HomeMy WebLinkAboutPermit Mechanical 1994-8-8
O~13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
LOCATION OF PROPOSED WORK' '::? V/2- R~.A/C~
ASSESSORS MAP' /)~-'"2, y-~
OWNER' / ~f?'r--e,- i-S~~,~.z? P.H.V'
ADDRESS' ~/?:O~
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LOT'
CITY'
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BLOCK'
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JOB NUMBER
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225 Fifth Street
Springfield, Oregon 97477
, TAX LOT'
SUBDIVISION:
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PHON'" '74/ / -OOc;:!!;B
ZIP:
-7 _0/":):::>
DESCRIBE WORK' /p/4.r;;p.::~ 1"~/ .--P.?-'~ ~ c:'5F-?"5?" ~~
NEW REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME
GENERAl'
ADDRESS
CONST,
CONTRACTOR'
PHONE
EXPIRES
PLUMBING' .
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MECHANICAL: .;;b~/ --?i_., 'b-", '.,;; r>.-:- E"........~ AJ.~' 9? ~U". _ s;r .y/"",~ ,L:. -.:2S~
ELECTRICAl'
5~-.
- OFFICE USE -
QUAD AREA' LAND USF' FLOOD PLAIN:
. OF BLDGS' . OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . 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.
o Temporary ElectrIc
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Unde,slab PlumblnglElectrlcal/
Mechanical - Prior to cover.
o Footing - After trenches 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 PtumblnglMechanlcat
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation 0' decking,
o Floor Insutatlon - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench.
o Sto,m Sewe, - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
,
REQUIRED INSPECTIONS
o Rough Mechanical - 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 - P,lor to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of untt.
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sldewatk & Driveway - After
excavation Is complete, forms
and sub.base ma,terlar In place.
o Fence - When completed.
o Street Trees - When all required
trees Bre planted.
o Final Plumbing - When all
plumbing w9rk Is complet,e,
D Final Electrical - VYnen all
electrical work Is complete. C
~ Final MechanIcal - When all
mechanical work Is complete.
o Final BUilding - When all
required Inspections have been
approved and building Is
completed.
DO'her
MOBilE HOME INSPECTIONS
o Blocking and Set.Up - Whep all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plufQblng
Inspections have been approvod
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
ventlng have been Installed.
J
Lot faces
Lot ~yp~
Lot sq, fig,
Interior
Lot coverage
Corner
Topography
Panhandle
Total h/llght
Cul-de.sac
BUILDING PERMIT
ITEM SQ, FT,
X $/SQ, FT, a
Main
Garage
Carport
Total Value
BUilding Permit Fee
State Surcharge
Total Fee
(A)
....;.
,'..
. ~ ..,' ',' ;, .
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" 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.
Setbacks,
HSE GAR ACC'
I P.L.
IN
\S
Iw
IE
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDe)
PLUMBING PERMIT
tTEM
Flxlpres
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
Stat~. Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove! Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
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~~
Issuahce
State'Surcharge
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, 0, and E Combtned)
FEE
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I 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 'evoked 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 Imp,oved,
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the O,dinances 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.
J 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 ts located at the front
of the property. and the approved set of plans will remain
on the site at all times during construction,
Signature #~~~'1- )
Date ~-;; ~/ /- /
(;" '--
VALIDATION:
RECEIPT NUMBER
DATE PAIr>
/ C/ 2 '? 2....
.g-g-9~
AMOUNT RECEIVEr>
RECEIVED BY
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