HomeMy WebLinkAboutPermit Mechanical 1994-4-18
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ADDRESS: //<(0 Ar7~/l..S 011.-/
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
,Office: 726-3759
" LOCATION OF PROPOSED WORK:
/703
ASSESSORS MAP:
LOT:
CITY'
SPRINGFIELD
/" Aw'7"lSe
<
BLOCK'
STATE:
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DESCRIBE WORKl.^ Q ffil~~&' . ~ 0C5~Q.)
NEW" REMODEL X . .ADDITION ~ DEM~H
OTHER
JOB NUMBER
91CJ:f't; G
,225 Fifth Street
Springfield,Oregon 97477
TAX LOT:
SUBDIVISION:
9t,::;-~
,
PHONE:
ZIP:
, 97lfI'J!
I
f'~:fo~ EC tN7.
/77'b 75-0 -I,I~!;-O
5df),q~. 65~~tZCO)
. CONST.
CONTRACTOR'S NAME ,,',' ADDRESS CONTRACTOR #
GENERAL: Htl..S7 ~~;!/F./l."AlS~(::;<... '7/7,(/':<Pb~l?tJAl1Jc:.. S3553
, '
PLUMBIf>lG'
MECHANICAL:
, ELECTRICAL:
QUAD AREA: Cl R 1\)\JJ '
"1", "", , '. ,.'~ I'
# OF BLOGS:
OCCY GROUP: '
i, . )..~~ ~...,
# OF STORIES:
~. -"'.:"
WATER HEATER: '
'-- OFFICE USE -
LAND U~E: \ \''2J4
# OF U'i\J'TS:
,~ "
, CONSTR.TYPE:
HEAT SOURCE:
RANGF'
EXPIRES
~
FLOOD PLAIN:
ZONING CODE: +\fJ~
# OF BDRMS:
SECONDARY HEAT:
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
." I ,'\ - . .
made the same Working day, Inspections requested after 7:00 a.m. will be made the following work day. '
. . , ,- .
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
o Underground Plumbing - Prior
to filling trench. '
o ,Underfloor Plumbing/Mechanical
..,... Prior to Insulation or decking.
o Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation-'Prior to
decki ng.
o Sanitary Sewer - Prior to filling
trench. '
o Storm Sewer - Prior to filling
trench. '
""'.' , .
o Water Line ...:..' P'ric{r to filling ,
trench. ',:, _ " ,
rV"lI Rough Plumbing, .:.- Prior to
~ cover. .
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REQUIRED INSPECTIONS
I"SZl Rough Mechanical -'- Prior to
~ cove~ ,
~ 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.
~ Framing - Prior to cover.
J~rWall/Ceiling Insulation -: Prior to
'~, cover. ' ,
00 Drywall - Prior to taping.
o Wood Stove - Afteri~stallatlon.
o Insert- After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
" forms are erected but prior to
", placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
, and sub-base material in place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing work Is complete.
~ Final Electrical -,When all
~ electrical work is complete.
r\1I Final Mechanical - When all
LAJ mechanical work Is complete.
~ Final Building - When all
~ required Inspections 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.
4
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - After all required
. inspections are approved and
porches, skirting, decks, and
venting have been installed,
1
l 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 .faces, Lot Type Setbacks
Lot sq. ftg. Interior I P.L. HSE'GAR'ACCI
IN I
Lot coverage Corner
\S I
Topography Panhandle
,Lw I
-'. ,-
Total height Cul-de-sac- -, IE I
BUltDING PERMIT :
ITEM SQ, FT. X $/SQ, FT.
VALUE
\
Main \..
Garage
Carport
~M.,U~J
--#r1 mJ
Total Val ue
Building .Permit Fee
l \~ 5; Q
t:\ ~~
\~~~
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)~ -
_ (B)--B-
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
Sanitary Sewer
NO
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
~ ~A~r.
.nNN. /<.00
(
Plumbing Permit
State Surcharge
.1~
\.S.lS"
Total Charge
(C)
I MECHANICAL PERMIT
Furnace
Exhaust Hood
L.t.SO
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
,Mechani9al Permit
l S. CO
~D.~
.1S
~~. 15
Issuance
State Su rcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile 'Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
\ fa 1>. ca~
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
- 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.
Plan Check Fee: rJ / . g 3
I '
-g /2-.//f'~
Receipt Number' /2de>~'
~ece;vedA14~
PI~ Reviewed By
Date Paid:
4s-/'j'cj
'/ Date /
Systems Development 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 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.
~nature'"----r-. y ~~ .
Date
7'-//8!~
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
/2~C('1J
If -c8 -'9 er
\CO~'81
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RECEIVED BY