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HomeMy WebLinkAboutPermit Mechanical 1997-6-6 RESIDENTIAL PERMIT APPLICATION ... Inspections: 726.3769 Office: 726.3759 SPRINGFIELD '. , , , " . ", : ". t, .~ ~ , . f,'., LOCATION OF PROPOSED WRRK: ';;( ~I ?'.') ASSESSORS MAP: to,} t)~4.~ LOT: BLOCK: (;n 1<.1< /7 L.. . :C\ .-- ~ ' ...., , ".0,7 /, UC/(07' . Of ""7 ""- ~ JOB NUMBER~,-"-' ~ 225 Fifth Street Springfield, Oregon 97477 DR.'SP+d Of) , TAX LOT:~, , ~ ',. ' r.~ I " . SUBDIVISION: OWNER: ADDRESS' '~l-I'(" 5"' CITY' "P -f} rJ . :l,A So n0 US ~ c.nl'?/J A t...... DR . - DESCRIBE WORK: (7 A S STATE: 1'1/)' ~,( / /) A I A G fJj ....... PHONE: 7 {"J /. 974"3 . ZIP: 9- -:> b/ 7,'7 A h d u../ A-r .p. /(" He~/e~/< J NEW REMODEL \./ ADDITION OTHER CONTRACTOR'S NAME GENERAl' PLUMBING: MECHANICAL: ELECTRICAL: 5lE./9 5 r, ,Y1 QUAD AREA: 'i # OF BLDGS: 9CCY GROUP:' , , ...to.,. . # OF STORIES: WATER HEATER:' o Temporary ElectrIc D Site Inspection - To be made after excavation, but prior to setting forms. o Underslab PlumbIng I Electricall Mechanical - Prior to cover. o Footing - After trenches are excavated,' , o Masonry - Steel location, bond , beams, grouting. o Foundation - After forms are erected' but- prior to concrete placement. o Underground Plumbing - Prior to filling trench. DEMOLISH ADDRESS' . CONST. CONTRACTOR # ,~. PHONE '" EXPIRES "....' ,\ /-IeA T> n c: v '~ /O?. ")""'),"",\ 3'/~-~t.1) b - OFFICE USE - LAND USF' , ..,# 0": ,UNITS: CONSTR. TYPE: HEAT SOURCE: RANGE: To request an Inspection, you must call 726-3769, This 15'a24 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. REQUIRED INSPECTIONS fU' R~ugh Mech~nlcal ~PrJor to cover,' , - .' . . D Rou~h'Eh3ctrlcal -,. Prior to ' cover. ' o ElectrIcal ServIce - Must be approved to obtain permanent electrical power,' o FIreplace - Prior to facing materials and framing Insp. o FramIng - Prior to cover" o Wail/Ceiling Insulatlcln ..:.:: ~!?rlor to cover,' o Drywall- Prl,or to taping: O Underlloor Plumblng/i'JIechanlcal 0' , - -,Prior to Insulation or decking. Wood Stovo - After Installation. o Post and Beam - Prior to floor Insulation or decking. O Floor Insulation - Prlo( to'.' decking. . /',! '. , , .. 0, o Sanltal)' Sewer - Prior to flllln'g trench. o Storm Sewer - Prior to filling trench. ' O Water Line - Prior. to filling trench." , , r' , , D Rough Plumbl~g '-, Prior to cover. , .' " "., o Insert - After fireplace approvlll and Installation of unit. \'." , \ "\ " , " . . '.DCurbcut & Approach - After , forms are erected but prior to placemont of concrete. o Sidewalk & Driveway - After , excavation Iscompiete, forms and' sub-base material In place, '0 Fence - When completed. D Street Trees - When all required , trees are planted. . ",' , , ' , '9P ,FLOOD PLAIN: ZONING CODE: ". OF BDRMS: , SECONDARY HEAT: SQUARE FOOTAGE: o Final Plumbing - When all 'plumbing w9rk Is complet,e, D Final Electrical ,...... When all electrical work Is complete, ~Inal Mechanical - When all ~echanlcal work Is complete. o Final Building - When all required Inspections have been approved and building Is completed, ~Other:~4 f./.ue " '. MOBILE HOME, INSPECTIONS o Blocking and Set.Up - When all blocking Is complet,e. 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 hav~ been Installed. l . ' Lot faces ': Lot sq. ftg, Lot coverage Topography Total height .... . t" , '. ;.\ i. . . ,. ',' . . " ~,'.. , Lot Type - , Interior' , ,",.,.'- ,':., '".Jf:t"""",' ," /\".. ' 10 . , . '" ". ,'f' _. ~ ..~. I '.h ", 1....., ;." ...../ . " '~'.. '.' ". .'. ,.,." , ,I . '" . _.' '" ' '. it "t' 'I.,., I'):, I '''.1{,1' ~ ! i lilt., ' ,',~~!> \;,::'i":,,, \." :~'c' ',:I,,:,:(')i/yn,;.":',. . .' ""~' .,. .; ", 1 . " ': .. ,- \~""., .~ I!.. , \;" " Setbacks, '" 'P.L. I HSE I GAR'/ ACe' N I I S' , L I -, , . W I I E I I - { Panhandle " )o~ (A) Corner - Cul-de"sac , I Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO ;"1 , BUILDING PER~IT;\t'J,;'d!~, ITEM SQ, FT. X $/SQ, FT. '" Main Garage Carport Total Value Building Permit Fee State Surcharge , Total Fee ~\, !ft" , .. '.' ',::" VALUE. '. >' ,~ SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM Fixtures Residential Bath(s) NO Sanitary Sewer , FT. FT, FT. Water Storm Sewer Mobile Home Plumbing Permit State Surcharge ... Wood Stovellnsert/Flreplace Unit Dryer Vent ~//AlrU?/tr Mechanical Permit jJ1/,() " Issuance ,7r+,c(J- (D) State Surcharge Total Permit ' MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A B C O'and E Combined). ,.' ,. ' . , . , I, ( IS THE.PROPOSED WORK tN THE. . ""HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. J , I I I BUILDING' \P)\t(JE,P:LAN CHECK ANt;> BUILDING PERMIT , ). ThIs permit Is granted on the express condition that the said ,-' construction shall, In all respects, conform to the Ordinance adopted by the City, of Springfield, Including, the Development Code, regulating the construction and,use of buildings, and may be ,suspefl,ded or revoked at any time upon ,ViOlation of any provisions of said ordinances. , APPROVED: ~" Plan Check Fee: Date Paid: ,Receipt Number: Received By: ' , . Plans Reviewed By' Date, Systems Development Charge is due on all undeveloped properties within the City limits which are being Improved. FEE ~t?O ::c 00 -J.S. 00 /O,eo 1,2..0 '2~. 2.0 .$,~ ADDITIONAL COMMENTS ,/.JJ5W'::~ < 1/.1/4.. , ~ , . ~~~~, / ' (, " " ~, By sIgnature, I stato an,d agree, that I have carofully 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 tho work described here'ln, and that NO OCCUPANCY will be made of any structure without permission of the BUlldl"g Safety Division. I further certify that only contractors and employees who are In compllanc~ with ORS 701,055 will be used on this, project. , I further agree to ensure that all required Inspections are requested at the p'roper time; that each address Is readable from the street, that the pormlt card Is IOCBtod at the front of the property, and the approved set of plans will remain on the site at all times ding construction. ~atur Date 1 VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY ~go ~/~/9? ( ~ , ~~~