HomeMy WebLinkAboutPermit Mechanical 1994-1-20
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSEp" ~K' ,I rP;.~ . -
ASSESSORS MAP' \ 1 'I )~ ~ ~~
LOT'
BLOCK'
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JOB NUMBER
225 Fifth Slreet
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
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OWNER: ,:\~ ~ (-10'\\'\1<)[\ PHON'"
ADDRESS', l ()~ -l ~ n ^- :CL'\V /f\
CITY- ~q(i r\l STATE:-UIHL~nY\ ZIP: Yr+"l:t
DESCRIBE WORK:~/(,) (- h~f) ~ l ffUW-?(} f7t1J"---':J./...Jtgfr) - ^', U
NEW REM~D4J - ADDITION UEMOLlSH OTHER 0- 0 \(\ J'tLn~ IJtI l":t I \t ) _
. CON ST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES PHONE
:~:~::~: ('rr'~~'{C\)(]\) \sk)v \\c\ID\\\\Y'q" ~ Lo'1{~\)19 4H-~1
MECHANICAL' () \ n J) () .(}4.
- - .
ELECTRICAl'
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN'
. OF BLDGS: . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYPF' . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANG'" SQUARE FOOTAGE:
To request an InspectIon, you must call 726-3769. This Is a 24 hour recordIng. All InspectIons requested 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
D Footing - After 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
10 filling lrench.
D
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D
Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to Wllng
trench.
D Water Line - Prior to filling
trench.
'GI Rough Plumbing - Prior to
f' cover.
~QUIRED INSPECTIONS
Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtai n 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 10 taping.
D Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
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 Fence - When completed.
D Street Trees - When all required
trees are planted.
~Flnal Plumbing - When all
plumbing work Is complet.e.
Final Electrical - When all
electrical work is complete.
~nal Mechanical - When all
l.(-J ~~chanlcal work Is complete.
D Final Building - 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 Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, sel.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspectlons are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot Type
Lot sq. fig.
interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT.
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s} N'
Sanitary Sewer FT.
Waler FT.
Slorm Sewer FT.
Mobile Home
Plumbing Permll
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood SlovellnserllFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, e, C, 0, and E Combined)
.
/.
L.IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application musl be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
I P.L. HSE GAR ACC
IN
Is
Iw
IE
VALUE
FEE
10,CU
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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:
Recel pI Number'
Received By:
Plans Reviewed By
Date
Syslems Developmenl 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 alt
information 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
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 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, an ap, rove set ~f PI::rn will remain
on the~r.%:g,(, - I'J ma" on ctl~n.
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VALIDATION: J}/'ln
RECEIPT NUMBE~ '. 1~
DATE PAI("\ ,-/-).(\- :::-..\~r
AMOUNT RE~EI ~ Aj ,CZ::fJ
RECEIVED B ' (JJ(].
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