HomeMy WebLinkAboutPermit Mechanical 1997-10-24
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RESHH:NTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT:
SPRINGFIELD
BLOCK:
,JOB NUMBER-_2czJ 6S ~
225 Fifth Street
Springfield, Orego\! 97477
t
TAX LOT:
SUBDIVISION:
OWNER: ~
ADDR~~~" .~~LDCf
CITY: ~\~ B a
DESCRIBE WORK: ~ 5
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STATE: I..)L,.....I
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'ADDITION~ DEMOLISH.
NEW
REMODEL
aU,AD AREA:
1/ OF BLDGS:
OCCY GROUP:
1/ OF STORIES:
WATER HEATER:
D. Te~porary 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.
, D 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 Underfloor Plumbing/Mechanical
- Prior to Insulation or deckIng.
o Post and Beam - Prior to floor
In'sulatlon or decking. .
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. ',! . .
o Water Line - PrIor to 'filling
trench. ,
o Rough Plumbing - ~r!or to
cover.
PHONE:
~QlD"'~SJ
ZIP:
OTH ER
ADDRESS
CONST.
CONTRACTOR 1/
PHONE
REQUIRED .INSPECTIONS
o 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 Wall/Ceiling Insulation -:- Prior to
cover.
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 & Driilew3}' - After
excavation Is complete, forms
and sub,base material in place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
EXPIRES
4(A<.f'lS ~)
FLOOD PLAIN:
ZONING CODE:
1/ OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
o Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all'
~ e/cal work is complete.
~~~~~echanical - When all
mechanical worl< Is complete.
o Final Building - Wh~n all
required Inspections have been
approved and building is
completed.
. ~her &A-S Se:(2(;-r'~
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blockIng is complete.
o
Plumbing Connections - When
home has been connected to
water and sewer, '
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL: ~ ~~(1~ fj ~ \~Ta..~.,.. ~7i I ,'(),JA.,Q::q:; \Q. \4( 1"10\
) . l)
ELECTRICAl. ,
- OFFiCE USIiMO~'t--
, "'\~~ 'P ~ ~O"'\
LAND USE: \~" \~ .~ \~
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- O~~~AN~Q""
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To request an inspection, you must call f'i!l'i-3769. ThIs Is a 24 hour recording. Alllnspeclions requested before 7:00 a.m, will be
made the sarne working day, Inspect,ions requested after 7:00 a.m. wi/I be made the foi/owlng work day.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the ,home is connected to
the serv'ice panel.
o Final - ,After all required
inspections are approved and
porches, skirting, decks, and
ventl[Jg have been installed,
.~.
Lot faces
'lot Type
Lot sq. ftg.
Interior'
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-.sac
. .-,.... J
BUILDING PERMIT
ITEM
sa. FT.
X $/ sa. FT.
Main (
.' ,
'.. ,
'. f I' ;~._:'
Garage
Carport
Total Value
Building Permit Fee
Stale Surcharge
Total Fee
(A)
,
"\::~:" . ~ ':.,
. '. .. ~.: . ,
IS THE PROPOSED WORK iN THE,
. '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
I PL.
IN
Is
Jw
'\ E
, ,
VALUE
"
,J
-,-
(B)
SYSTEMS DEVELOPMENT. CHARGE (SDC)
.. .
.... .
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
PlumbIng Permit'
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood.
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent
~C; LLr "
~Jr
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
I
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
)
State SurchargtJ '"
. Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
..:"
"FEE.
. ,.
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APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express conditio'n'lhatthe 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 Che9k Fee:
Date Paid:
~ . ,
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Ch~ar.ge .I~. ~.u~(on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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By,slgnature; 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. ~
Slgn~L~h~L\ (~ 1
Date \()~~y -~')
f
VALIDATION: '" Q' '1..rJ-...
RECEIPT NUMBER rA 'I f:)J~
f D-d-c.f-- q 7
-'.'" 1- ~
AMOUNT RECEIVED !::t:cI-W
RECEIVED BY c::::::k'l A J
I
DATE PAID