HomeMy WebLinkAboutPermit Mechanical 1995-2-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Otflce: 726.3759
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SPRINGFIELD
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LOCATION OF PROPOSED WORK: 1(,,0 'l., ,),z.qUo; e.
ASSESSORS MAP: .I?"O~-Q ?-?3"
LOT'
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BLOCK'
OWNER:~,,:,I 6r~/I //Je~K 6r..Mn
ADDRESS' 'f O. ~QX /.IIO'-/"l,
CITY: 13..1 jF' ro P STAT'"
DESCRIBE WORt<. ~{?I<l~:l\j
NEW REMODEL 01.
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JOB NUMBER
95'0//<6
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
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SUBDIVISION'
PHON'"
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ZIP:
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OTHER
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DEMOLISH
CONTRACTOR'S NAME
GENERA' .
PLUMBING'
MECHANICAl' Deret' (,('o..Q~ >'\
ELECTRICA' .
QUAD AREA:
· OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER:
ADDITION
ADDRESS
CON ST.
CONJRACTOR .
PHONE
EXPIRES
- P,o. [2;c.x L-tIOY~ 6f.Jc,,,",,,p of..
J
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
RANGF'
'i7 'ic:, '-I
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must carl 726.3769. This Is a 24 hour rocordlng. Alllnspectlons requeslod 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 prior to
settfng forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to eover.
o Footing - After trenehes 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 'Underlloor PlumbIng/Mechanical
- Prior to Insulation or decking.
o Post and Boam - Prior to floor
Insulation or decking,
o Floor Insulation - Prlor to
dacklng.
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.
REQUIRED INSPECTIONS
o Rough Mochanlcal - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain 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 Slovo - After Installation.
o Insert - After fireplace approvl1l
and InstallatIon of unit.
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - Afler
excavation Is compiotc, forms
and sub.base materIal In place.
o Fence - When completed.
o Street Treos - When all requIred
trees are planted.
o Final Plumbing - When all
plumbing work Is eomplet.e,
o Final Electrical - When all
electrical work Is complete.
rY1 Final Mechanical - When all
I,Ll.J mechanical work Is complete.
o Final BUilding - When all
required Inspections have been
approved and building Is
completed.
01 Othor ~ ~~~"'
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MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When all
blocking Is complete.
o Plumbing Connoctlons - When
homo has been connected to
waler and sewer.
o Electrical Connection - When
blocking, sel-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.
InterIor
Lot sq, fig.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de-sac
" ..?:.,....;:.
-'i'i'.,
- THE PROPOSED WORK IN THE.
"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
I' yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
I PL. I HSE GAR ACC
I N I
I S I
Iw I I I I
~
BUILDING PERMIT
ITEM SO, FT: X $/SO, FT, a VALUE
Main
Garage
Carporl
Total Value
Building Permit Fee
Slale Surcharge
Total Fee
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
ResIdential Bath(s) . NO
Sanllary 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 Stovellnsert/ Fireplace Unit
Dryer Vent
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t' . r
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Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
State Surcharge
Sidewalk fI
Curbcut
ft
Demolition
State Surcharge
Total Mlseellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and' E' Combined)
FEE
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'? . 0rl7
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APPROVED:
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
Systems Development Charge Is due on all undeveloped
properties within tho City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I stato and agree, that I have carefully examined
the completed application and do hereby certlly that all
In(ormatlon 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 01 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 re~ulred 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 appro,V~~Of plans will remain
on the site at ?911~durlng7/.r~ctlon.
Signature ~ ~ ~- ~
Date ::<//3/~
VALIDATION:
RECEIPT NUMBER /h 2~V
.
2-/"3"-"35
"7~ -<.=-
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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