HomeMy WebLinkAboutPermit Mechanical 1998-9-17
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RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726-3769
Office: 726-3759
ASSESSORS MAP:
LOT"
SPRINGFIELD
BLOCK:
OWNER' . ::rucl':J J,,);) $pn
AODRESS: c::271'Y- 6v.-I,..,,,ian
CITY: S'r.:?n""j"heJc)
DESCRIBE WORK:
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NEW
REMODEL
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL: ~ru-- 4"" 1i>.4:JH::J
ELECTRICAL:
t
STATE: j:)---
6~s ~1"""l~4e- \ 41""
AOOITION
OEMOLlSH
OTHER
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JOB NUMBER
Cjf5 /1 L-15
225 Filth Street
Sprlngllelej, Oregon 97477
TAX LOT:
SUBOIVISION: '
650lf
PHONE'
721, - ;J.{),;Lf"
ZIP:
1?'1'Ji
ADDRESS
CONST,
CONTRACTOR 1/
EXPIRES ,~ PHONE
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 Wail/Ceiling Insulation - Prior to
cover.
, D Drywall - Prior to taping.
D 'Wood Slovo - After Installation.
o Insert - Alter fireplace approval
and Installation of unit,
o Curbcut & Approach - Alter
forms are emcted but prior to
placement of concrete,
o Sidewall{ & Driveway - After
excavation Is complete, forms
and sub.base malerlal In place,
o Fence - When cor.1pJeted.
o Street Trees - When all required
trees are planted,
1,.11.,
3o/S'-,2f'3}{
7 01. O.s.c~
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QUAD AREA: LANO USE: _, ATTENTION:Oreg~~ERtU\retS vou to
1/ OF BLOG9\IOTICE". 1/ OF UNITS: folLOW rules adopteq8~m~ <t!c3~~~ Utility _
"1'1' Notification Center. Tnose.rules a're setio,tl,
OCCY GROUfHIS PERMIT SHALL EXPIRE IF ~~I{YPE: in OAn 052 001-001()'t~lriyi..-JntR 952-001-
1/ OF STORII1W, ~~!I}E~-!HIS PERMIIfIffi MJ)1RCE: 0090. You may obtai~~8P~~R~~h~Ts by
calling the center.ll"Jbte: ffietelt:I.IIIVne
WATER HEA'OOto.~MfNCr;n OR IS M3ANDON~:,__ ;",r'Jmberforthe OregQIllI1\fIijlitYl*o~~ion
'"; '\. : ,,," A' ,C "''7n' I,t":l. n f'"nt",.. j", 1-~n.o-~~?-?~44)'
fi.~~ '" ~ i f..4~~1 r-:! i'~l \ J ~\ . \.j'14 ~ . " - - " .
To request an Inspection, you must call 726.3769, This Isa 24 hour reco~dlng, All Inspecllons 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 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 - Steel location, bond
beams, grouting,
o Foundation - After forms are
erected but prior to concrete
placement.
D 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,
o Floorlnsu'lation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench,
D Storm Sewer - Prior to filling
trench,
o Water Line - Prior to filling
trench, ,
o Rough Plumbing - Prior to
cover,
\
- OFFICE USE -
o Final Plumbing - When all
plumbing w9rl< Is complete.
I
D Final Electrical - When all
electrical work Is complete,
~ Final Mechanical - When all
!.L-J"fn'echanlcal work Is complete.
D Fln,J!1 Building - When all
.' required Inspecllons have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete,
o Plumbing Connections - When'
home has been connected to
water and sewer,
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - Alter all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
Lot 'f?:,ces
Lot Typt..
.'
Lot sq, ftg.
Interior
Lot coverage
Corner
Topography
, Total height
Panhandle ,',
Cul-de'sac
"
BUILDING PERMIT ';
',f
t
ITEM
SO, FT,
X $/so. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
',:
I'
Residential Bath(s)
; -.
'N~
FT.
Sanitary S~w~r.
';i ..
Water
.!..,
FT.
.'
.' ,
Storm Sewer
FT:
Mobile Home
Plumbing Permit,
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
oryer;ent
/4 "c
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
,
Sidewalk
fl
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
..~ ." .: 'j. ....-
f' . ;': :~":..
':":(';"
Setbacks
I P.L. HSE GAR ACC
N
s
w
E
VALUE
"
FEE
. ". 'I
"\i ' .
J 00
(;,
0< uO
/S-. 0 i)
_j!}rO 0
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Z6.?..~
IS THE PROPOSED WORK tN THE.
'HISTORICAL OISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be s.lgned
and approved by the Historical
.. Coordinator prior to permit Issuance.
APPROVED:
BUILDING VhUJE, 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:
Oate Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Oevelopment Charge is due on all undeveloped
properties within the City limits which are being improved.'
ADDITIONAL COMMENTS
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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 Oivislon,
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
trom the street, that the permit card is located at the front
of the property, and the approved set of plans will remain
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YALlDATION:
RECEIPT NUMBER
/)3/312-
If /1/ /1 <j
( 2& 20 () ,
;JJ wrf-
DATE PAID
AMOUNT RECEIVEO
RECEIVED BY