HomeMy WebLinkAboutPermit Mechanical 1997-3-28
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: ::2 3D
ASSESSORS MAP: \'l7)~~~
LOT:
w.
BLOCK:
BILL FRAzee
~30 w. e..6",-r~~ '~Pr\....
9~~\~<b~ \.E.\..t:)
OWNER'
ADDRESS:
CITY:
DESCRIBE WORK: -.l/Y.srfJ-LL.
NEW
REMODEL
BLVD
DR.
STATE'
HEt+1 Pump
SY.::>/cm
5'400
JOB NUMBER ql[r4~ I
225 Filth Street
Springfield, Oregon 97477
SUBDIVISION:
PHONE: '7i..ffD- iDlo/
ZIP:
Q14'1'1
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:~~Ot't- l='\OIAl
ADDITION
DEMOLISH ___ OTHER
ADDRESS
CONST.
CONTRACTOR It
PHONE
- OFFICE USE -
LAND USE: :.......,.
It OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
L~XPIF1ES
\,,~\ l)o~ ~. Sk..!) J Sp\l-ta. 911111 WI.f(f;Q
D Temporary Electric
D
Site Inspection - To be made
alter excavation, but prior to
setting lorms,
ELECTRICAL:
QUAD AREA:
It OF BLDGS:
OCCY GROUP:
It OF STORIES:
WATER HEATER:
lt1)CJ.'d'i1 7;;'!, -!JIOO
FLOOD PLAIN:
ZONING CODE:__
" OF BDRMS:
SECONDAF1Y HEAT: ______
SQUARF:: FOOTAGE:___,____
, ,
To request an Inspection, you must call 726.3769, Tills is a 24 hour recording, All inspections requested before 7:00 a,m, will be
made the same working d~y, Inspections requested alter 7:00 a,m, will be made the following worl< day,
D
Underslab Plumbing! Electricall
Mechanical - Prior to cover,
D
Footing - After trenches are
excavated,
D
Masonry - Steel location, bond
beams, grouting,
D
Foundation - After forms are
erected but prior'to concrete
placement.
D
Underground Plumbing - Prior
to IllIingtrench,
D
Underlloor Plumbing! Mechanical
- Prior to Insulation or decl<ing,
D
Post and Beam - Prior to Iloor
Insulation or decking,
D
Floor Insulation - Prior to
decking,
D
Sanitary Sewer - Prior to filling
trench,
D
Storm Sewer - IJrior to (iI,linQ
trench,
D
Water Une - Prior to filling
trench.
D
Rough Plumbing
cover,
Pri or to
REQUIRED INSPECTIONS
fJI Bou'{j'h Mechanical - Prior to
lbdCover,
D Rough ElectricaI- Prior to
cover,
o Electrical Service - Must be
approved to obtain pe;'rnanent
electrical power,
D
Fireplace - Prior to facing
materials and framing Insp,
o
D
Framing - Prior to cover,
Wall!C'eiling Insulation - Prior to
cover,
o
Drywall
Prior to t;Jping,
D Wood Slovc - After Installation,
o Insert - After fireplace approvlll
and Installation of unit.
o
Curbcut & Approach - Alter
forms are erected but prior to
placement of concrete.
D
Sidewalk & Drivew:IY - After
excavation is complete, fori'llS
and sul).basc m<1teri:lI in place,
o
Fence - Wilen completed,
D
.
Street Trces - When,all required
trees are planted,
o
Final Plumbing - When all
plumbing worl, is complete,
o
Final Electricnl - Wilen all
electrical worl< is complete,
~I Mechanical - When all
rnccllanical worl< is complete,
o
Final Building - Wilen all
required inspections have been
approved and building is
compleled,
o
Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Wilen all
blockln~J is complete,
o Plumbing Connections - When
IlOme Ilas been Connected to
water an(1 sewer,
D
Electrical Connection - When
IJlocllin\). set'uD, anej plumbing
i n ~;pec t ions Ili1Ve l)ccn approvec!
and the hOlno is connected to
the service panel.
o
Final - After all required
Inspections are approved and
porches, sl<irting, decl<s, and
venting tlave been Installed,
Lot laces
Lot Type
Setb'lcl<s
---.'-
HSE'GAR ACC
I'
,HE PROf"OSED WORf~ iN THE
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application musl be signed
and approved by the Historical
Coordinator prior to permit issuance,
Lot sq, ftg,
Interior
I P,L,
Lot coverage
Corner
N
Topography
Panhandle
S
E
..I....~___,-~--~-
J ~ ; _ I if -~ ,..., .' t f ).'
APPROVED:
Total height
Cul-:de;sa~,:
-
.,
BUILDING PERMIT
ITEM SQ, FT. X $/ SQ, FT. VA LU E
Main
"
Garage . , .,
Carport \ ,
,
Total Value
Building Permi t Fee
State Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE ,(SDC) ,
'. . "" .:.~.: '. .. ,." ~....+ .~:' . '~:"'., ': i .,~ .~., ~ I, J.;. .:t :..~
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
NO
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharoe
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Venl Fan
NO
Wood Stove/lnsertl Fireplace 'Unil
Dryer Vent
Mechanical Permit
.....
$..~
d1B
Issuance
Slate Surcharge +~
Tolal Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slale Su rc harge
Sidewall<
ft
Curbcul
It
Demolition
?tate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excludinO electrical)
(A, B, C, D, and E Combined)
61(0 (JJ)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on lhe express condition thaI the said
conslru'~ti'on 'shai'l,' irf all:respecls, conform 19 lhe Ordinance
adopted. by t,he Cily of. $pringfi,eld, including the
Develop~rrenlCode; regulating the consTruction and use of
buildings, and may be suspended'or,revoked at any time
upon violation of any "prbvisi~ins bf's~'id ordinances,
, Plan Check Fee:
. .. \" ; ", .... ,:'_'. .... t '
Date Paid:
. ~,\ \"
I. ~. \
Receipt Number:
Received By:
------.-. .---.--..--.----
Plans Reviewed By
Dale
Syslems Devel,opmen,t Ch_arge is_du.~ on, all undeveloped
p'rBpe';(ie's wilKin 'lfl~ Clly li,r'r;/I;.'whi~'I;' a're'being improved,
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the compleled application and do hereby certi Iy 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 Stale of Oregon pertaining to the work described
heroin, and that NO OCCUPANCY will be made of any
structure without permission 01 the Building Salety 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 althe proper time, thaI each address Is readable
from the street, that the permit card Is located at the front
of the property, Dnd lheapproved set of plans will remain
on the site al all limes during construction,
Signature
f11~ ~/}~
() ,3 -62ff -q/
DDle
VALIDATION: {\( \
RECEIPT NUMBER ~SCY6\
DATE PAID \1, ~.q')
AMOUNT REC~.~Vf. ~ n( (c,-lUJ
RECEIVED BY r / ) 1M ./