HomeMy WebLinkAboutPermit Mechanical 1997-10-3
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
o ((ice: 726.3759
ASSESSORS MAP:
LOT:
BLOCK:
B recd '-/1 h:.r ml11
ADDRESS: 733 ~L-rr-J.e:nn La) /3/Y d
CITY: SprU1tjtl e,/d
lns~aJ I
OWNER:
STATE:
OR
DESCRIBE WORK:
NEW REMODEL _!~ ADDITION
J-)&+ 'Puma S\lsfan
I I
DEMOliSH ____
CONTRACTOR'S NAME
GENERAL:
OTHEll
.
JOB NUMBER
Cf I I t.(Jrs.-S
225 Fifth Street
Springfle/el, Oregon 97477
TAX LOT:
SUBDIVISION:
PHONE:
&f!7 -:J5dd
ZIP: Q'1i/-1tJ
ADDRESS
CONST.
CONTRACTOR It
PHONE
PLUMBING:
MECHANICAL:f:OrYl+Dr-l: RotV ((5/ DDn,f;+.5fe..-D
-~
To request an Inspection, you must call 726.3769. This Is a .f.~Q~~cording, AfI inspections re'queSled before 7:00 a,rn. will be
made the same working dilY, Inspections requested afl~~~o\lb~' will be made the folfowlng worl< dilY,
, RE~~~~~ECTlqNS '
~~U~~#~ical - Prior to
G. ~_.~~'~\J
. . \.ty'{;. ~ CJ ~<() ~~
o Site InspectIOn - To b~~d9~~' ~V~~~h Electrical _ Prior to
after excavation, but ~ _~~ (\.,~v~~.
setting forms, ,\~"b' r:J~:;' ~~ (.c,~V
. ~...~~ ~~O ~~
o Underslnb Plumbl,ng/ElectliN:!'nl~~ "r~ Electricnl Service - Must be
Mechnnlcal - Prior to coverCJO ,~approvecl to obti.lin perrnilncnl
~ eleclrlcill power,
o Footing - After trenches are r
excavated.
ELECTRICAL:
QUAD AREA:
II OF BLDGS:
OCCY GROUP:
It OF STORIES:
WATER HEATER:_
o Temporary Electric
o
Masonry - Steel location, bond
beams, grouting.
o
Foundntlon - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Under/loor Plumblngl Mechnnicnl
- Prior to insulation or decl<ing.
o
Post nnd Beam - Prior to (1001'
Insulation or decl<lng.
o Floor Insulntion - Prior to
decl<lng.
o
Sanitary Sewer - Prior to filling
trench,
o
Storm Sewer - Prior to filling
trench.
o
Willer Line - Prior to filling
trench.
o
Rough Plumbing - Prior to
cover.
- OFFICE USE -
L^ND USE:_
II OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
R^NGE: ___
o
Flreplilce - Prior to facing
materials and (raming Insp,
o
o
Frilmlng - Prior to cover.
Wall/C'elling Insulatio,l1 - Prior to
cover.
o
Dryw11il
Prior 10 taping,
o
Wood Stove - After Insta/lalion,
o
Insert - Afler flrepface approvfll
an'q install;)lIon of unit.
o
Curbcllt & Approach - After
forms arc crccled lJlIl prior to
plilcernenl of cOncrcl(~,
o
Sidewalk & Drivew:IY - Arler
excilvalion is complete, forms
ilncJ sui),base maicri:ll in place,
o
Fence - \lVt1Cn completecl.
o
~Hrool Trees - Wilen all required
trees arc planted.
()O Lj/PD
I.::XPlnES
10 -2g 1<1
7 210 ~DI DO.
fLOOD f)L^IN:
ZONING CODE:
It OF BDRMS:
SECONDAFlY HEAT: ______,____
SQu^nr=. FOOTAGE: ___,_..___
o
Final Plumbing - When all
plumbing worl< is complete.
o
Fin:li Electricill - Wilen all
electrical worl< is complete,
~ech:lIlicnl - When' all
mechanical worl< Is complele,
D
Final Ouilding - Wilen all
required inspections have been
approved and building is
camp/ciccI.
,
~
o Ol,l1er
MOBILE HOME INSPECTIONS
[:=J
Olocking nnd Set.Up - When all
blocl<inD is complele,
o
Plumbin~J Connections - When
Iwme has been Connected to
w:.1ler ::\f)el sewer,
o
Electrical COllllcction - When
1)locl<iIl\J. sel-uP. oneJ plumbing
i Il~;pec Ii ons Il;lve~ been approvecl
aneJ tile Ilollle is conneclecl to
tile service pallel,
CJ Finnl - Afler all required
in:jpections arc approved and
porches, sl<irting, decks, and
venting have been Installed,
lot faces
lol Type'
lot sq: ftg.
Interior
Lot coverage
Corner
Topography
Panhandle
Totill height
Cul-de,sac
'J
BUILDING PERMIT
ITEM
SQ, FT.
X $1 SQ, FT.
Milin
Garage
Cilrporl
Total Value
Building Permit Fcc
Slate Surcharge
TOlal Fcc
(^)
,~ '. ~ : .~:,!f.~d';~f'i~~~;~;:~~ :'t~.:1r.;~~1.1i~J~;~:d' t 1
Sctl)aGI<~;
P,l, HSE GAR
N
S
W
E
V A lU E
"
.5-Y.SI:,EMS DEVELOPMENT CI~\.f\RGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixlures
Residcnliill B<Jth(s)
N"
Silnitary S~wer
FT.
Water
FT.
Slorm Sewer
FT.
Mobile Home
Plumbing Parmit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N"
Wood Stove/lnserl/Flrepl<Jcc Unit
Dryer Vent
j)~~~-p--
I
Mechanicill Permit
Issuance
Stale SurcharGe -t-O. ~
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Horne
State Issuance
State Surcl,arge
Sidewalk
It
Curbcul
ft
Demolilion
~late Surctlargc
Tolal Miscellaneous Permit~; (E)
TOTAL AMOUNT DUE (cxcludina clectriccll)
(A, B, C, 0, and E Combincd)
FEE
'ACC I
I
I I
IS THE PFlOPOSED WORI< iN THE
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
It yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permil is granted on 11')e express condition that the said
construclion sl,1all, in all respects, conform to the Ordinance
adopted by the City, of Springfield, including the
Development Code, regulaling the construe lion and use of
buildin~Js, and may be suspended or rQvol<cd at any lime,
upon viola lion of any provisions or-sa-id ordinances.
Plan Checl< Fcc:
Date Paid:
Receipt Nulnber:______~_~
Received By:
-----.-. .---.----.----
Plans Reviewed 8y
Dale:
Systems DevelopFnpnt Charge is due on all undeveloped,' '
pro'perties within the City limits which are being improved.'
ADDITIONAL COMMENTS
,.j,I:'
-,,*.~~
i::~;.~~;'2.?i.i
'/0... -''/'l;', ,/""
.. i'~;;~'!.:,l..".,',.'~" . ~~~: .,~_:~-):.':. ~
"Y.- ' , :._... ~.r. '....;~:~~-".-;,
'~'-"'/. 't,o. ~\4..... '/";''''.:..';. /' l .1,.,,,
.(/_ '.,f?,. ,..t..yr-., 'V"~ 4 .....","J.
. L!(i-i.$Jt.;.', '~.~):.:;~:::I.;;,~;),/~~:;;':S'>
By slgnatur::.;,,')~'r~~f1t.:n:d;.~gree, that I have carefull~ examined
the completec:J-,..appl-t;g:allon and do hereby certify that all
, '..
information here'oj~is true anel correct, and I further certify
that any and all worf< performed sl,all be done in accordance
with the Ordinances of llw City of Springfield, and the Laws
of the Stale of Oregon pertaining to the worl~ described
herein, and that NO OCCUPANCY will be maeJe of any
structure will,oul permission of the Building Safety Division.
1 further certify tllat only contractors and employees who
arc in compliance'with ORS 701.055 will be used on this
proiect.
t-is-- -=----
-t _LQ,~_-:-
7~. +- .l..fS
--,-------
B-Co .?-D
I furlher agree to ensure thaI all required inspeclions are
requested at the proper lime, that each address Is readable
fromlhe slreet, that the permit card Is located at the fronl
of the pi 0 pj:2rty, . ,d lc-approved set of pla.ns will remain
on tile sile all i es d ring{\ co~t/!Clion.
Signature J# /' ~
()~ d ~
JO..C}-91
Date
VALIDATION:
RECEIPT NUMBEf'l
.67 ~<65
J D- =3- Cf 7
~~.r
DATE PAID
AMOUNT RECEIVED
FlECEIVED BY