HomeMy WebLinkAboutPermit Mechanical 1996-12-5
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DESCRIBE WORK: Gc"S n~p~c.e ~~--t
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
ASSESSORS MAP:
LOT:
OWNER:
ADDRESS:
CITY:
NEW
REMODEL
CONTRACTOR'S NAME
11Vl~ 1'\-
GENERAL: r I \Q;Ib~LU\
PLUMBiNG:
MECHANICAL'
ELECTRICAl.
QUAD AREA'
. OF BLDGS:
OCCY GROUP:
1"', . '\.
. OF STORIES:'
",,".:,. ..... . , .. ". ,'" ~'.
WATER HEATER:
..
~'\- -
.
.'
:'.>' .
.
.."-'"
'. ':.~...'.
,
, "1'.. ....~.
." ,1...
:..0;:"\\
. ,
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:. ,\~ [J ie'inpora'ryi Electric::
D
Slto Inspection - To be made
after excavatton, but prior to
setting forms.
D
Underslab Plumblngl ElectricalJ
Mechanical - Prior to cover.
D
Footing - After trenches are
excavated.
o Masonry - Steel locatfon, bond
beams, grouting. .
D Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to fllllng trench.
D
Underlloor Plumbing/Mechanical
- Prior to Insufatfon or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor JnsulatJon - Prior to
decking.
o
Sanitary Sewer - Prior to fIlling
trench.
D
Storm Sewer - Prior to filling
trench.
,. ,
.0 Water Line -'Prior to'filllng
, trench. ~.} .
D
Rough Plumblng:-'7""_?rlor to
cover.
';0..
'. .~
'-
5pn'NGF'ELD
/0 ("7
BLOCK:
-'.4"
JOB NUMBER
70/ to/7
225 Filth Street
Springfield, Oregon 97477
,_ TAX LOT:
SUBDIVISION:
!') <;! O~
PHONE' 1'1..) ( - ~q07
CJ/a.'>I'c. ~d'1cH),,;n-r (w)-7-i.0 -,?...(oI07
STATE: -O.V1 ZIP q '74- 7x
P,Jr)"'''''-e...-.
,
ADDITION
DEMOliSH
OTHER
ADDRESS
L( [1'0 ,dL-ll'VIPI 'l
CON ST.
CONTRACTOR'
. ;;;L:, '7 'Ito
EX~RES, PHONE
7(/'7_7445
D Final Elulldlng - When all
required Inspections have been
approved and building Is
com~leted.
D Framing - Prior to cover. -',\":.::1- l \~. ......
" .)8(Othor fi~A7t)~ 7I'l-tt'k.
D Wall/Colling Insulatl.on...." Prior to (FI~ "wMS-ML)
co~~ -, /
-\gJ', ilkS j..ltOE
- OFFICE USE -
LAND USE: _
. OF UNITS:
~\..i\\
CONST.r;l. TYPE:__
,\',... ,
. I,.. "
, HEAT SOURCE:
.,:"\
RANGE: -'---_
TO,r9qu~s~an tn~'pocllcn,_Y;)iJ 'mus.t cA~JI 7'2G'~-7:G9. Tf'iJs it; a.24 hour recording. AIllnspectlonsl..eQueste9 beiore 7:00 a.m. will be
-'. '.' ~',' ...' ~ - . ~ ." , - ." -'- -.. '. '. .
"made Uie same working day, Inspections (equested atier 7:00 a.f7)._wlll be. m't'-de the (ollowlng, work day. : :--~ ", :-.'~;"~'
... " 'c') ,',-)".:' -REQUIRED INSPECTIONS
.. \. ...)... '. ~ : '.
+'0 Ro'U9,;'Mechanlcal - Prior to
cover.
" .
It,,',..
o Rough Electrical - Prior to
cover.
D Eleclrlcal ServIce - Must be
approved to obtain permanent
electrical power.
D
Fireplace - Prior to facing
materials and framing Insp.
--' ~ '.
D Drywall - Pri'or to taping.
"
~'-'.
D
Wood Slovo - AUer Installation.
,
D Insert - After fireplace appr6vltl
and Installation of unit.
o
Curb cui & Approach - After
forms are erected but prior to
placomont of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Fence - Wilen completed.
D Street Treos - When all .requlred
trees are planted. . ,-. "'. -.:..
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:_.
SOUARE' FOOTAGE:_
D
FInal Plumbing - When all
plumbing, W9rl< Is complete.
D Final Elcctrlcnl - When all
electrical work Is complete.
~ Final Mechanical - When all
~echanlcal work Is complete.
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Conncctfons - 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.
p ,
I
C
~.
D Final - After a1l required
. Inspections are approved and
1 porches, skirting. decks, and
I venting have been Installed.
1.
I'
I
Lot Type "'_ Setbacks 'IS THE PROPOSED WORK IN THE _
I PL. ACC I ,-- HISTORICAL DISTRICT. OR ON
Interior HSE GAR
IN I THE HISTORICAL REGISTER?
Corne r If yes, this application must be signed'
Is I and approved by the Historical
Panhandle Iw I Coordinator prior to p~rmlt issuance.
Cul-de.sac
IE I APPROVED'
Lot faces
\., ',. ,\ "",
Lot SQ. ftg. ,~
Lot coverage
Topography
Total height
"
BUILDING PERMIT
ITEM SO. FT., X $/SO. FT.
VALUE
Main
Garage
'.
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Resldenllal Bath(s) N'
Sanitary S~wer FT,
Water FT.
Storm Sewer FT.
Mobile Home
/11' I't!:,~ ) ~(-
r-~
, --
PlumbIng PermIt
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu rnace
Exhaust Hood'
-
.
Vent Fan
N'
Wood Stove/Insert/Fireplace Unll
Dryer Vent
4~ U/lY6 f- /..IXiPz..r
M;d~-f~ibalpj;;;;'I~(" ' ~/N
\ . ,.! .~\, ......!~~" :~",j'::::'..
IS~liance'
;;, S- I;)
J5'"f'"O
-L'_B 6-{)
-~:?-
2-fO 2'D
State Surcharge>-:' '.
rzr 7':> iF
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
DemolitIon
State Surchargf!:
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
? /, 2-0
-- ,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
constructlon shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Dute Paid:
Receipt Number'
Received By:
Plans Reviewed By--~---
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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-$~) ~--p~~
~ A- ~A.f/b 7*JR I r"/b(pAr-'T
~ CJ~7J5Jura~F//O-??AlZr~
(M ~~/EI 72~ - 2.2...9~
H~cq7~.l" ,.lfJIk:'Ah,T .{7~~~f,
By sIgnature, 1 state and agree, that I have carefully examIned
the completed al?pllcatlon and do 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 Statc 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 certJfy ttlat only contractors and employees who
are In cornpllanco with ORS 701.055 will be used on this
project.
I further agree 10 ensure that all required Inspections are
requested at the proper tlme,.that oach 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 alllmes during constru~tlon,
Signature .14MMA 4AJ1\.J)J.J
V \ 2.-'f-Cfl
Oat'"
VAliDATION:
RECEIPT NUMBER
23 ;JG 1
/2 -;- -Y'c;
:20,.2'"
,f~
DATE PAID
AMOUNT RECEIVED
RECEIVED BY