HomeMy WebLinkAboutPermit Mechanical 1997-10-16
OWN~~' C ') \ \ \ \'; M"'.{- L\ ~~~
ADDRESS:' :\ ~{<)(p eLC I'lV\~
CITY: S{).(-\ 0~ h Q 10 ~
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D~SCRIBE"WOR~: V-.-0~;;s'~~r~:I[r C~~~
NEW REMODEL. r . ADDITION
RESIDENTIAL
PERMIT APPLICATION
Inspection,s; 726-3769
Office: 7.26-3759
1:-..,1 "',
CONTRACTOR'S NAME
GENERAL: . ~l==.\ \=
SPRINGFIELD
"
BLOCK:
G<::::, (1' e...vTS
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JOB NUMBER
Qil5iY-
225 Fifth Street
Springfield, Oregon 97477
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TAX L01:
SUBDIVISION:
PHONE:
IYlo- OY d- S
STATE: rQ Q ~ l"Y""'\
Lt....)~ bn" ()\~ic\Q_,
DEMOLISH
OTHER
ZIP: 9~<...{/'X
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. ADDRESS' ,
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CONST.
CONTRACTOR #
PHONE
PLUMBING'
MECHANICAL:
ELECTRICAL:
~.;\ '.c'
QUAD AREA'
# OF SLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER:
. .,....... ""''''',;"..t-''''''''''''''';-
- OFFICE USE -
LAND USE:
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
EXPIRES,~
FLOOD PLAIN:
ZOI':JING CODE:
# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769, This Is a 24 hour recording. AILlnspectlons requested before 7:00 a.m. will be
made the same working day,lnspections requested after 7:00 a.m, wi'.' be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Rough Mechanical - Prior to
cover.
D Roug'hElectrical ...,. Prior to
cover. ~
~~~ ~O~O~
o Electrical S~.~~\!. .:...~~t\<&~
eo. approved,. t~"/.>fb~af ~t~an~
tl('\Cl;..'ele~~\.po,~~" S) '(UP
o Footing - After trenches are ~O \~~\ r:J~?- _... b..~\)O~€
excavated. ~ 'f.~~ ~r ~o facing
. \~ ~e!la~~ framing Insp,
o Masonry - Steel location, bond ~~\~ ~C~\) ~O\).
. beams, grouting. ~a~~~.l;; Prior to cover.
o Foundation - After forms are ~ \~, '
erected but prior to concrete Wall/Ceiling Insulation '"7 Prior to
placement. ' cover.' .
O Site Inspection '- To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
o Underground Plumbing - Prior.
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking. .
o Floor Insulation - Prior to
. decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to Hlllng
trench. '
o Water Line - Prior to filling
. trench.
D, Rough Plumbing - Prior to
cover.
o Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvlll
and Installation of unit,
.DCurbcut & 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 ,St~eet Trees - When all required
trees are planted. .
D Final Plumbing - When all
'plumbing W9rl< Is complete.
. D Final Electrical ,- When all
e7work is complete.
~inal Mechanical - When all
mechanical work Is complete.
o Final Building - When all
, required Inspections have been
approved and building Is
completed.
D Other (A-S ~
, Gn-s SU-t2iNu_
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.
,.~~ ;h, \
'~ "1'"
. .;;.,.... '. ""J 1 ~,l)~Y~;tt~\: --
Lot faces Lot Type
Lot sq. ftg. Interior I P.L.
IN
Lot coverage Corner
~. Is
Topography Panhandle . Iw
Total height Cul-de-sac IE
BUILDING PER~IT 'ii
ITEM SO. FT,
[Ii'
X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
VALUE
"
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
~ &.A<5/\ /U--
Mechanical Permit
Issuance
State Surcharge -+ 6.03.
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
(B)
FEE
~/C;. --
-1f 10,
- ..-
1'7~+ .4-5>
Setbacks .
HSE . GAR ACe'
,S THE PROPOSED WORK iN THE " '
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VAu1E, 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 the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Infoq'Tlatlon 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
struoture without permission of the Building Safety Division,
I furthercertify that only contractors and employees who
are In complla'nce 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 will remain
on the site at all times during construction.
Slgnature~: ~~~\~\ \
Date l6/tLP /~-,
I (
VALIDATION:
RECEIPT NUMBER
DATE PAID I ()
AMOUNT RECEIVED
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RECEIVED BY