HomeMy WebLinkAboutPermit Mechanical 1991-11-26
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SPRINGF'ELD
RESIDENTIAL
PERMIT APPLICATION
JOB NUMBER q //3 'J::S
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27 -22., ~
Inspections: 726-3769
Office: 726-3759
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK:
TAX LOT: O~/J/7
I
/7/J~
. .. <.;.... -
ASSESSORS MAP:
BLOCK'
SUBDIVISION:
LOT:
OWNER: ~.;~ rI.rv:Jv
ADDRESS:' ~~(ob" '_~~
CIW ~ 0 STATE' {}"
DESCRI~E ~ORK' - MAl Q ~- / ;)M I~
NEW REMODEL ADDITION DEMOLISH
1(/7-d-~16'"
PHONE:
ZIP: 4;1lJ--7,
OTHER
CONST.
CONTRACTOR #
CONTRACTOR'S NAME
ADDRESS
EXPIRES
PHONE
GENERAL:
PLUMBING:
.it MECHANICAL:
-zJt:- 1 D s: tiS-
~ /~~ 4:Ab1 w.SiA. ---~,,'/~~?I-I{
. ( D
'3 tl-lf,-~{r:l
ELECTRICAL:
- OFFICE USE -
QUAD AREA: LAND USF" FLOOD PLAIN:
#OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE' SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
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 requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Temporary Electric
o Final Plumbing - When all
plumbing work is complete.
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Rough Electrical - Prior.to
cover.
o Final Electrical - When all
electrical ,work is complete.
~ Final Mechanical - When all
~echanical work is complete.
o Underslab Plumbing/Electrical/
. Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
O' Footing - After trenches are
, 'excavated.
o Final Building - When all
required i'1spections have been
approved and building is '
completed.
o Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting. .
,0 Framing - Prior to cover.
tzr Other ~S . LINE.
D Foundation - After forms are
erected but prior. to concrete
placement.
o Wall/Ceiling I~sulation -: Prior to
cover, .
D Underground Plumbing - Prior
. to filling trench.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underfloor Plumbing/Mechanical,
- Prior to i nsu lation or decki ng.
D Wood Stove --:- After installation.
D Blocking and Set.Up - When all
blocking is complete.
D
Post and Beam - Prior to floor
insulation or decking.
D Insert - After fireplace approval
and installation of unit.
o Plumbing Connections -. When
home has been connected to
water and sewer.
o Floor Insulation - Prior to
decking. .
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
o Storm Sewer - Prior to filling
trench.
D Water Line":'" Prior to filling
trench.
. 0 Fence - When completed.
D Final - After all required
insp~ctions are approved and
. porches, skirting, decks, and
venting have been installed.
D Rough ~Iumbing - Prior to
cover.
o Street Trees -'- When all required
trees are planted.
Lot Type Setbacks
Interior I PL. HSEGAR ACC I
IN I
Corner
Is I
Panhandle
Iw I
Cul-de-sac
IE I
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsertlFireplace Unit
Dryer Vent
Mechanical Permit
/'
oM 10,
/,t:;.1HJ
e: -
/ CJ. ' D
,75
25,75
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Su rcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
2--~.7S-
',-
',-=
. 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.
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, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
N~
/ .
Plan Check Fee:
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;-tha"t 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 s~ al!-ti/Jes'~uri~~~uction.
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'Date 1/ -o-b-4 {
VALIDATION:
RECEIPT NUMBER
311/
//-2& ~91
2.S-,7j-
~ >r:::;>J _4
l
DATE PAID
AMOUNT RECEIVED
RECEIVED BY