HomeMy WebLinkAboutPermit Mechanical 1997-3-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
LOCATION OF PROPOSED WORK' 57f;
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ASSESSORS MAP'
LOT:
"
OWNER:
ADDRESS'
CITY:
DESCRIBE WORK'
NEW /' REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
BLOCK:
STATE:
c1.R'
l'lLId ~tJ
ADDITION
DEMOLISH
OTHER
.
JOB NUMBER q 7()L( ~
Co
225 Fillll Street
Springfield, Oregon 97477
Dr
SUBDIVISION:
PHONE: _I1.W- /Jfl3
ZIP:
914' 71
ADDRESS
CON ST.
CONTRACTOR'
'::"
MECHANICAL:
ELECTRICAl'
~ft:-.J L/~LII.61!:: ZW~
(j~.-,f+yrc~ . 'I
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
. OF STORIES:__
WATER HEATER:
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TypE:_
HEAT SOURCE:
RANGE: __
EXPIRES
PHONE
7t'sl/:S-
!J!Li7 3~~'d./J,y
FLOOD PLAIN'
ZONING CODE:_
. 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 :un. will be
rnad2 !he so.me working day. Inspections requested after 7:00 a,m. will be made tho following work day.
D Temporary Eloctrlc
o Silo Inspoctlon - To be made
after excavallon, but prior to
setting forms.
o Underslnb PlumblngfEloclrlcal1
.Mechanlcal - Prior to cover.
o Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms arc
erected but prior to concrete
placemont.
o Undorground Plumbing - Prior
to filling trench. .
o
Underrloor Plumbing/ Mechanlcol
- Prior to Insulation or decking.
o
Posl ond Boam - Prior to rloor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sowor - Prior to tilling
trench.
D Storm Sower - Prior to fillIng
trench.
o Wator Line - Prior to filling
trench,
o Rough Plumbing - Prior 10
cover.
REQUIRED INSPECTIONS
o Rough Mochanlcal - Prior to
cover.
o Rough Electrical - Prior to
CQver.
o Electrical Servlco - Must be
approved to obtain permanent
electrical power.
o Flreplaco - Prior to racing
materials and rramlng Insp.
o Framing -. Prior to cover.
o Wail/Ceiling Insulation - Prior to
cove~ .
o Drywall - Prior to taping.
D Wood Slovo - AHcr Installallon.
D Inserl - After fireplace approval
and Inslallatlon of unIt.
o Curbcul & Approach - Arter
forms are erected but prior 10
placement of concrete.
o Sidewalk & Drlvcwav - After
excavatlon Is complete, forms
and sub.base material In place.
o Fence - \-Vt1On completed.
o Slrool Treos - When all requIred
trees are planted.
o Final Plumbing - When' all
plumbing worl< Is complete.
. ,
D Final Eleclrlcal - When all
electrical worl< Is complete.
l~al Mechanical - When all
~chanlcal work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connecllons - When
home has been connected to
water and sewer.
o Eleclrical Connecllon - When
blocking, set-up. and plumbing
Inspections have been. approved
and the homo Is connected to
the service panel.
o
Final - Alter all required
Inspectfons are approved and
porches, skirtIng, decks. and
venting have been Installed.
Lot faces
LOI TY.
Interior
LOI sQ. fig.
lot coverage
Corner
Topography
TOlal height
Panhandle'
Cul-dc.sac
r. :::'.
,..... ".,',
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.IS THE PROPOSED WORK IN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
CoordInator prior to pcrmlt Issuance.
PL.
Selbacks
, , , I
HSE GAR ACC
I
N
S
E
W
---- - ----
APPROVED:
BUILDING PERMIT
ITEM SQ. FT. X $/SQ, FT. ~ VALUE
Main
Garage
Carport
Tolal Value
Building Permil Fee
Stale Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
N'
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
MobIle Home
Plumbing Permit
Stato Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stovc/lnsert/Flroplace Unit
Dryer Vent
Mechanical Permit
Issuance
Stale Surcharge--4 fUZo C~ A&~'~
Tolal Permll (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
Curbcut
II
Demolition
Slale Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrical)
(A. B, C, 0, and E Combined)
"
FEE
/~~1Jb
.75
.'i'7
')..0, ;). U
(2(17 .d-()
BUILDING 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 Ihe Cily 01 Springfield. including the
Developmenl Code, regulating Ihe construction and use of
buildings, and may be suspended or revoked al any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Dale Paid:
Recelpl Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within tile City limBs which arc being Improved.
ADDITIONAL COMMENTS
By signature, I stalo and agree, that I have cnrefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further cerllfy
that any and all work performed shall be done In accordance
with the Ordinances of the City of Sprlngfleld, and the laws
of the State of Oregon pertainIng to tho work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the BuildIng Safety Division.
I further certify tl1at only contractors and employees who
are In compliance wllh ORS 701.055 will be used on thIs
project.
I further agree 10 ensure Ihat all required Inspections are
roquested at the proper time, that each address Is readable
from Ihe slreet. that the permit card Is located allhe front
of the property, and the approved set of plans will remain
on the site at all times durl~gAcon>>ruct1on.
Slgnalure / 'MId't.iJ~~
--1'1:... ~
Date
I' Y /if 4'7
VALIDATION:
RECEIPT NUMBER ,2 IffsV!
'3 - ['.1{ 'L[ /
-:J-&.)'" /l)
DATE PAID
AMOUNT RECEIVED
RECEIVED BY -.L4t ---