HomeMy WebLinkAboutPermit Mechanical 1998-5-4
OWNER' DOA C-~U S ~V'\
ADDRESS" 5~8' 4 C,-t..Ud1,U_GA-
CITY: Sv,~~ ~ .
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DESCRIBE ~K' J-k.GL..t ?t..I-VV\..p
NEW V REMODEL ADDITION
'-~.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT'
II
O'l.
CONTRACTOR'S NAME
GENERAL'
PLUMBING:
(;MECHANICAL'~ ~ ~
ELECTRICAL' i1
v'
QUAD AREA'
If OF BLDGS:
OCCY GROUP:
If OF STORIES:
WATER HEATER:
SPRINGFIELD
.
JOB NUMBER
qg--05 (9
.
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to ,'j,"
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225 Fifth Street
Springfield, Oregon 97477
52.~Lf
3 3 ~ <-4
~
CO 22.5
TAX LOT:
SUBDIVISION:
BLOCK:
PHON!:'
f,f:.)~
STATE:
OtL
q 74-78
ZIP:
DEMOLISH
OTHER
ADDRESS
CON ST.
CONTRACTOR If
1
EXPIRES ,~ PHONE
'7~Li o:-X~ r
KY'/6 V'
.?-~~t 3t];r~38
Norlce-: OFFicE USE -
TIHiSlplqn=-SHAtt.-EXPtRl: It.. I HE: WORK
AUa>MCMNfm)-YN9cn TI IIS-Fi:MMI, IS NOT
~1Ef.F&R-lS-ABANaONEfi FDR
ANMAS~8A M~fiI()J:'_
FLOOD PLAIN:
ZONING CODE:
If OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: ___
RANGF'
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumblng/Mechanlcal
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to mllng
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Final Plumbing - When all
plumbing w9rl< Is complete.
D Rough Electrical - Prior to
cover.
D Final Electrical - When all
electrlca ork Is complete.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
nal Mechanical - When all
mechanical work Is complete.
D Fireplace - Prior to facing
materials and framing Insp.
D Final Building - When all
required Inspections have been
approved and building is
completed.
D Framing - Prior to cover.
D Other
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Wood Stovo - After Installation.
o Insert - After flreplace.approval
and Installation of unit.
D Blocking and Set. Up - When all
blocking Is complete.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
D Plumbing Connections - When
home has been connected to
water and sewer;
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Fence - When cor.lpleted.
D Street Trees - When all required
trees are planted.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
L~t ~y.
Lot SQ. ftg.
Interior
Lot coverage
Corner
Topography
Total height
';
Panhandle
Cul-de-sac
BUILDING PERrtJJlT "'j
r~ '.&.
r~ ',t:
ITEM
SO. FT.
X S/SO. FT. =
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
,
. .'
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'.' '; .' 1., ~>.,: ~.~
." '.". .1", . fl-,1 '''I ", , .
,''-' . ....J,. ':"
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.
. ,
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Setbacks .
P.L. HSE GAR ACC'
N
S
w
E
VALUE
,
.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S~wer
Water
FT.
'-
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
,
State Surcharge -t-. O. 03/D MI'K....l..t--
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
I
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
..
$I-S".----'
-1fJ O.
.:i"7~.+,~
.!5.;>. (p, ~
\.
IS THE PROPOSED WORK iN THE.
HIST081CAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED:
" ~?-' .,. .,~.
BUILDIN'G vAHlE, PLAN 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
ouildings, 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
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
j
ADDITIONAL COMMENTS
"
f~' (
j
By signature, I state and agree, that I have carefully examined
the completed application 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 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.
l
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 co
~Ignature d'~_
~le S--Yfr t/
c"'~
c;r--
VALIDATION:
RECEIPT NUMBER ~ Cj &; 3 ~
q- l.( -q <b
<Eidfo. ~
~
DATE PAID
AMOUNT RECEIVED
RECEIVED BY