D Site Inspection - To be made
after excavation, but prior to
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,
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
REQUIRED INSPECTIONS
, 0 Rough Mechanical - Prior to
cover. .
o Rough 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 Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - After l~stallat'lon.
o Post and Beam - Prior to floor
. insulation or decking. ~ 0 Insert - After fireplace approval
. . and Installation of unit.
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.
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 required
trees are planted.
o Final Plumbing - When all
plumbing work Is complet,e,
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
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 . Setbacks C'THE PR~POSED WORK IN THE
Lot sq, ltg, Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
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.de.sac IE I
APPROVED'
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT, ~ VALUE
. .
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE. (SDCj .
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Re,sldentlal Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(e)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Fireplace Unit
Dryer Vent
Mechanical PermIt
/0.nJ
l().O-V
~ :~.
,p'r".1Ib
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
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
. Syst~m's Development ,Charge Is due on all undeveloped
properties within theGit~ IIml,ts which are being Improved,
ADDITIONAL COMMENTS
I
, I
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 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 wll~re In
on the site a~%~rlnO:or6l'rUCt1on: /r'\-..
if. J~..
Slgnatu,"' /~ II:::- tf'O~ ~_
P'
~ - ';;"O-7~
Date
VALIDATION:
Dirty" ~
DATE PAID (~f;rrJ (at(
AMOUNT RECE~V., D . i8
RECEIVED BY \ J/!lAJI .
,
RECEIPT NUMBER
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'CARRJE!I:t' 1.1n TON I-4EAT P\.NP 3e'r'KC03<1:l.301 10M3c:>1l MC.o1 . ."." MAX RJ5E . 3" ~p
'CARRIER" FAN COIL FB4ANF030 unTI-I1501<l1l CF AUX !-EAT DUAL CIRCUIT 60"S.
NEWTRCN ELECTR05TATlC AIR CLEA"-lER
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