HomeMy WebLinkAboutPermit Mechanical 1998-7-23
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ottice: 726.3759
.
I
LOCATION OF PROPOSED WORK: IIt)'l /)/~m/)IV'/.\r:,
1703 ? L/2.LJ
B~ t!:e/0
v'
ADDRESS' /109 I.),.olffl-ond st'..
CITY: r;.tJl-in5.J'/;' /d
ASSESSORS MAP'
LOT'
OWNER:
BLOCK:
frJG- () 1!:L9
STATE:
L)r
DESCRIBE WORK: /tJsl:~/~CM.s .f;LI"/JdCt::
NEW REMODEL ADDITION
CONTRACTOR'S NAME
GENERAL' Fr;;.r;6~ L/
Hc.~i';n.Ci
"
J
PLUMBING'
MECHANICAL'
ELECTRICAL'
.
JOB NUMBER q~ 09/5
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
0(22../7
SUBDIVISION:
PHONE' SF/ 7?6.:26 9ft'
ZIP' 9~?7
W/"I. C. 0Md /lefU ~v.>hx. 4A<d ~~~ serb'Ke
;;. v
DEMOLISH OTHER he tt-o.,c;.t .
CON ST. 70sy;::r
CONTRACTOR' EXPIRES ,....
/~yol"
ADDRESS
~..107
w s-r-A
L::-"-" ~ t:..,
?J,
PHONE
, . SW ,;J~.h
QUAN~f!::
. OFllll5>P!?RMIT SH^L~ EY.f'Im: If THE WOl1RF UNITS:
occ4:Ur~ZF'D "NDEP TLJ'~ O'E.J'1MIT IS /lK;CTNSTR. TYPE:
. o,c€JMMiiNCt=O OR I~ ARANnONFD FOR HEAT SOURCE:
WAT~~YHm~A~ PERIOD.
_ OFFICE ~ENTION:Oregon law requires you \0
follow rules adopted by the Oregon Utility
LAND USE: . ~er Thosu.Wl\fl;I2IJ:AlWt forth
I\lOllll\,;d\lVII -JeTT\ .
in OAR952-001-001 0 thW~n.QAfl95t-001-
0090. You may obtain copieso'i' t'K~?u,,,,, UJ
C""II\j II'" "",,,ler. (Ndt@'lfhaIMt~(l~e
n"mhp.r lor the Orego'S~~~lI, ~p~~c~~~~:
Center is 1-800-332-2~):
SQUARE FOOTAGE:
RANGE: _
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 mado
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 Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Waler Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover. '_
~QUIRED INSPECTIONS
ough Mechanical - Prior to
cover.
)( f()uc-# tT-'15
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is compietc, forms
and sub.base material In place.
D Fence. - \Nhen completed.
D Street Trees - When all required
tree.s are planted.
D Final Plumbing - When all
plumbing worl< Is complete.
, ,
D FInal Electrical - When all
electrical work Is complete.
~ Final Mechanical - When all
mechanical work Is complete.
D Flna' Building - When all
required Inspections have been
approved and building Is
completed,
~her GA-r
.5P~t//~
MOBILE HOME INSPECTIONS
D Blocking and Sel.Up - When all
blocking Is complete.
D Plumb1ng Connoctlons - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
Inspecllons have been approved
and the home Is connected to
the service panel.
D Final - Alter all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
Lot faces
Lot sq. Itg.
Lot coverage
Topography
Total height
BUILDING PERMIT '1
ITEM
sa. FT.
Main
Garage
Carport
Total Value
Bul/ding Permit Fee
State Surcharge,
, .
.
Total Fee
L~t ~y.
Interior
Corner
"
Panhandle
Cul-de.sac
'.
.~
't
....., 1-;.-
I PL.
N
S
Iw
IE
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
FT.
FT.
FT.
N'
X $/SO. FT. =
'.
(A)
(C)
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
elK ,f)! fO
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. 0, and E Combined)
,F.EE
6,/)0
/.OD
/S:~rJ
IO,PO
_'1~/ 7~
., ;/c..2-0
.' , ~;' '1\ ~',,'i l~#..
~. j", r. " I" 11;;. ~,,1.
",' -:....:m:..~
. 'IS THE PROPOSED WORK IN THE.
HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
Setbacks.
HSE GAR ACC"
I
I
I
I
BUILDING \1AUJE, PLAN CHECK
AND BUILDING PERMIT
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
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 suspenqed 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
Dale
Systems D~velopment Charge, Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
C;t::.?J~IlA--r1f
rR1U I~
{;?"t=7- J /JA _ .1
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certHy 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 perlalnlng 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
arc In compliance with ORS 701.055 will be used on this
project.
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 perml rd Is located at the front
,
of the property. and the ap v set of plans will remain
on the site at all tlm ding
Signature
DatD
/ 7/';;5 /~~
/
"
VALIDATION:
RECEIPT NUMBER ()? 6 ? 17-
::T:~A~nRECEIVED 7 J~ j~'f~ /l
RECEIVED BY q . N~