HomeMy WebLinkAboutPermit Mechanical 1998-10-1
RESIDENTIAL
PERMIT APPLICATION
Inspections 7263769
Office 7263759
5PRINC,IELD
...
.
JOB NUMOER
'1 f /2- 1./<('
22!J rlfth Slreet
Sprlnofleld Oragon 97477
ASSESSORS MAP
97l./7it
CO rOO
LOT
BLOCK
OWNER ~-"rM~ d, ~ e~. '1\C\,J",c....
ADDRESS 33'2./" (' )."Pfr>'\(~e9
CITY ~\ ",c.';:.:;t=>\A STAl e
'T ~'
DESCRIBE WORK T",,~\\
NEW
REMODCl ,.,/
CONTRACTOR S NAME
GCNERAl
PLUMBING
nrp~lf'\
~Ar, ~~W'\
ADDITION
DEMOLlSII __ OTrIEIl
SUODIVISION
PHONE
74h - 8b~
ZIP ~Z!j,] ~
AODnESS
CONST
CONTRACTOR'
PHONE
MECHANICAL
(' nm'Wl t::'r.Q~~"^~ l.9CSI 1J..-..... ~ 1)
ELECTRICAL
ATTENTION Oregon law reqUires you to
. OIlOWI\'DI~pt..rl hy the Oregon Iltlllty
N, Itlf~cF\\to,l;l, Q,'mler Thol'e rules are setforth
In OAI195~:ub'f:'OUlU rnrougn UAH lI:>~,001.
019(J)l)'Olj It/a9~Btaln CQPl9E of tns r~les by
cllJlJl)/HhA\1le!er (Note the telephone
Ilumoer fdrth'a dregoriUftlily I\lOlITICallOn
WATOt!mteP'ISER80n.<l<l??<l14}-__
NCiIC~-
TH''''''''' . ZONING CODE
I;) rt:MMI J ;:iNALL EXPIRE IF THF WPRK
'UTI 1""""-"- , or [JDnlvlv
-" Vn ....:LI ul~uER THIS PERMIT IS NOT
-GG~NC-ElTefrIS ABANboWeI:ird~ II CAI
ANI( lilt> ,)ov '1!;~OO, SOUAnL' rOOTAGC
- OFrlCE use -
lAND USE _
# or UNITS
CONSTIl lYPE
HEM SOURC~
nANGF __
l'XPII1ES
I'JOUhfJ d>,d>~h
72h -"'IIX)
rLOOD PLAIN
To request an Inspection, you must call 7263769 TIlls Is ;:! 24 hOUI recordlno All Inspections reque<,lcd tJclorc 7 00 n rn will be
made the same workIng dilY, In .pe..ctlons rcquested after 700 a In WIll be ml.lde lhe folfowtrH) wor!< day
o Temporary [foctnc
o Slto 1115pecllon - To be ml.ldc
a(ter excavallon. bUI prior \0
::;ctllno form').
o
Underslnb Plumbll1g/ElectrlcnlJ
Mcchnnlcnl - Prior 10 cover
o
Footlng - Afler trenches arc
excavated
o Masonry - Stecl loccltlon bond
beams, grouting
o
Foundnllon - After (orms arc
erected but prior to concrele
placcm..9'1t
I
Underground PlumbIng - Prior
to'lfllJlng trench
o
o
Undcrfloor Plumbing I t..1cch 'lnlcnl
- PrJor 10 Insula lIon or dccl<lnO
, !
, I
Post nnd Beam - PrlGr 10 floor
In~ulatlon or decl<lng ~
-' '
o
o
rloor Insulntlon - Prior to
decking
o
Sand4lfY Sewer - Prior 10 fillIng
trencll
D
Slorm SC\Jcr - I'nor 10 filling
trench
o
Water Line - Prior 10 11I11n()
lrcnctl
o
Rounh Plul1lblllU - Prior 10
cover
REQUIRED INSPECTIONS
o nough Mechnnlcnl - PrIor to
cover
o n.ough [leclnc,ll - Prior 10
C'()Vcr
o
CleclflCdl Service - Musl bC'
approved 10 ob!.1l/1 pc, rrlDIlC'nl
cleclrlcDI power
o
Flrep]ace - Prior to (nclng
materln!s and framing Insp
o
Frnmln{J - Prior 10 COvcr
o Wnll/Celllno Insul.llJon - Prior 10
cover
o Oryw<lll - Prior \0 t"1plng
o Wood Stove - A(lu In'.IDlh'lon
o ]n:;;crt - Idler fireplace clpprovfJl
and Installation of un!l
o
Curbclll & Approolcl1 - Alter
forms arc c.rC'cled bul prior \0
plnccmcnl of concrt.lc'
o
Slc]ewnlk & Dnvew IV - Afler
eXCi)V,l\IOIl I::, complete rorm....
anc] sut) b'lSC 11l;:l'Ultll Irl plle..e
o
Fence - WI)Cn com pie led
o
~,trool Tree:;; - WIlen all required
lrees arc pl<lnled
o
rm,lI PllllllbJllg - When iJll
plumtJlng worl< IS complete
o rUl.J1 Electl~cill - I/vllen all
@ClcunCd'\Vo';'oscomPICIC
- r lnl Mcch,lJlICill - Whcn all
Cl Hxllur"llr<ll worl< If, complete
o
rlndl OUL!C.!lIlU - Wilen all
reqUired Inspections have bcen
upproved and bUI!C]lllg IS
C'ornplclt.d
o Other
MOBILE HOME INSPECTIONS
o
Olockll1g nnd Set Up - WIlen all
bk)(.l(ln~J IS c.omplcte
o
PlurnlJllH) Connections - WIlcn
home ]1,1.... been connected to
w lIer dn(l ..:>CVJ< r
[~ [lectrl( ,II Conncctlon - Wilen
l)lorl(JJl(J ....vl up and plllrTlblng
]ll',p(.cllon... Il'lVC IJccn DfJproved
dlltj Ille tlome.. J'i connected lo
IIw ..:>ervle..c p,ulel
o
Fltlnl - Afler ull rcquJred
Inspections .::Ire approvcd and
porches, ~]mllng dccl<s, and
vcntlnC] have been Insta]led
Lol fuces
Lot iyp(
Lol sq flg
lnh;:f1or
Lol coverage
Cornu
Topography
Total llelgll!
P.lnlli.ll1CJ!c..
Cui de ..3G
BUILDING PERMIT
ITEM
so FT
x :r/50 IT
Main
Garage
Carport
Total Value
OUllc..lLng PerrIlll rec
Stute Surch.H[je
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(Ell
PLUMBING PERMIT
ITEM
Flxlures
Residential OJtll(~)
N'
Sanitary Sewer
1'1
Water ... r-1
Storm Sewer I fT
Mobile Horne
Plumbing Permit
Stale Surcll::H\JC
Tolal CllLIrgc
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Venl fan
N'
Wood Stovelln::>ert/f Irepl1cC' Unll
Dryer Vent
j/(j At:-__~
Mecllanlcal Peril 11 t
Issuance
State Surc....ll~Hqc
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile HOllle
Stale I~suancc
Stale SurcllLlrge
Sldewall<
fl
Curbcul
II
DemolltJon
Slole Surcharge
TOlal Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding eleclrlc,li)
(A, 0, C 0 Jnd E COrnblrleu)
IS THe pnOPOSED WORI< IN THE
HISTonlCAL DISTRICT, OR ON
THE HISTonlCAL REGISTER"
II yes, this application must be signed
and approved by the HistorIcal
Coorulnator pnor to permit I~suance
Sellne 1<,
PL HSE GAR ACC I
N
S
----
w
E
---'
VALUE
FEE
!);ou
10 00
--:r~7i[ -
L(;. UJ
APPROVED
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This peTfl1lllG gr::mlecJ on the express condlllon Ihalll1e smd
con->tructlon ->hall, In all rcspects, conform to tIle Ordinance
adopted by the City of Spnngllcld, Including the
Devclopment Code regulating the constructIon and use of
bUlldlng~, lnd moy be suspended or revol<cd at any tIme
upon vlolJllOn 01 ,my proVISions of said ordinance::;
PI.J.1l Check ree
Datc P.1I0
ReLClpl Numbcr ___
Recelvcd 8y
Plnns Rcvlewed-lJy.- -~---
Datc
Systems Development Charge IS due on all undeveloped
properties Within lho Cily 11f111t5 whIch drc being Improved
ADDITIONAL COMMENTS
'-
"
~
(
Oy :.;Ignaturc, I stdte and agree, that I have carefully examIned
the completed application and do hereby ccrtlfy that all
Information llcreon 1-> lrue ane! correct, and I rurthcr certlry
that any c1nd all work performed shoJI be done In accordance
wllll thc Ordlnancu.. of IIH Clly of Springfield, and lhc Law~
of the Stdle or Oregon pcrtalnlng to the worl< dc::;crlbcd
hereIn and tllal NO OCCUPANCY wrll be rnade or any
strUl..turc wllllout permlSGlon ollhe Budding Salety DIVISion
I rUrlllU certify thJt only contractors and employees who
arc In compliance With QRS 701055 wll1 bo used on tills
prOloct
-.~
I further 19ree 10 c.n..UIC Ihat III rcqulrcd Ins,p.q:::llons arc
rcque..led..It the proper tlllle, lllat eaell addre->:. Is readable
frorn the street, that the permll c....ard Is IOC<lICd at the front
of the property, <Jnd the dpproJed set of plan:. Will rcmJln
on the ->Ite at all times dU\lng construction
'(~ .... \
Slgnolure Jb;.t7. Q,,,~
Oat....
VAL\D/ITION
D)/~Z-l
RECEIPT NUMBa1
DAl E PAID I i) / ( 11''1
AMOUNT RECEIVLD ____4)/ 2.4/ J
FIECEIVED OY __ r;..f hJ ~
_-1--__ ____