HomeMy WebLinkAboutPermit Mechanical 1994-10-20
RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726.3769
Office: 726.3759
LOCATION OF PROP\'7liDw~, 6 \ ~ 4 \
ASSESSORS MAP: \ ,~~ a.... \
LOT:
BLOCK'
OWNER:- (A\\ \)\~ 11\ \ J-\OOGJ\t \
ADDRESS:' \\O~\\0 \C\~
CITY: r ~~o.r \'\l _
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DESCRIBE WORK: ~ OJ:::) ~q,
NEW REMODEL ADDITION .'
JOB NUMBER
q<\ \\0\ f)
225 FI fth Street
Springfield, Oregon 97477
, TAX LOT: -1.;0 q ()()
SUBDIVISION:
PHONE:
\r<<.'1 .q~6~
C\ fl 00\
, STATE: '~()r\ ZIP:
C\~~
DEMOLISH
OTHER
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CONTRACTOR'S NAME
GENERAL:
PLUMBING: ~-" ..' - rl\C1 '\1
MECHANIC~'P\' \ Qr\ t'M \ ~O f) \,-,~rr- -
ELECTRICAL: \
ADDRESS'
CONST,
CONTRACTOR II
PHONE
EXPIRES
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- OFFICE USE -
QUAD AREA' LAND USE' FLOOD PLAIN:
II OF BLDGS: II OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: II OF BDRMS:
II OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG E: 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 workday,
REQUIRED INSPECTIONS
o Temporary Electric
O Site Inspection - To be made
after excavation. but prior' to
setting forms.
o Underslab Plumbing/ Electrical!
'Mechanical - Prior to cover.
o Footing - After trenches are
excavated.:
0, 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 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 filling
trench.
D Water LIne - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
o Rough Mechanical -.:. PrIor to
cover.
, 0 Rough Electrical - Prior to
cover.
o Electrical ServIce - Must be
. approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framlng- Prior to cover.
I
o Wall/C'elllng InsJlatlon - Prior to
cover.
D Drywall - Prior to taplng,_
D Wood Stove - After Installation.
o Insert - After fireplace approvlll
and Installation of unit.
o Curbcut.& 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,
D Street Trees - When all required
trees are planted. '
o Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work Is complete. C
o Final Mechanical - When ail
mechanical work Is complete,
o Final Building - When all
, required Inspections have been
approved and building Is '
~:::'el~a~JW
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 plufQblng
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,
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT.
l\1ai n
Ga~age
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
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\ IS-THE PROPOSED WORK,tNTHE-
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'
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC) :
(B)
PLUMBING PERMIT
ITEM
Fixtures
,
.
Residential Bath(s) N"
Sanitary Sewer FT,
, Water FT.
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(C)
NO
Wood StovellnsertlFlreplace 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
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A\O!1L>
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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:
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 hereor'lls 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 Olvislon,
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,zand tbe approved set of plans will remain
on the site at all ti p'es ,:frlng construction. "
Signature .iI..4 :AA
, . "II"
Date IO.-:-z.LJ-7/
VALIDATION: \. 0
RECEIPT NUMBER \~\~
DATE PAID \O~ .~)\ ~
A'MOUNT RECEIV,~\O. W
RECEIVED BY ~_~