HomeMy WebLinkAboutPermit Mechanical 2001-8-8
. .
, ReSIDENTIAL
PERMIT APPLICATION
Inspecllons: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT:
.
~.
BLOCK:
OWNER: .rnfffJ..~ i ~,.,O ~
ADDRESS' . J 4(04 a ~ ~
CITY: Srn~~JJ
DESCRI,BE ~RK:~ r&. ~t~
NEW v REMODEL ADDITION' .
CONTRACTOR'S NAME
I'JxAAa ",
d'
STATF,r;;iJ-'
.
J08 NUMBER 0 (- OO~(oS' -01
225 Fifth Slreet
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION:
I J-OO
PHONE: _""1!J7 - ()~7f
ZIP:l1,41i
f LU~ ~
~.k P.4..9-p- 'A. 1A~
DEMOLISH OTHER
ADDRESS
CONST,
CONTRACTOR #
PHONE
GENERAl.
PLUMBING' ~/"\ I I
MECHANICAL - ~
'--'
ELECTRICAl'
/Q57tJIJ().9-Jfp
EXPIRES
'1M
h/TB
7Zh-11/fJ'o
- 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: RANG'" SQUARE. FOOTAGE:_
To request an Inspecllon, you must call 726-3769. This Is a 24 hour recording. All Inspections requested befo~e 7:00 a.m. will be
~
made the same working day. Inspections requested af . 0 a.m. ~III be made the following work day.
o Temporary Electric
o Sfte Inspection - To be mado
after excavation, but prior to
setting forms.
o Undersleb Plumblng/Electrlcel/
Mechanical - Prior to cover.
o Footing - Atter trenches are
excavated. .
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms Bre
erected but prior to concrete
placement.
o Underground Plumbing - Prior
10 filling Irench.
o Underlloor Plumblng/Mechanlcel
- Prior to insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o WeIer Line - Prior to IIIl1ng
trench.
o Rough Plumbing - Prior to
cover.
,
,
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 Insul.tlon - Prior to
cover.
o Drywell - Prior 10 t.plng.
o Wood Stovo - After I~stallatlon.
o Insert - After fireplace approvel
and Installation of unit.
o Curbellt & Approach - After
forms are erected but prior to
placement of concrele.
o Sldewelk & Driveway - After
excavation Is complele, forms
and sub.base material In place.
o Fence - 'Nhen cC.I,pleted.
o Slreet Trees - When all required
trees Bre planted.
o
Final PlumbIng - When nIl
plumbing w9rl< Is complet.c.
D FInal Eloctrlcal - When all
electrical work is complete.
echnnlcal - When all
mechanical work I s complete.
o Flnel Building - Whon all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - When .11
blocking Is complete.
o Plumbing Connectlons - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and ply,glblng
Inspections h.ve beon @I(I9'1:,l:l
and the home Is conncCteo:>to..>
the service panel. ~ rri ~
('").. **
("") 0:0..
o Fln.1 - Alter all oilllulrli-d ffi S
Inspections are app:rQY.ed a.o,d'
porches, skirting, ~~s~n'yg
venting have been;lnil~lIed. 0
.. ...:::..~F...:JG'
aG'). aLoJ
~ ..... Ui i=i co
Lot faces
LOl sq. flg,
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fee
Lot ~ype '.
Interior
Corner
Panhandle 'f
Cul,de.sac
:,
"
,
. <. ~ .~" ~\-;l'.-'
"',\;1/, ~(if,:\~; .
. "'-
. . ;.
t IS THEPROPOSED WORK iN THE':
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
alld approved by the Historical
Coordinator prior to permit Issuance,
X $ISQ, FT. ~
(A)
Setbacks.
I PL. HSE I GAR ACC
I N I
Is
w
IE
APPROVED: '
VALUE
.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
"
This permit is granted on the express condition that the said
construction shall, In all respects, conform 10 the Ordinance
adopted by the City of Sprlngfleld, including the
Development Code, regulating the conslrucllon 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 (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sower
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
N'
FT.
FT.
FT.
(C)
Dryer Vent
Wood StovellnserllFlreplace Unit
NO
Mechanical Perrnlt
Issuance
Slale Su rcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stato Surcharge
Sidewalk
II
Curbcut
II
Demolition
Slate Surcharge
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
Systems Development Charge Is due on all undeveloped
properties within the City limits which'are being Improved.
ADDITIONAL COMMENTS
FEE
By signature, I state and agree, that I have carorully examined
the completed application and do hereby certify that alt
Information hereon Is true and correct, and I further cerllfy
that any and all work performed shall be doneln accordance
with the Ordinances of lhe City of Springfield, and the Laws
of the State of Oregon perlalnlng 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
arc 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 tho street, hat the permit card Is located at the front
of the property, nd lhe approved set of plans will remain
on the site at al times durl~ construction,
Signature ~
~!
Date
VAI.IDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY