HomeMy WebLinkAboutPermit Mechanical 1997-5-15
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LOCATION OF PROPOSED WORK: 7"'5?5 ,:1?' LW-~ ...&2y~
ASSESSORS MAP' /7 -d""'? '-=3 c.,; -2'7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT:
.
SPRINGFIELD
.
JOB NUMBER
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BLOCK:
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: ~'9./c:Q
SUBDIVISION:
PHON'" '7C;/:) - "/3'7""??
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OWNER' ~.~ E...-:::I7L...-c';>'-€-
ADDRE'''''' 7~ ~bff~ ~/~
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CITY:
STATE:
'?//-"5 ZIP: 2.:?7"//
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DESCRIBE WORK: 1__lr r "'~ ,
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NEW REMODEL ADDITION
CONTRACTOR'S NAME
GENERA' .
PLUMBING:
MECHANICAl' ~q~~
ELECTRICAL'
~. ,-,~~...p~"';:- i~~ ~/.~4'-.
DEMOLISH OTHER #&c: d5&V~;2:>
CONST.
CONTRACTOR'
ADDRESS
EXPIRES
PHONE
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- OFFICE USE _
QUAD AREA: LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF UNITS' ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: . OF BDRMS:
· OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE: _
To request an Inspection, you musl cafl 726.3769. This Is a 24 hour recording. Afllnspectlons requested before 7:00 a.m. wfll be
made the same working day. Inspections roquested after 7:00 a.m. will be made the following work day.
D Temporary Electric
D Site Inspection - To be mado
after excavatlon, but prior to
setting forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D Footing - After trenches arB
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms Bre
erected but prior to concrete
placement.
o Underground Plumbing - Prior
10 filling lrench. .
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and B08m - Prior to floor
Insulation or decking.
o Floor Insulation - Prior \0
decking.
O Sanllary Sewer - Prior 10 tilling
trench. ,
o Storm Sewer - Prior to fIIllng
trench.
o Water Llno - Prior to filling
trench.
o Rough Plumbing - Prior 10
cover.
REQUIRED INSPECTIONS
f\':?I Rough Mechanical - Prl,or to
~~4# Q/?5
o ~~~_9h 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.
, 0 Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior 10 laplng.
o Wood Stove - Aller Installation,
o Insert - After fireplace approvlSl
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is complele, forms
and sub-base material In place.
D Fonce - When completed.
o Street Troos - Whan all required
trees are planted.
o Final Plumbing - When all
plumbing w9rl< Is complet,e.
o Final Electrical - When all
electrical work is complete.
C2I Final Mechanical - When all
~#fior~ete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
J:1]Othor ~~~A~~
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete. ,
o Plumbing Connecllo~s - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up. and plumbing
Inspections have beon approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Install cd.
Lot faces
Lot Type
Lol sq. flg.
Interior
Lot coverage
Corner
Topography
Panhandle
Tolal height
Cul.de.sac
BUILDING PERMIT
ITEM
SO. FT.
X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
TOlal Fee.
.
t,,,' :',
.
"
I. IS THE PROPOSED WORK IN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Ihls appllcallon must be signed
and approved by the Historical
Coordinator prior to permit issuance:
Selbacks
I PL. HSE GAR ACC
IN
Is
Iw
IE
VALUE
,.
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Balh(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PER1y1~
Furnaco Wtv-,-
Exhaust Hood
,
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Venl
Mechanical Perml t
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
State Surcharge
Sidewalk
It
Curbcut
fl
Demolition
State Surcharge
Tolal Miscellaneous Pennlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
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APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT .
This permills granted on the express condition that the said
constructlon shall, in. all respects, conform to the Ordinance
adopted by the City .of Springfield, including lhe
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 Revlewed'By
Dale
Systems Development Charge Is duo on all undeveloped
properties within the Clly limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I atale and ogree, that 1 have carofully examined
the completed application and do horeby cerllfy that all
Information hereon Is true and correct, and I,further cerllfy
that any and all work performed shall be done In accordance
wllh the Ordinances of Ihn Clly 01 Springfield, end the Lawa
of the Slillo of Oregon p.erlalnlng to tho work described
herein, and thai NO OCCUPANCY will be mada of any
structure without peflnission or the Building Safety Division.
I further certify that only contractors and employees who
arc In compliance with ORS 701.055 will be used on this
project.
I further agree to ensuro that all required inspections are
requested al the proper time, thai oach address Is readable
from tho slreet, that the pormlt card Is locsted at the front
of the property. and tho approved set of plans will remaIn
on the site at all ')f'es durIng const(Jctlo...n.
Slgnalure _/lu-u.fJH 4-f/('<v>, ,'\
.
Date
o F;- /.- r7
VALIDATION:
7?:>9~
RECEIPT NUMBER _ _' . _
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AMOUNT RECEIV:C; 'r? c::.. ? p
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DATE PAl'"
RECEIVED BY