HomeMy WebLinkAboutPermit Mechanical 1998-12-24
. ....... . ~ .
RESIDENTIAL ,
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOCATION OF PROPOSED WORK: /0 (2
1'70 32?'ft..f
LOT:
,
BLOCK:
OWNER: \JiM ,f,it:::71. /J/IVA,v' . ,1
ADDRESS: /0/2, 'efOVTEAPt/( J
CITY: . S /~':'1fJr;rYf
DESCRIBE WORK'
NEW
REMODEL
CONTRACTOR~S NAME
GENERAl'
PLUMBING'
MECHANICAL:
5e4SoAl~
ELECTRICAL:
STAT 1='
C:;/L
225 Fifth Street
SprJngfleld, Oregon 97477
TAX LOT: /t)ODO
SUBDIVISION:
PHONE:
7'ft-- to 25
ADDITION
DEMOLISH
OTHER
ZIP:
99-'f7 7
ADDRESS
CONST.
CONTRACTOR II
EXPIRES ,,'"' PHONE
~h"..,
/
97j'-' &,v4~/t.
y/-~
~"
- OFFICE USE -
ATTENTION:Oregon 1tl~~L#tOOJYou to
follow rules adopted b~ the Ore.9on Utility
Notification Center. ThoS~~~ aRlSlei rUllIl
in OAR 952-001-001 0 th~Q~~~52..001- ,
0090. :ou may obtain cQQies of the rules ~y
':'ull;;:tg-the \:;el Iter. (NOte~ffi~ ~~~ptlOh~T:
number for the Oregorsijw}t~~~tif~~
Center is 1-800-332-2344),.
ANY 1=:1\; 'I /[\1 JJtHIUH, ,
To request an Inspection; you must call 726-3769. Ttlls Is a 24 hour recording, All Inspections requested belore 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,
QUAD AREA'
LAND USE: _
II OF BLDGSV!>o-....p.......
1\1\ rU{,C;
OCCY GROD,J?IS' "'--- .,~ ~..t. L e""-'RE IF T,(I.nM~T-R( TYPE:
IH ~CnMII an"L ~^rl ~vvon~
II OF STOHI5S', .....n...,..."" 'l~ir'lr'J"I 11,JI8 PERMrr~HnlN~qURCE:
1-\0 IIIVflf-'-L..V (,.,:II~iJl;.;.;.f f l I "tr.J
WATER H~:!)~fiIJIE~~S;:::; O~ !!2 .!\,eA~\OONED~E:
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."
D Masonry - Steel,locatlon, bond
, beams, grouting. .'
D Foundation - After forms are
, erected but prior to concrete
placement.
D Underground Plumbing -- Prior
to filling trench.
.:.
o Underlloor, Plumblng/lllle'chanical
-, Prior to Insulation or decking.
o Post and Beam - Prior ,to floor
Insulation ~r decking.
o Floor Insulation - Prior to
decking. . ' , '
D, Sanitary Sewer - Prior to filling
trench. " .
o Storm Sewer ~ Prior to Hlllng
trench. .
D Water Line - Prior to filling
, trench.
O Rough Plumbing .,- Prior to
cover, ", '
II OF UNITS:
, ' ,
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover,
o Rough Electrical ....,. Prior to
cove~ "
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Final Plumbing - When all
. ,plumbing worl< Is complete,
, ,
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete,
o Final Building - When all
O Fireplace - Prior to facing required Inspections have been
materials and framing Insp. approved and building is
, completed.
o F"'mln. - P,'o, to co,.,.. 0~.' fr/f> f2<i:t1
o Wall/Celling Insulation - Prior to
cover,
o Drywall - Prior to t1ipln~.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and installation of unit,
DCurbcut & Approach - After
, forms are erected but prior to
placement of concrete,
o Sidewall< & Driveway - After
excavation Is complete, forms
and sub-base ma!erlal In place.
o Fence, - When cCi'.lpleted.
D,Street Trees - When all required
, trees are planted,
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,
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 Typ,
Lot sq, ftg.
Interior
Lot coverage
Corner
Topography
Total height
..'
Panhandle'
,~ .
I P.L.
N
S
.l~,
Cul-de'sac \ ,~V:!.__ ~
E
BUILDING - PER~IT flit:
ITEM sa. FT. x $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
, , ,
PLUMBING PERMIT
ITEM
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
NO
Wood Stove/lnsert/Flreplace Unit
~ ;ent /Jvi"
I J /I':> ,
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
b. 0 i/
5":0./
/ .s-; () (/
/ 0, J ,)
'(sf 75/'
-L-b. 2A
Setba'cks
HSE!GAR
I
I
':'1 ! ,; ;;~j',~i;fC~:L"
ACe' I .
I
I
, IS THEPROPOSED WORK tNTHE _
'"HIST08ICAL DISTRICT, OR ON
THE ,HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
J
"',' ~:PRqVED:
BUILDING V~iliJE, ;P1AN 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:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
SystelTls Development Charge. is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and db 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.
Slgn.tu,e a~~
D.te~017/2~
VALIDATION:
RECEIPT NUMBER [)3 2 3 f 3
DATE PAID I 1-/2. i:.( / 9 6' /)
AMOUNT REC~IVED ' ?-f z..,6,' 'J
RECEIVED BY tJ..i! W~