HomeMy WebLinkAboutPermit Mechanical 1998-11-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
.
SPRINGFIELD
.j-,,, ,
LOCATION OF PROPOSED WORK: ::l.l-J f) '5 J) Um A c,
ASSESSORS MAP: ;-7/]~ ;z..~ L4
LOT.
OWNER. K AU
. I
ADDRESS. .;2l.j'1 '5 Duxn AS
CITY- L~P'(.t \ n9 +\"; Lei
DR.
BLOCK:
~OUYlTAI Y1
Dr-<..
STATE:
(Of<.
DESCRIBE WORK: ..:t::nSrnLL rJ-h a;.. u!r 1'1
NEW REMODEL ADDITION
.
JOB NUMBER
7'~/'sSI
225 Fifth Street
Springfield. Oregon 97477
~PR,(Jq.r,elc-J OR- g?cJt/
.
TAX LOT: t"!TeJ/ O/~
SUBDIVISION.
PHONE:_.!ll::J (~- :<'1- R-K
ZIP: q~(/~/7
DEMOLISH
/1011) FU/J1lOC'ff r:L H.I'nf PUn?O
OTHER
ADDRESS
CON ST.
CONTRACTOR .
EXPIRES ,;:. PHONE
CONTRACTOR.S NAME
GENERAl.
PLUMBING.
MECHANICAL: AS50C'If.ltM I-Ic.An~ d A!l'.
ELECTRICAl.
P.O,1OuX lY I;l.
>'~b. OjL q)<.JlIlJ
SlYl- (~k.{--,l<;qO
#: JO l.ol i S a-.'1 )-.,1tlOO
- OFFICE USE -
QUAD AREA- LAND USE: FLOOD PLAIN.
. OF BLDGS: _ . OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: . OF BDRMS.
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF. SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recordIng. Alllnspf3ctlons 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 Inspoctlon - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrical1
Mechanical - Prior to cover.
o 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 Underfloor Plumbing/Mechanical
- 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.
o Storm Sewor - Prior to filling
trench.
D Water Line - Prior to filling
trench. ... .
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
CQver.
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 Wall/C.elllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected bllt prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete. forms
and sub-base material In place.
D Fence - When completed.
D Street Trees - When all required
trees Bre planted.
D Final Plumbing - When all
plumbing w9rk is complet.e.
~al Electrical - When all
electrical work Is complete.
~ Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
J
Lot faces
L~t ~y~
Lot sq. flg.
Interior
Lot covQrage
Corner
Topography
Total height
Panhandle.
Cul.de-sac
BUILDING PERMIT.'
:, .~
ITEM
so. FT.
X $/SO. FT.
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fec
(A)
..,.t:'\::\:l
.
Setbacks
I P.L. HSE GAR ACC.
IN
Is
w
----
E
VALUE
.,
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
FT.
FT.
FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
, 7Jf'" 4s"
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, 0, and E Combined)
FEE
?J1h)
H~
/e>fP
;,:2.0
J .;lk,,;W
?h,~
IS THE PROPOSED WORK IN THE _
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER7
If yes, this application muat be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED.
. .,
BUILDING VALliE, 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
adopled by the City 01 Springfield. Including the
Development Code. regulating the construction and use of
buildings, and may be su_spended 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.
ADDITIONAL COMMENTS
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 perlalnlng to the work described
herein. and thaI 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.
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 allJ!7s during /rstructlon.
Signature ^ ~J%:' ~~
,
Date
/1-(- 9y
VALIDATION:
RECEIPT NUMBER
"'/9~~
/y~ /!'S
/~C, !!-
L/r~_
,
DATE PAID
AMOUNT RECEIVED
RECEIVED BY