HomeMy WebLinkAboutPermit Mechanical 1994-10-20
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
'LOCATION OF PROPO~D ftXO~: _ 6~ 5
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JOB NUMBER
225 Fi tth Street
Springfield, Oregon 97477
, TAX LOT:
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LOT: BLOCK: SUBDIVISION:
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OWNER: G~\U f\ ~a PHONE: \g~' .,\'\\~,-~
ADDRESS: - \ \0 ~ ') lA) \ C\,", - -
cln <f\~{l STATE:d..~kli\OO ZIP: LV\<\D\
DESCRIBE WORK:0J..l ~\~, \).... ~ \..~
NEW REMODEL \ 'ADDITION DEMOLISH OTHER
ADDRESS
CONST.
CONTRACTOR #
PHONE
CONTRACTOR'S NAME
GENERAL-
PLUMBING: Ar\.^" ......: ...... 1. \
MECHANICAryt ~Wll ~t\f\ <:iill \ '^~~\~
ELECTRICAl'
EXPIRES
- 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: RANGF' SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording, All Inspections requested before 7:00' i:i,fn,-wlll 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/Electrlcal/
'Mechanical - Prior to cover.
o Footing - After .trenches are
excavated. "
o Masonry - Steel location, bond
beams, grouting. '
D Foundation - After forms are
erected but prior to 'concrete
placement.
D Underground Plumbing - Prior
to filling trench. ,
D Underfloor Plumbing/Mechanical
-'- Prior to Insulation or decking.
REQUIRED INSPECTIONS
I\::Z1!ROU9h Mechanical"":' Prior to
( cover,
D Roug'hElectrlcal - 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.
I
D Wail/Ceiling InsJlatlon - Prior to
cover.
D Drywall - Prior to tapinG,
, .
o Wood Stove - After Installation,
D Post and Beam - Prior to floor '
Insulation or decking, '. '.' ,,0 Insert - After fireplace approvlll
. ',' and Installation of unit.
O Floor Insulation....., Prior"to
decking. ' ", '-
D 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,
o 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 piace,
, 0 Fence - When completed.
D Street Trees - When all required
. trees are planted. '
o Final Plumbing - When all
plumbing work Is complete,
o Final Electrical - \/V.hen all
electrical work Is complete, C
~Inal Mechanical - When all
mechanical work Is complete,
Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - Whe[l all
blocking is complete, .
o
Plumbing Connections - When
home has been connected to
water and sewer,
o Electrical Connection - When
blocking, set-up, and plurvbing
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,
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
; ;,;'. }:1~..t>~~~.>~: }::
,~~ PROPOSED WORK 'NTHE -
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'
SYSTEMS DEVELOPMENT CHARGE (SDC) ,
(B)
PLUMBING PERMIT
ITEM
Fixtures
,
Residential Bath(s) NO
Sanitary Sewer FT.
, Water FT,
Storm Sewer FT.
Mobile Home
",
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
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, D, and E Combined)
FEE
\S.LD
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2-<..Q . ""} rj
2.\..0 .-L.{)'
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 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
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 tlie 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, and the approved set of plans will remain
on the site at all tlmes7rl construction.
Signature ~
/O-2-CJ-9r
Date
VALIDATION: \ c::::..I\
RECE'PT NU,\'l). ~ \ . _ JJ
DATE PAID '2I:J ~
AMOUNTRE~ ~~. 'LQ
RECEIVED BY ~)