HomeMy WebLinkAboutPermit Mechanical 1998-3-3
, RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
17
ASSESSORS MAP:
Oed-
LOT:
~
SPRINGFIELD
BLOCK:
RoxA 1Y~(e 5& HA u.8
ADDRESS: '-57 er 7-. C..4 /AI? ~ 'L t../A
CITY' .5/4/,,-r( J FrEC#
OWN ER:
DESCRIBE WORK:
I /1./ 5 7:4 CC .4
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL'
PLUMBING:
o~e
/I e4"/
STATE:
HFC.
f/()Vf1 t
DEMOLISH
OTHER
JOB NUMBER Ci'w ~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
ol&~
SUBDIVISION:
PHONE:
7 Cj/- 0 -z.. '-0
ZIP:
9'7V71"
/'u at /
ADDRESS
CON ST.
CONTRACTOR #
EXPIRES .~ PHONE
MECHANICAl'
~4/P1.&4y ;'/e""'1'4f ~)07 1A).s.?:d
-;:r. .t5 .EC.Ec7/frL.4C
7o~'1.>
- <3:.5 F'/i'L USE -
~ -'2
LAND us1/n-~c'). ~
"6 ~ ~,>
II O1t1lJ ~~q: VA ~_ '
'rp."~ ,'~ '//'
CONS~ ~I=:~ &-'_
V' r,~ (;; ~
HEAT SO~PQ ~~ Y(<.
A)'?> 1> ~
WATER HEATER: " RANGE: _ (<'2 /'0 ~~ SQUARE FOOTAGE:
, , 'rt? --f~ ~n .~..
, v ~ 4,0 .",.
To,request an Inspection, you must call 726-3769. This Is a 24 hour r~~. ~nspections requested before 7:00 a,m, will be
made the same working d3Y, Inspections requested altor 7:00 a.rn, wi~e ~~~e iollowing worl< day,
REQUIRED INSPEC~~ ~
~ 0,;.
o Rough Mechanical - Prior to 0 Final Plumbing - When- all '
cover. plumbing worl< Is ,complete.
ELECTRICAL:
QUAD AREA:
1/ OF BLDGS:
OCCYGROUP:
1/ OF STORIES:
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslilb 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.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or deckIng,
o Floor Insulation ,--0 Prl<;>,r .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.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing -', Prior to cover.
o Wall/C'elling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - Alter Installation.
D Insert - Alter fireplace approve!
and Installation or unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
"
o Sidewalk & Drivewa~' - After
excavation Is complete, forms
and sub-base material in place,
D Fence - WIlen completed.
D Streot Trees - When all required
trees are planted.
7- (!) 0 ?-
3 <is! ~ Yf;
~ F 7S'77(;'
FLOOD PLAIN:
ZONING CODE:
II OF BDRMS:
SECONDARY HEAT:
D Final Electrical - When all
electrical worl< is complete.
~ Mechanical - When all
mechanical worl< Is complete.
o Final Buildlng- When all
required Inspections have been
approved,and building Is
completed.
D Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Wilen 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
t he service panel.
II
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
':' : ;'j'.; :. ,~~;~ '.; '.
~; I I.
lot faces
Lot Tyr:,
Lot sq. ftg.
Interior
Setbacks
I P.L. HSE GAR ACC
IN
Is
Cul-de.sac
W
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.
Lot coverage
Corner
Topography
Total heigh!
Panhandle'
E
----,._-
APPROVED:
BUILDING PERMIT
ITEM
SQ. FT.
X $1 SQ. FT.
VA LU E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perm~!'is 'g~a,n,ted 0[1 the expre,ss\Co.nditip'n that the said
construction shall: in all respects, conform to the Ordinance
adopted. by. the I City, of Sprlr.lgfl~ld. ir;lcludlng the
Development Code, regulating the construction and use of
buildings, and may be sl:Jspe'nded or revoked at any time
upon violation of any provisions of said ordinances.
Main
Garage
"
Carport'
-<:.
~. '.
, '
Plan Check Fee:', .
Total Value
Date Paid:
Building Permit Fee
Receipt Number:
State Surcharge
Received By:
Total Fee
(A)
.---. -_.__..~------
Plans Revi~wecJ By
Date
SYSJE,MS DEV.El:.OPMENT CHARG'E~(SDC)"
(B)
Systems Development Ch'arge" Is 'dte on all undeveloped
"
propert~es ,,:,~n'.ln th? City limits .wt)ich.are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
"
Fixtures
Residential Bath(s)
NO
,..:,
~..
.x
Sanitary S~wer
Water
FT.
.
::
.; ....
. '. ;,' ,~,: t
"
FT.
l..,.
Mobile Home
.',
. ,\,'
" ' ~.
~ , ~
('t~' ..,.~i~
.'; ~~.
Storm Sewer
FT.
~;,::. .
Plumbing Permit
,I ':.' ......
'.~,' -' :r' ::;~;:
, .
.~- (I' /';;:::
'...:\'~ ...~\,.. ~~.......~
'.
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Total Permit
(D)
.f /6,
4/0.
( 7r--r . Lj~
k.dc
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 Division,
I further certify IIlat only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permll
Issuance
State Surcharge
Sidewalk
ft
I further agree to ensure that all required Inspections are
requested at the proper lime, that oach address Is readable
from the street, that the permit card Is located at the front
of t.he propertY~I~ the approved set of plans will remain
:;~:::u:~" al~)Z d~;;Z:;A-
r/ P'
~ - 3 -'1Y>
Date
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Curbcut
It
Demolition
State Surcharge
VALIDATION: ,/
RECEIPT NUMBER j.q 01':J
3 - I)--'~ ~
$ e2ro . d-o
Total Miscellaneous Permits (E)
DATE PAID
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
AMOUNT RECEIVED
FlECEIVED BY _, ~
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