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HomeMy WebLinkAboutPermit Mechanical 1995-6-12 RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: / tS a 2... ASSESSORS MAP: LOT' SPRINGFIELD 56"0 (!J'2 CAS CA dE 2... <... BLOCK: OWNER' ADDRESS: CITY: c h lets C hKf t/(atOI11 t- 5""( 0 CA.f cAd E <:; i'J~; N 6-- ;:: iE I d -, {J/(E6tJAJ I'tJ F 11 c ~ T :,{)J ~ '5 y J f-z=r.1 U If ( ~~~ STATr=. DESCRIBE WORK: j I\J S"T A- LLA f-I~ON NEW~' REMODEL ADDITION CONTRACTOR'S NAME GENERAL: PLUMBING: MECHANICAL: ELECTRICAL: Hf3r1<1/ELf C1- P~ttE ~, , / 6WA. ') m DEMOLISH OTHER JOB NUMBER 950/3flA , , 2,25 Fifth Street Spi-ingfield, Oregon 97477 TAX LOT: SUBDIVISION' o~~&O . ' PHONE: 7C),.l,... ~7(3 ZIP: 9 7l(...7~ ~ / " , ADDRESS CONST. CONTRACTOR # EXPIRES PHONE REQUIRED INSPECTIONS D Rough Mechanical.,.... Prior to cover. ' . D 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. D Framing- Prior to cover.- D Wall I Ceiling Insulation - Prior to . cover. " , . D Drywall - Prior to taping. D Wood Stove - After i~stallation. \ D Insert - After fireplace approval and Installation of unit. D Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After , excavation Is complete, forms and sub-base material in place. D Fence':":" When completed. o Street Trees - When all 'required;' trees are planted. , . ' t:>QOil l(),~31~~ S7l/(!j-;6'~1 CJ.QI ~ NU 0-6t::'r u..:-~ ,t= C/(-GA/ c. Q7CU;.3' . , ~ OFFICE USE - QUAD AREA: LAND LlSr=. FLOOD PLAIN: # OF BLDGS: # OF UNIT~' ZONING CODF' OCCY GROUP: CONSTR. TYPE: # OF BDRMS: # OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RANGr=. SQUARE FOOTAG E: To request an inspection, you must call 726-3769. l:hls is a 24 hour recording. All inspections 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. D Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbingl Electricall Mechanical - Prior to cover. D Footing - After trenches are excavated. o Masonry - Steel location, bond beams, grouting, , o Foundation - After fo"rms are , erected,but, prior to concrete placement. D Underground Plumbing - Prior to filling trench. D Underfloor PlumbingJ Mechanical -Prior to insulation or decking. D Post and Beam - Prior to floor Insulation or decking. o Floor Insulation - Prior to decking. . D Sanitary Sewer - Prior to filling trench. D Storm Sewer - Prior to filling trench. ' o Water Line - I:'rior to filling trench. D Rough Plumbing - Prior to cover. D Final Plumbing - When all plumbing work Is complete. D Final Electrical-When all electrical work Is complete. ... :,', . . ... f'X(Final Mechanical - When all ~echanical work is complete. D Final Building - When all required Inspections have been approved and building is completed. , D Other . MOBILE HOME INSPECTIONS D Blocking and Set-Up - When all . . blocking Is complete. , o Plumbing Connections.,.... When home has been connected to ' water and sewer. . D Elect~ical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. ' , D Final - After all required ' . inspectlonsarea'pproved and porches', sklrtln'g, decks, and venting .have been, installed: Lot faces Lot Type Interior I P.L. IN Corner Is Panhandle Iw Cul-de-sac IE' X $/SQ. FT. VALUE , ' , Lot.sq. ftg. Lot coverage Topography Total height ! '.... BUILDING PERMIT ITEM SQ. FT. Main " Garage Carport '. '. ' .... I,. . Total Value' Building Permit Fee State Surcharge Total Fee (A) 'SYSTEM_S DEVELOPMENT CHARGE (S.o,q> " (B) PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) NO Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) ? tr() Vent Fan NO Wood Stove/lnsert/Flreplace Unit Dryer Vent ~r~~~(~) {p6-0 / S/N7 I D ~o , ;.J.. 'Q ~~<> Mechanical Permit Issuance State Surcharge ,75>..,.. ,.,0- Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State ,Issuance State Surcharge Sidewalk ft Curbcut ft DemollHon State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) ? 1- .~ Setbacks HSE GAR ;' (,_ " 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. ACC I i I I I APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express.condition that the said construc'tlori shall,'ih allnispec,ts, confor~ to the Ordinance adopted by, the City of Springfield, including the Development Code, regu'lating the construction and use of buildings, and may be sus'pended or revoked at any time upon violation.of any'provlsion's of saicf'O"rdinar.lces, Plan Chec.k Fee: . ; ...' 't ~ Date Paid: ". Receipt Number' ReceIved By: Plans Reviewed By Date . ~ . . .- - . . .. . ,Systems'Development, ~harge Is: du~ ,on ,'all undeveloped prope.rt'ies within the City limits ~hich'are being improved. . ADDITIONAL COMMENTS . 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 app~oved set of plans will remain on the site a II times dU~. . structlo~. A? O~ (:?7~~ G'-(~7~ Signature Date VALIDATION: RECEIPT NUMBER DATE PAID /70 '7-0 ~//Y5:)- 7k ,20 ?~ AMOUNT .RECEIVED RECEIVED BY