HomeMy WebLinkAboutPermit Mechanical 1996-12-4
OWNER ----/.JDl"l ( ClMJa <:
ADDRESS 7-97-'+ C/-1~I~U, oltJ.CP.
CITY Srll'i '1\1-1-, c. tel (STATE
In<:.:t./ ( 7b.(,k~tN'l d'PI1-tJ...~.j;latJ !M€.. /D.("Pi/ Ii
REMODEL V ADDITION" DEMOLISH _ OTHER
RESIDENTIAL
PERMIT APPLICATION
Inspections 7263769
Office 7263759
LOCATION OF PROPOSED WORIZ
ASSESSORS MAP
LOT
110'3
DESCRIBE WORK
NEW
~
spnlNC,lELD
~ ~
JIll: ~Fi
:> b J.- 4 c.)VC +-.Ra 1A .
'J. 3, "] d-
BLOCK
(J,~
JOB NUMEJER
9(tl/GJ5
225 Fifth Street
Springfield Oregon 97477
PL;L-~
TAX LOT
0:3 00 0
SUBDIVISION
PHONE -7--'-1-7 - 0539.
ZIP
C(17<177
I-f it) I.l.
PHONE
CONTRACTOR S NAME
GENERAL
PLUMBING
MECHANICAL
(f:zv€t<-\.&/l ~ S.
ELECTRICAL
ADDRESS
CONSl
CONTI,ACTOR H
91J&-i_<ht.
cXPI11CS
9222'-1
L/?, ...:;:. "'?("){
7-17
OUAD AREA
, OF BLDGS
OCCY GROUP
, OF STORIES
WATER HEATER
- OFFICE USE -
LAND USE _________
II or UNITS
CONSTR TYPE
HEAl SOURCe
RANGF
rLOOD I'Lf\IN ____
ZONING CODE
II OF GORMS
SECONDARY HEr,T ~_
SOUARe FOOTAGE ___
To request an Inspection, you must cdll 7263769 Tills Is a 24 tlour reCording All Inspections requested before 700 d rn Will be
made the sarne working dny In<,pucl1ons requested after 700 a m will be made the following work day
D Temporary ElectriC
D
Site Inspection - Yo be made
after excavation but prior to
setllng forms
D
UndcrsJ.lb PlumblngfElcctIH..,dl
Mechanical - Prior to cover
D
Footing - After trenches are
excavated
D
Masonry - Steel location, bond
beams, grouting
o
Foundnllon - After forms arc
erected but prIor to concrete
placement
o
Underground PlumbIng - PrIor
to filling trench
o
Underlloor PlumbIng/MechanIcal
- Prior to Insulation or dec)~lna
D
Post [Ind Beam - Pilar to floor
In~ulatlon or decking
D
Floor Insulalton - Pilar to "\
decking
o
Sanitary Sewer - PrIor to filling
trench
D
Storm Sewer - fJllor 10 III ling
Irene!')
D
Water LIne
trench
Prior 10 fllllng_
" ...
o
Rough PlumbIng - Prior to
cover
>
,
REQUIRED INSPECTIONS
G:..r7l Rougl1 Mectlanlcal - Prior to
~er
D
Rough Electrical - Prior to
('OVCI
D
[IcctIlC,ll Service - Mu~l 1)(>
approved to abtolll pelrnanpnt
electrical power
o
Flrcplnce - Prior to faclng~
materials and framing In~p
D
Fr.lrlllng - Prior 10 cover
D Wall/Celllng Insulation - Prior to
cover
, (
D Orywull - Prior 0 tJ.plngJ
D Wood Stove - After Installallon
D
Insert - After (,replace dpprovlll
and Instal18110n of unit
\
D
Curbcllt & Appl::lc.lch - After
forms are Uf>(..\ed but pilar \0
plncuncnt of C'oncrt.lc'
D
SlclewaJk & DrJ\c~J..l~' - After
cXc-avdtlon Is complete fOlll1S
and su~) base rrntUIClI In place
D
Fence - Wilen com pic led
D
, ,
~~lreol Trees - When '111 Icqu~lred ......
trees arp planted
D
FInd] Plumbing - When all
plumbing worl< IS complete
o
FInal Electllc,,1 - When all
electrical war)~ IS conlpIete
C'I--tf rm IJ Mcclll/lledl _ WII(.!11 all
~ChJnlCal worl~ It> complete
o
Flnnl Budding - When all _
reqUired Ins-pectlons have~been
approved and bUJ!eJJng IS
completed ~..,
, -
"
,
o Other
\. ......,.\,... l ' \
)_H
MOBILE HOME INSPECTIONS
D
BJochll1g <lnd Set Up - When all
bloLkln'] I~ complete
D
PlumbIng Connections - When
tlame ha~ been connected to
water t'lrlU seVJer
o
Elcclrrcal ConnectIon - When
blocklno set up, and plumbing
Inspections ~l,we been approved
and the home I~ connected 10
the ~crvlce pnnel
o
Flllal - A(ter ..111 reqUired
In~peclions ':He approved and
porches, ~1~ll tlng decks and
venting htlvc been Installed
/J
Lot faces
Lol Type
Lot sq fig
Interior
Lot coverage
CornLr
Topography
Panhandle
Total height
Cui de sac
BUILDING PERMIT
ITEM
X $/30 r:T
SO FT
Main
Garage
Carport
Tolnl Value
BUilding Pel rTll L Fcc
Stdte SUrC1HHqC
To\nl Fcc
(AI
Setbac:l(,
-;;:--iHS~r-;;:;;'R I ACC I
I
N
--~~
IS THE PF10POSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
I r yes thiS application must be signed
and approved by the Historical
Coordinator pnor to permit Issuance
S
--~-----
W I
-Eu -I
VALUE
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
i:~D
:S-;lP'V
~i;[). /"') ".-0
_J..f) (f7)
;<-0
2../... 20
- +-
PLUMBING PERMIT
ITEM
Fixtures
ReSidential Balh(s)
N'
Sanitary Sewer
F1
Water
FT
Storm Sewer
_ ~~, ;1"~:-:
M ',"U-r"l;"
FT
/-A-~ L/F/t<.
. :;--:-If;;j /i<c:----
Plumbing Permit
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnacc
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/ FI rcpl o.ce
i~,,~;:;, !/{)(OP</
CI'IS" DAYf!- f /(Wff-_
Unit
Mechanical Permit
Issuance
State Surcharge
17J-f'-fI
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
Curbcul
II
DemolItIon
State Surchdrgc
Total MIscellaneous PermIts (E)
TOTAL AMOUNT DUE (excluding clcclnLdl)
(A, B, C, D, and E Cornbl/1cd)
\
FEE
.-/\~
,
--=~
;--, ,
9/.', 20
~~~- .
-.J
APPROVED
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
T~lIS pCrfTlillS glantcd on Ihe express condlllon that the said
construction shell I In alllcspccls, conform to the OrdInance
adoplcd by the City 01 Springfield Including Ihe
Devcloprncnt Code regulating the construction and use of
bUildings, ,Jnd may be suspended or revoked at any lime
upon vlolotlon of <lny prOVIsions of said ordlnanccs
Plan CIIOLI< Foe
Date Paid
ROLel pl N u rnbcl __
ReccI vocJ By
- -~--- ----- ~-----
Plans Revlcwed Gy
Date
Systems Development Charge IS due on all undeveloped
properties Within the> City 1IITlltS which are being Improved
ADDITIONAL COMMENTS
------
By slgnat.ure I stdlc ond <.iglOO thClt I have carefully examIned
tile completed application and do tlcreby certify that all
Information hereon IS true and correct, and I furl her certify
tlldt <lny and <ll! work performGd shall be done In accordance
With the Qrdln<lnC8S of thc City of Springfield, and the Laws
of the Stdle of Oregon pertaining to the work described
herOin .Jnd Lllat NO OCCUPANCY Will be made of any
structure Without perrnlsslon of the Building Safely DIVISion
I furthcl certify tlldt only contractors and employees who
arc In compl\dllcc WIth GRS 701055 Will be used on this
Proloct
I further agree to ensure that all reqUired Inspections are
requested <lIthe proper time, that each address Is readable
from tile street, that the permIt card Is located at the front
of the property, and the approved set of plans will remain
on 1>.18/11 limes dUTlng construction
SI9nalur'{:::::?-:;!/)] ~--L--
Dalcjd-.-cf -< (.
. ,
VALIDATION
2 J i& (
DAlE PAID /2..-f-Jp
~MOUNT RECEIV["D ___ 2~ ~t::l
IIECEIVED I3Y -- - 1/ ~
l
RECEIPT NUMBER