HomeMy WebLinkAboutPermit Mechanical 1994-9-6
RESIDENTIAL
PERMIT APPLlCATI
Inspections: 726-3769
Office: 726-3759
SPRINGFIELD
LOCATION OF PROPOSED WORK: 7/'7:5c::? ~/ '~.?ie'
ASSESSORS MAP: /?~2""""<?/
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DESCRIBE WORK: ~~~ ~';~~~
LOT:
OWNER:
ADDRESS'
CITY:
NEW
REMODEL
BLOCK:
STATE: '
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JOB NUMBER 9.;/ /9.7/
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:~"~O
SUBDIVISION:
PHONE: 7~~- S3f:? ~
..
ZIP: 9""/ V;;>R
ADDRESS
CON ST.
CONTRACTOR #
PHONE
.REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o RoughEIt!ctrical ....,. Prlor'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 - Prior to
cove~' ,
o Drywall - Prior to taping.,
, "-
o Wood Stove - After Installation.
o Insert - After fireplace approval
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.
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:
ADDITION
. DEMOLISH
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 req'uested 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 Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steellbcatlon, bond
beams, grouting.'
o Foundation - After forms are
erected, but prior to~o,ncrete
placement.
o Underground Plumbing - Prior
to filling trench. '
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. '
D Water Line - Prior to filling'
trench.
D Rough Plumbing - Prl,or to
cover. "
D Final Plumbing - When all
plumbing W9rk Is complete.
o Final Electrical - Wflen all
electrical work Is complete, ~
[Z] Final Mechanical - When all '
mechanical work Is complete,
o Final Building - When all
required Inspections have been
approved and building is
completed.
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MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Whe[1 all
blocking Is complete,
o Plumbing Connections - When
home has been connected to '
water and sewer,
o Electrical Connection - When
blocking, set-up, and plurobing
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,
'.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total Ilelght
Lot Type
Interior
Corner
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM ' SQ, FT. X $/SQ, FT,
Main
Ga!;C.ge
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
, " ',>.1: , : i; :" -J j ;: ~ ~;~:~;)h~,:~t
\,;,'IS~~~!;IE PROPOSED WORK. tN THE - '
'~'}jISlS>Rl'eA,L,,.gISTRICT, OR ON '
THE HISTORICAL REGISTER?
~' _, j C
If'yes, this application must be signed
, ...;.~ .t. .ij
and appro~ld by the Historical
Coordinator prior to permit Issuance.
Setbacks '
HSE GAR ACC
h~L.
-I N
Is'
W
E
VALUE
'.
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fix~ures
Residential Bath(s) NO
Sanitary Sewer FT,
Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
Stat~. Surcharge
Total Charge ,
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
-.4 ~P/~L
Mechanical Permit
Issuahce
State 'Su rc.harge
Total Permit
(B)
(C)
NO
,~//y.
T2~
r ~&:>
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demoll lion
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
L --> 6??
/&7- oz:;:o
. 75--'
..~.,
$.20
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, reguiating 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 F:~e:
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 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, and the approved set of plans will remain
on the site at all times during construction.
Signature ~f tf-wtJ
Date () - 6 - 9 v(
VALIDATION: '
RECEIPT NUMBER I V~ 2c>
,...- ( j"
DATE PAID 9-?- ~t-J
AMOUNT RECEIVED 2tC _ '2 t:S
4
RECEIVED BY . vj~~