HomeMy WebLinkAboutPermit Mechanical 1992-11-24
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORI<" t;?/t ~ (' a.:/JE:; 'f}I "^ <
ASSESSORS MAP' / H "3'.-:2 ~..;<! Y
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LOT:
OWNER'
ADDRESS'
CITY:
DESCRIBE WORK:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
BLOCK'
STATE: _/lK:
3~
DEMOLISH
OTHER
.
~'2/620
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
91f77
TAX LOT:
SUBDIVISION'
~y~~
PHONE: -2#/-...:;).~S'7
ZIP:
t}~//?7
ADDRESS
CON ST.
CONTRACTOR ·
EXPIRES
PHONE
MECHANICAL'
ELECTRICAL'
?lM/ j,A<i~~_1
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'1di) 7 tv. s' g, ?Eeu-
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?t76'~,,{" I')'~~
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OUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
"
'- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR, TYPE:
HEAT SOURCE'
RANGE:
, .
FLOOD PLAIN:
ZONING CODE:
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
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To request an Inspection, you must call 726.3769. This Is a 24 hour recordhig, All Inspections requested before 7:oci a,m: will be
made the same working day, Inspecllons requested after 7:00 a.m. will be made the following work day,
REQUIRED INSPECTIONS
D Temporary Electric
D Site Inspection - To be made
after excavatlon. but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - Aftor trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground PlumbIng - PrIor
to filling trench.
D Rough MechanIcal - Prior to
cover. .
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Underlloor Plumbing/Mechanical D Wood Stove - After I~stallatlon.
- Prior to Insulation or decking.
D Post and Boam - Prior to floor
Insulation or deckIng. D Insert - After fireplace approval
and Installation of unit.
D Floor Insulation - Prior to
decking, .
D Sanitary Sewer - Prior 10 filling
trench. ~
D Slorm Sewer - Prior to filling
trench. .
o Water Line - PrIor to filling
trench,
tJ Rough Plumbing - Prior to
cover. .
^, . ".
D Eie~trlcaIConnectlon1~ When
, .blocklng; sehup"and 'plumbing
. :Inspectlons',havo beehlapprovod'
and the,t,homa Isiconnected 10
:the ~~.~Ice:panel. " '.
o Fence - When completed. . '-'. " ':.4. ' ' . . .
, ,O',Fln.al. -,.A!l~r.,al.l:.!e!1ulred, "
D . " "4 _: d'" ; "Ii' .,._-"',, ,,j,.,' i:~. r..' ",-'.JmH?~RtI.qr~,:.a(e:.ap.R!.9,~ed .a~nd;
_. StrQet:,ne~s,:- When al.I.~requlred.. .. ,....,.' ~S?orcljes~s~lrtl."Q;,pecl<s~ and ~..
trees are 'planted, ' r'", ventlng'liave,ljeen,lnstalled:'
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 Final PlumbIng - When all
plumbing work Is complet,e.
o Final Electrlcal'- When all
.ele91~lcal work 15 complete.
, I ~ ' . . I" .
IKJ Final Mechanical - ,When ~I'I
mechanical worK Is complete.
. ~ ~
D FInal Bullalng - When all
required Inspections have been
approved and building Is
completed,
DOther
MOBILE HOME INSPECTIONS
D BlockIng and Set. Up - When all
blocking Is complete,
D PlumbIng Connecllons - When
home has been connected to
water and sewer.
L!)t, fa~~~ ,,' (~':~lf.', LotrIYRe:... ;'5] ..-~, '.,: ,Setbacks ',.: ,
'i. ; :~~ fig,' ",,': ':I~':~';;; :~L::;;~;~fior;';',:.,:,' :I~i.,: li~iS'E~'GAR'I~ACC'I':
~: s, ",I' " .'~'''':-I' ~.;~,::C!_ '\t=;: r-"~""'- . -", .~, ,-',~,,:'t:. . "'f.', '!.~".il:'!:',JI~I:I'
I., . ''.' . . ,\' " ..~~:.!fl t':."" ~"(:;"~l:"'f:~':~ . " 'iN- ,',: ". 'p.J! I.
Lot-coverage, ~.,..,I. ,.~'\.i"rner. . ~ 4' . . I
~ . if ,~ '.:1 '
. :' ",' ::'p ',' ,..i"-J-':'''; ,. S ' ,..'
To'pog'raphY :.....-,.." _ pan~andle I
" Iw
Total height Cul.de,sac
L I
BUIl~DING VALUE>,PL.AN CHECK
AND BUILDING PERMIT .
, ,
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,." "';~ ;.;".~"",.: '.;. ~,r..~"'!>,
BU!~DING:iP.~~~N!E
ITEM.' ",1 SQ, ,fiT"".'
< ,_."
" -'\
. .. '"1
. F ~"!""
, ,X' $/SQ, FT, =
Main ...-.
. . Garage
-,
Carport "
I "
.1 ,
)"/,'
i~
Total Value
Building Permit Fee
State Surcharge
'"
Total ,Fee (A)
,"' .
'. ~'
., ..11'
VALUE
SYSTEMS 'PEV~Lo.P.MENT 'CHABGE(SDC)
"
11
'(B)
.-
PLUMBING PE,RMIT
ITEM
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 StovellnsortlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
, (D)'
MISCELLAN EOUS' PERMITS
Mobile Home
.'
"
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Derr,olltlon
State Surcharge
Total MlsCellan~ous permits':'.
.,~.
..
, '(E)
TOTAL AMOUNT DUE (eXCluding electrical)
(A, B, C, 0, and 'E Combined) "
,
FEE
/.S;orJ
A'}, tJO
.
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,..:)5', 7.1
l. :r,HE p'RqP\C?l'\ED WORK,.IN. T':lE "',
-'H!~;:t9f!9At.i PI~TRICT,IOR'6N .
l'HE HISTORICAi:.'REGISTER?
.j I- '1: t ;-' ";1' .
I(yes','thls'appllcatlon must be signed
and approved by the Hlslorlcal
Coordinator prior to permit Issuance.
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APPROYED:
This permit Is granted on the express condition thatlhe said
construction shall, In all re,spects, conform to the Ordinance
adopted by lhe Clly of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
up.on vlqlatlo!'l of any proylslons of said, ordinances.
Plan Check Fe~'
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties wllhln Ihe Clly limits which are being Improved,
ADDITIONAL COMMENTS
By signature, I state and agree, that 1 have carefully examined
the completed application and do hereby certify Blat all
Information hereon 15 true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances of tho City of Springfield, and tllO Laws
of the Slale of Orogon pertaining 10 Ihe work described
hereIn, and that NO OCCUPANCY will be made of any
structuro without permission of tho Building Safety Division.
I further certify t1Hlt only contractors and employees who
are In compliance Witll OAS 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 tho property, and tho approved set of plans will remain
on the site at all times during construction.
Signature
Dale
/{- >'1- 1"\-
VALIDATION:
69?c/
RECEIPT NUMBER
DATE PAID _1r";L~Ji3 ~
AMOUNT f1ECEIVED -:::?~ ~
"7J7~ .
y,/
RECEIVED BY
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