HomeMy WebLinkAboutPermit Mechanical 1999-6-18
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORi'"
i7 6 '3
ASSESSORS MAP'
LOT'
CITY'
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' .
PLUMBING:
ADDITION
.
SPRINGFIELD
~~
(p z- q vV e...,t-
cJ. '7 '-f;)-
.
JOB NUMBER .2..2t2W:2
225 Filth Streel
Springfield. Oregon 97477
'fVJV'"\J\'e.w &r I
BLOCK:
STATE:
~e...,
OWNER: Ue.Dvu.>J U{'YV\:",OJo,.)
ADDRESS' G, z.q l.Je...t:.+ -C:...kV~e.vV tJ..1{'.
~p\""\ N'jI: ~ ,,\A
DESCRIBE WORK' C-o^-luu+-I.. E./e.c..-h ic.. ,c )'{"Ivo..c..f' .J-o
,
DEMOLISH
OTHER
'5p~J... De.. q 7477
()d- 30 (
TAX LOT'
SUBDIVISION: _
PHONE: i~<l \) 741.r &1&0
_ ZIP:
07477___
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AODRESS
CONST.
CONTRACTOR #
EXPIRES .." PHONE
MECHANICAl'
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I
ELECTRICA' '
QUAO AREA:
. OF BLDGS:
OCCY GROUP:
. OF STORIES: ____
WATER HEATER'
- OFFICE USE -
LANO USE: _'_
. OF UNITS:
CONSTR. TYPE: _
HEAT SOURCE:
RANGF'
FLOOD PLAIN:
ZONING CODE:__
. OF BDRMS:
SECONllAFlY HEAl'
SQUARE FOOTAGE: __
To rOQuest 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. Inspectlons requested after 7:00 a.m. will be made the following work day.
D Temporary Electric
D Silo Inspocllon - To be mado
after excavation, but prior to
seltlng forms.
D Underslab Plumblng/Electrlcal/
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 do~klng. .
1/ ( '\.
o Floor Insulation - Prior to
decking, ,
\ '.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewor - Prior to filling
trench.
o Wolor I.lno - Prior IQ filling
trench. ,
,
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mochanlcal - Prior to
cover.
D Rough Eloctrlcnl - Prior to
CQver.
D Electrical Service - Must be
approved to obtain permanent
olectrlcal power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/C'olllng Insulation - Prior to
cover.
D. Drywafl - Prior to taping,
D Wood Stovo - After Installotlon.
D Insort - After fireplace approvlSl
and Installation of unll.
o Curbcllt & Approach - After
.. forms are emcted but prior to
placement of concrete.
o Sidewalk & Driveway - Aller
excavation Is complete, forms
and sub.base materIal In placo.
o Fongo - WhOn r.OmpIOIOd,
D Street Trees - When all required
trees are planted.
D Final Plumbing - When 011
plumbing W~HI< Is complet.c.
D FInal Electrical - When all
electrical work Is complcle.
~ Final Mechanical - Whon all
~meChanlcal work Is complete.
D Final Building - When all
reQuired Inspections have been
approved and building is
completod.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Sot. Up - When all
blockln{J Is complete.
D Plumbing Connoctlons - When
homo has been connected to
water and sewer.
D Electrical Connection - When
blocking. sel.up, and plumbing
Inspecllons have been approved
and the homo Is connected 10
the service panel.
D Flnsl - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
..
lot faces
lOI TY.
Interior
;.,': :. ,i ::~
.'
.IS THE PROPOSEO WORK iN 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.
lot sq, ltg,
lot coverage
Setbacks
r P.L -;:;~~F~; Ac"'Z1
E.___...I' I
S I
RECEIPT NUMBER .~ 4-<:::;2 d
'_..'.n...._.. DATE PAID -_._--#.L~/ '7 5 nC.~_.._..___..__
'7/ '20 AMOUNT RECEIVED 26 ?o
TOTAL AMOUNT DUE (excluding electrical) ~ ' .4'~.
(A, B, C. D. and E Combined) _n___ _.RECEIVED BY __'..._..__.._~.,; ",~
Corner
Topography
\To.t~1 height
Panhandle
Cul~de.saG
_'I/I!...-:- ..:.- J
,E ...,..,_,
BUILDING PERMIT I
"
ITEM
SO. FT,
X $/50. FT.
VALUE
Main
,
Garage
"
Carport I'
I '
c
,
TOlal'Value
Bulldl"O Parmlt Fao
BIIIIO Surr.horoo
Total Foc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
, , 1.....; l- . ,
(B)
,
PLUMBING PERMIT
'TEM
FE!"
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
FT,
Storm Sower
FT,
Mobile Home
PlumbIng Permit
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace 1l9V'~
/).?~
Exhaust Hoarj
/
/
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
/ C; f}-O
--/. {) ,tJ'V
__l.!..~_
7-6 ,?-O
Issuance
Stale Surcharge I 7f' r,fS
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stato Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
Tolal Mlscollaneous Permits
(E)
-"---1 '\
APPROVED: ......:.___,
.,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This parmi! is granted on tho express condillon that the said
construction shall, In all respects. conform to lhe Ordinance
adoplodby the Clly of Springfield, Including the
Development Co~de, regulating the construction and use of
ouildlngs, and may be, suspen,ded or ',evoked at any time
upon violation of any provlr;ions of said Qrdinances.
Plan Check Fee:
.'
Onlo Pal<l;
Receipt Nurnbcr:__.._._
Recel ved By:
PInna Huvlowod IJV
Onto
Syste",!s Developmenl Charge Is due on all undeveloped
properties within the City limBs which are being improved.
- I
.!, .' ..
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Informatlon 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 wllhout pormission or tho Building Safely Division.
I further certify IIlat only contractors and employees who
arc In compliance with GRS 701.055 wlH 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 tho street, that the permit card Is located at the fronl
ot the property. and the approved set of plans will remain
on the sit~m~~ynstructlon.
Signature ~ rt)J\\ ~
Date
(17 - J <:f;- CZ5-
VALIDATION: