HomeMy WebLinkAboutPermit Mechanical 1996-12-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
o ftice: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
LOT'
.
SPRINCFIELD
.l.." , .
/05'\
BLOCK:
OWNER: -<-y')(,j(IO F?hi (0
ADDRESS:' I~. :}~<SOJ\+
CITY: sprr r;q--H
~ tA<\-\ti i.L hO Q +- ('u I J'fY"LD
I
DESCRIBE WORK:
NEW REMODEL 'I
CONTRACTOR'S NAME
GENERA' '
RtTu+
STATE: Q-PDon
J
ADDITION
DEMOLISH
OTHER
.
JOB NUMBER~/ GJ?a.
~
TAX LOT:
SUBDIVISION'
PHONE: .J2Jo -lJ S1..o
ZIP:
cn4f{
ADDRESS
CONST,
CONTRACTOR'
EXPIRES ", PHONE
PLUMBING'
MECHANICAL: WtP-f ~ 4{rRlJ mrun Strut 5.5(O"3?
ELECTRICAl'
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
Qd/::Jlo/q'l 74/-ato77
- ,
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:_
To request an Inspectlon, 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 work day.
D Temporary Electric
D Site Inspection - To be made
after excavatIon, but prior to
settIng forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
D
Post and Beam - Prior to floor
Insulation or deckIng.
D Floor Insulation - Prior. to
decking.
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
D Rough Mechanical - Prior to
cover.
D
Rough Electrical - Prior to
CQver.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to tapIng.
D Wood Stovo - After Installallon.
D Insert - After fireplace approvlll
and Installation of unit.
D
Curbcut & Approach - After
forms are efCcted but prior 10
placement of concrct(~.
D Sidewalk & Driveway - Afler
excavation Is complete. forms
and sub.base material In place.
o Fence - When completed.
D Streot Trees - Whon all requIred
trees are planted.
o
Final Plumbing - When all
plumbing worl< Is complete.
D
Final Electrical - When all
electrlcal worl< is complete.
l5<I1inal Mechanical - Wtlen all
/" ....echanlcal work Is complete.
D
Final Building - Whon all
required Inspections have been
approved and buildIng Is
completed.
DOthor
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - Wilen all
blockln{) Is complete.
D Plumbing Connections - When
home has been connected 10
water and sewer.
D Electrical Connection - When
blocking, sel.up, and plumbing
Inspections have been approved
and tile home Is connected to
the service panel.
D Final - Afler all required
Inspections are approved and
porches, skirting, decks, and
ventIng have been Installed.
~~, . " .
e ,.
.,
Lot Type Setbacks l<i THE PROPOSED WORK iN THE.
I Pol ACC I .... HISTORICAL DISTRICT, OR ON
HSE GAR
Interior IN I THE HISTORICAL REGISTER?
Corner " yes, this application must be signed
Is I and approved by the Historical
Panhandle Iw I Coordinator prior to permit issuance.
Cu)-de.sac IE I
APPROVED'
Lot facos
Lot sq, ltg,
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
SQ, FT,
X $/SQ, FT.
VALUE
Main
"
Garage
Carport
Total Value
Building Permi t Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
Stato Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
~~->
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permi t
/~~
/D.~
12.0
2/0 _LP
Issuance
,7r1' .-1;-
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
~Iate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
~,..;()
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:
Dale 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 .carofully 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 Ordinanc~s 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 corti fy 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 arc
requested at the proper tlmo, that cach address Is readable
from the street, that the permit card Is located at the front
of the property, and tho approved set of plans will remain
on the site laY.aH ~i~es ~1~ co,!str~ct~on.
~naturellltIJtlJA\ ~
Ibl-(P -q(p
Date
VALIDATION:
RECEIPT NUMBER
DATE PAIr>
AMOUNT RECEIVED
2.35'13?
12.. -c, -}'~
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RECEIVED BY