HomeMy WebLinkAboutPermit Mechanical 1999-3-12
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK' 2/ (,0
ASSESSORS MAP: /1 () 3 .., (, I 3
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OWNER: ~\Ai\ ~('1a
ADDRESS:'~\lOn \\JOf-\--Vl ~ S\~
CITY: ~('('\~P_~ O~ STATE:..oCO_fl\Cln
DESCRIBEWORK:~~(~1---~~(\ \-\>0..\ QUV'/\.{>I \\ 't\\D\..'2l6...%
REMODEL -./" ADDITION DEMOLISH . OTHER
LOT'
NEW
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAl ,t\ri (uP Li !r. 5c:r,
- I
BLOCK:
.~ C?/.? 3311
JOB NUMBER rlO ..,
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: /J /.. /l ()Q
SUBDIVISION:
pHONF' Jdl.o - ~I \ Y
ZIP: 01lL\ 'I J
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ADDRESS
CONST,
CONTRACTOR'
EXPIRES ',":, PHONE
qv>~O ~\nSnu.;\'
S'Slo 1i-;)"'"
f..-i(~ -An 77
ELECTRICAl'
__ ._.,.....,,"("'\<rO('l.("\n laW reQUlret:) yuu l.V
1"\1 I L..-' ~ . . - - th oregon u".",
follow rules adopted by e s8\ RiFfl!CE USE -
, Center Those rules are
QUAD AREA: NotificatIOn -""1:Jt~rOUgIlANDl&s,€:-001- I\I~T!"~ FLOOD PLAIN:
inOAR9t:><:.UU"vv, ' '" ftherulesby ..--.
. OF BLDGS: -ue93 y-" ~"\1 obtall\ COPle)h2Jfe~Nlr&l;e--- -, ..~ ". "'Rr.::T 3HAll EZQflU~(:L CTHOEDEW: -
~ " - the center, (Note: t e .~ ' }\I"IHl: /I" ORK
OCCY GROUP: calling - 'gon UtiliJ.9~'$li:ili,Cll~flE!: '..''l, ,17'.::t' :JNDER.... Of..allRMMITS,'S N
numbertOllll",v'v .?:\44\. IHII;; ~l:H ()T
. OF STORIES: r~"t..."" 1.800.33?HEAT SOURCE: r. - -,~ I'::,' rS.ECON I.lAR:!'OH EAr:
" u ."l'\lwUNl:U r R
WATER HEATER: RANGE: _ ANY 180 DAY PF=RIOD. SQUARE FOOTAGE:__
To request an Inspection, you must call 726.3769. Ttlls Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested after "/: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 Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking,
o Floor Insulation - Prior to
decking, '
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D 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.
D Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to tapIng.
o Wood Stove - After Installatfon.
D Insert - After fireplace approVAl
and Installation of unit,
o Curbcut & Approach - After
forms are erected bllt prior to
placement of concrete,
o Sidewall{ & Driveway - After
excavation 15 complete. forms
and sub-base malerla.1 in place.
o Fence - ,",Vllen completed.
D Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing W9rl{ Is complet.e.
o Final Electrical - When all
electrical work.ls complete.
~al Mechanical - When all
[Zf ~~chanical work Is complete.
o 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
nome 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 - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot ~ype .
, " : ' .. \'!: ,', ,,: '~, '
',:
,eTHE 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 sq, ftg.
Interior
Setbacks
PL. 'HSE' GAR' ACC I
Lot coverage
Corner
Panhandle ~
N
S
Topography
Total height
Cul.de-sac
w
----
E
BUILDING PERII/IIT'J
ITEM SQ, FT.
:' 't
X $/SQ, 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) 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
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent ~~
iw jJ~
1 1S,0 IJ
Mechan1cal Permit
Issuance ..fiJ",tJ"
State Surcharge LfI1iI
Total Permit (D) 2-(. 2 J
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
APPROVED:
BUILDING \1AL(JE, 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 Sprlngfletd, Including the
Dovelopment Code, regulating the construction and use of
bulldJngs, and may be suspended or revoked at any time
upon vIolation of any provisions of said ordinances.
Plan Check Fee.
Date Pa1d:
Receipt Number:
Received By:
Plans Roviewed By
Date
Systems Development Charge 1s due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
a-n E U-z--rJ!.~-J ~.6/
/J./~ 1..,1 I /1~
I
By signature, I state and agree, that I have ca-refully 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
:~g:::~~durIG ~c~
Date L ~\ ld.-\qq
VALIDATION:
RECEIPT NUMBER rJ (? 5 1<1 ()
DATE PAIn. 3/'2-/7'1 I
AMOUNT RECEIVE~4t, '2-0 f
RECEIVED BY v:..Y {,.J~