HomeMy WebLinkAboutPermit Mechanical 1992-8-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: SI; 'f
[1 n:2.;Y7 J ~
ASSESSORS MAP:
LOT'
Sco;rr.5
I; tt,o/Y'/f/
BLOCK:
M/ly,.#e
ADDRESS' S- r;. Lf S c; () r;r.5
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OWNER:
WI! t ,yl"'/f'
CITY'
DESCRIBE WORK:
,.r!ST"'t'C
NEW
REMODEL
CONTRACTOR'S NAME
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STAT~'
oA'e
A1./I.
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ADDITION
DEMOLISH
OTHER
.
q{n7(l~
JOB NUMBER
225 Fifth Streot
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:
(),CS(o(X)
PHONE'
7;z.t; - .!!>sr; 3
ZIP'
9' 7 ~;,?
ADDRESS
CONST,
CONTRACTOR'
PHONE
GENERAL'
PLUMBING'
MECHANICAl' (,"'''18''',/ /!"',fT/~ '1/.07 '-oJ ,!,-2LI
ELECTRICAl' c,.,"'6t>/C .FCEcT#/~
QUAD AREA:__
. OF BLDGS:
OCCY GROUP:
1/ OF STORIES: _
WATER HEATER:
70.s-</ >
- OFFICE USE -
LAND USE:
. OF UNITS:__
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
EXPIRES
I ;?-.2/.?z.
3YV.zyt!/
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To requesl 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.
D Tcmpormy Electric
D Site Inspection - To be made
after excavation, but priOl to
setting forms.
D
Underslnb Plumbingl Electricall
Mechanical - Prior to cover.
D
Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms arc
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
D
Post and Beam - Prior to tlOOI
insulation or deckino.
D Floor Insulation - Prior to
deckin{).
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.
JfQUIRED INSPECTIONS
~OU9h Mechanical - Prior to
cover.
~ Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D
Fireplace - Prior to faclna
materials and framing Insp.
D
Framing - Prior to cover.
D Wall/Ceiling Insul(ltion - Prior to
cover.
D Drywall - Prior 10 laplng.
D Wood Stove - After Imital/ation.
D Insert - After r1replace approval
and InstallatIon of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Fence - Wilen completed.
D Street Trees - When all requIred
trees are planted.
D
Final Plumbing - When all
plumbing work Is complel,e.
o Final Electrical - When all
electrical work Is complete.
~inal Mechanical - When all
mechanical worl< IS, complete.
Final Building - Wilen all
required InspectIons have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
watm 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, sklrtln'g, decks, and
venting have been Installed.
"
.'
'; i
Lot (aces
LOI Type.
LOI sq. Itg.
Interior
Lot coverage
Corner
Topograpt,y
TOlal height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT.
Main
Garage
Carport
Total Value
BuildIng Permit Fee
State Surcharge
Total Fee
(A)
Setbacl(s
..B.h.. HSE GAB. ACC
~-------
~-----
.Y'!......._____
E
VALUE
(6)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
I',.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
Stato Surcharge
FEE
-(f7. CZf)
It) .
, .T:)
~YJ5
Tolal Miscellaneous Permits (E) ---._.~--
r
TOTAL AMOUNT DUE (excluding eleclrlcald~.Y IS
(A, B. C. D, and E Combined)
. THE PROPOSED WORK IN THE
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If ymi, this application musl be signed
"nd approved by t110 Historical
Coordinator prior to pClIllil issuance.
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is gr,ln(ed on the express condition ttla1 tho said
construction shall, in all respects, conform to the Ordinance
adopted by the Cily of Springfield. Including lhe
Development Code, regulating the construction and use of
buildings, and may be suspended or rcvol<od nl any time
upon violation of any provisions of said ordinances.
Plan Check Fcc: ___
Date Paid:
Receipt Number'
Received By:
Plans Reviewed l3y
Dnle
Systems Development Charge is due on all undeveloped
properties within the City limits which arc being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, lhat I have carefully ex~mined
the completed application and do hereby cerlify thai all
informalion hereon is true and correct, and I further cerlify
1I1al any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield. and tlle Laws
of Ihe Stale of GrcOon pertainlnn to Ihe worl\ cJe:,cribed
herein, ;llld Ihal NO OCCUPANCY will 'be Illadu of any
slruclure without permission of tile Building Safety Division.
I funher certify that only contractors and employees wt10
are In compliance with GRS 701.055 will I?c used on this
project.
I further agree to ensure that all required inspections are
requested at the proper timo, that each address Is readable
from the street, that tile permit card is located at the front
of the property, and the approved set of plans will remain
on the site at <1(rrimcs duriff construction.
Slgnaturn f/~ J~
/'
Date
g-- ~/- 9 "'}-
VALIDATION:
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