HomeMy WebLinkAboutPermit Mechanical 1999-7-16
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SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
9'ft:>rfJ
JOB NUMBER
225 Fi flh Street
Springfield, Oregon 97477
(( z.. Ot)
TAX LOT:
SUBDIVISION'
LOT:
BLOCK:
OWNER: 1)0(\ f\a I~ _
ADDRESS:' \ ~ rn. rrin:r f2.la.c. p
CITY: ~ri ()~ STATE:
DESCRIBE WORK: \ (l?rlr1ll I6rp(tllt- 4-!(
NEW REMODEL ADDITI~ DEMOLISH
PHONE:_W
- 9'10 I
Cf74'/n
t'\K
- '
ZIP:
OTHER
CON ST.
CONTRACTOR 1/
CONTRACTOR'S NAME
ADDRESS
EXPIRES '::'> PHONE
GENERAL:
PLUMBING:
MECHANICAL:~~>",\~~vo~PJO Dlumnje.,. &f- ,~,
ATfEN I I ' ,.. the Ore on Utllty rJ'
ELECTRICAL\'I":JJ ~uloe !:lrtooted by _~ ~<;:'+ fnrth
YO v . -" T e rUIl:::;, c..... 0-.
, II' -~:~... f"ontAr hos ..... ,r'\r,:,'l ~n1-
I'IIUL IV...t.-1 Othrougnuru. --".
. ,~ . OAR 952~001-:Q01.. 'oHhe rules By OFFICE USE -
, .,In, . obtam copies
QUAD AR~~~O. You may . _ ~e:theteL~MfQeSE:
calling m~ \.it;;,\t'V~. Utility Noii1icatloTf
II OF BLDGnUffl99!,fnrthe.Oregon_. 32-2344)9F UNITS:
OCCY GROUP: Centerls1-800 ~- ,: CONSTR': TYPE:
?Cj7-?l.f~
=#CJS;?CfD
FLOOD PLAIN:
NOTICE: P\t9wa1:1EWORK
THIS PERMITSH~~:_RMIT IS NOT
AUTHO~ILt:U UN J t)IfJlfOR
cu,v"vld~CEDO~~ .
AI\l\~DAY PE~~-RE FOOTAG E:
II OF STORIES:
HEAT SOURCE:
RANGE: _
WATER HEATER:
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 atter 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
D Temporary Electric
D Rough Mechanical - Prior to
cover,
D Final Plumbing - When all
plumbing w~)rl< Is complete.
~ ~a' Elact,'ca' - Who, all
l;ilectrlcal work Is complete.
~al Mechanical - When all
~chanlcal work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
D Site 'Inspection - To be made
after excavation, but prior to
setting forms.
D Rough Electrical - Prior to
cover. '
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power,
D Footing - After trenches are
excavated.
o Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting.
D Framing - Prior to' cove~,
D Other
o Foundation - After forms are
erected. but prior to' concrete
, placement.
o Wail/Ceiling lnsulallon '- Prior to
cover. ,
, ,
, (
D Underground Plumbing - Prior
to filling trench.
D Unde'rlloor Plumbing/ Mechanical
- Prior to Insulation or decking.
o Drywall - Prior to taping. . '
MOBILE HOME INSPECfIONS
o Wood Stovo - After I~stallatlon.
D Post and Beam - Prior to floor
Insulation or decking. , ,
o Blocking and Set.Up - When all
blocking Is complete.
o Insert - After fireplace approvlll
, ' and Installation of unit.
...;. .. ~ ..
: ,1 \, . '. ' .
o Floor Insulall6n - Prior to
decking.
D Plumbing Connections - When
home has been connected to
water and sewer,
"', O' Curbcu.t & Approach - After
: ,forms are erected but prlo'r to
placement of concrete,
o 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.
D Sidewalk & Driveway - After
excavation Is compiete, forms
and sub-base material in place.
o Storm Sewer - Prior to filling
trench.
. ~. r". ~'.... " '\
;( J .
D Water Line - Prior to ,fllllrig' " ...."
trench. (, '," ...
D Rough Plumblng:""p.~~r to
cover. , \.
~~ ,JjJ~ . c.~ ,
o Fence - When completed,
o Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
o Slreet Trees - When all required
trees are planted.
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Panhandle '"
Topography
Total height
Cul.de-sac
p.L.
N
Is
W
E
" . \1'; :""~ \.
~,J "
Setbacks
HSE GAR ACC
'HE PROPOSED WORK tN THE.
HISTOi=lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I
r--j
APPROVED:
BUILDING PERMIT
'J~'
ITEM
SO. FT.
X $/50. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
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 Stove/lnsert/Flreplace Unit
Dryer VJnt f
A1 C C/)./t
t
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combl~~, /'
FEE
I)' r-d" ~
Iu- (/ 'i)
;'0 .
2,c..~ )D
" " '/'
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:
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 /
t::1f:'i-rll-r J ~I<- No.I--r-
~ I..,
I
Uo.l UP
t ~~Lf7.~
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 Ordlnanc~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 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 tlie 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.
-0 I _
Signature ~~
7
Date
VALIDATION:
RECEIPT NUMBER 0 ~ 'f f )- }
DATE PAID 7 ( 2./ If r
AMOUNT RECEIVED_ tf 2f;~
RECEIVED BY g p~