HomeMy WebLinkAboutPermit Mechanical 1992-4-8
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ollice: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK'
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ASSESSORS MAP:
LOT:
BLOCI"
OWNER: 6c..~~ {~19~~
ADDRESS: ,~ ?~ ~
CITY ___~ ~._ _??.r'0
.
JOB NUMBER
'7':<~~
225 Fifth Street
Springfield, Oregon 97477
57
TAX LOT'
&>?~
SUBDIVISION:
PHONE: '7 ~/- - 3'.>~
~a- ZIP: 92~;?_?_~
~>-.:: ~ _'o~7V_ id~
SlATE:
DESCRIBE WORK: ~e~ - ,# b"1"'/?- ./d
NEW REMODEL ADDITION Y DEMOLISH
OTHER
CONST.
CONTRACTOR'
CONTRACTOR'S NAME ADDRESS
CENERAL: P?ff.~S.a?Y~
I
PLUMBING:
MECHANICAL: ~~~r:7>:.-~ ~
ELECTRICAt .
OUAD AREA'
. OF BLDGS:
OCCY GROUP:
N OF STORIES:
WATER HEArER:
- OFFICE USE -
LAND USF'
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
EXPIRES
PHONE
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS'
SECONDARY HEAT:
SOUARE FOOTAGE:
To request an inspection, you must call 726-3769. This 15 a 24 hour recording. All inspections requested before 7:00 a.m. will be
fll3<.JC tile samo working day, Inspecttons requested after 7:00 a.m. will be made the following work day.
CI Temporary Electric
D
Site Inspection - To be made
after excavation. but prior to
selling forms.
o Underslab PlumbinglElectrical1
Mechanical - Prior to cover.
o Fooling - After trenches are
excavated.
o Masonry - ~tecl location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
D
Undertloor Plumbingl Mechanical
- Prior to insulation or decking.
D
Post and Beam - Prior to floor
insulation or dcckinn.
f I Floor Insulation - Prior to
dcckino. . .
D
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
,
REQUIRED INSPECTIONS
rv1 Rough Mechanical - Prior to
Ip cover. .
D 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.
D
Framing - Prior to cover.
o WalllCeiling Insulation - Prior to
cover.
D Drywall - Prior to taping.'
D Wood Stove - After Installation.
o Insert - After fireplace approval
and Installallon of unit.
~.
o Curbcut & Approach - After
forms arc erected but prior to
placement of concrete.
o Sidewalk & Driveway - Alter
excavation is complete, forms
and sub.base material In place.
o Fence - When completed.
o Street Troes - When all required
trees are planted.
D
Final Plumbing - When all
plumbing woll< Is complete.
D Final Electrical - When all
electrical work is cOlllplete.
l-vl Final Mechanical - Wilen ull
IA,..J mechanical work Is complete.
o
Final Building - When all
required Inspections hove been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking llnd Set.Up - Wilen <.ill
IJlocl<ing Is complete.
D Plumbing Connections - Wilen
home has been connected 10
water and sewer.
o Electrical Connection - Whcn
blocking, sel-up, anel plumbing
inspections have been approvcd
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.
J
LOI faces
Lot Type.
Interior
Lot sq. fig.
Lot coverage
Corner
Topography .
Panhandle
Total height
Cul:de-sac'
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT
Main
Garage
Carport
Total Value
Building Permil Fee
Stale Surcharge
Tolal Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixlures
Residcnlial BOlth(s)
N"
Sanitary Sewer
FT
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Chnrge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Slove/lnscrtlFireplace Unit
Dryer Vent
~/ E;/~";y~ij/'?~
Mecllanical Permit
Issuance
State Surcharge
Total Permit
(D)
,
MISCELLANEOUS PERMITS
Mobile Homo
State Issuance
Stale Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D. and E Combined)
.S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be 51gnoo
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
PL. HSE GAR ACC
N
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W
,E
VALUE
FEE
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-::2."5": 7S"'
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permil is granted on the express condition ttlat the said
construction shall, in all respects, conform to the Ordinance
adopted by the Cily 01 Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any lime
upon violation of any provisions of sald"ordinances.
Plan Check Fee:
Date Paid:
Receipt Numbe'-'
Received By:
Plnns Reviewed By
Dale
Systems Developmenl Cllarge is due .on all undeveloped
properties within the City limits which me being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed applicntion and do hereby certify lhal all
informalion hereon is truc and correct, and I further certify
that any and all work performed shall be done in accordance
with Ihe Ordinances of Ihe City of Sprinnfield, Hntl the L<lW5
of the Stale of Orenon pertaining to tile worl( described
herein, and 1I1al NO OCCUPANCY will be flwde of any
structure without permission of the Building Safety Division.
I further certify ilIa! only contractors and ernployees wllo
are in compliance with ORS 701.055 will be use(l 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 properly, and the approved se f plans will remain
on the site at all . ~1
Signatur . 7/' I
y 1Y<6' ~;:7 ?
/
Dalp
\
VALIDATION:
RECEIPT NUMBER _._?2~ /
DATE PAID '-/-~ ?"'<..,
(
AMOUNT RECEIVED 7-5'. -:::> S--
RECEIVED BY &-~ .. ~
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