HomeMy WebLinkAboutPermit Mechanical 1997-5-28
RESIDENTIAL
PERMIT APPLICATION
-.
SPRINGFIELD
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tt 7CJ630
JOB NUMBER
~ - "6 225 Fifth Street
.-.a... ~.fI Springfield, Oregon 97477
LOCATION OF PROPOSED WO~ 93q-1Jlf~1 GilrJ//w ()r
ASSESSORS MAP' ) I 0 1 7 ~ I -, TAX LOT: n 7- 20 I
OWNER: t Ju!i 6tli-f] y\. '
ADDRESS' ,- q 80 Msf -lZii-rv11AJJ
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DESCRIBE WORK' .q2t.-s
NEW REMfj.
Inspections: 726-3769
Ollice: 726-3759
LOT'
CITY:
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BLOCK'
Or
STATE: ~1'Je..
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CONTRACTOR'S NAME
GENERA' '
PLUMBING'
C -:MECHA'~I~A0...)~
ELECTRICAl'
ADDITION
DEMOLISH
SUBDIVISION'
PHON'"
7'16 ~ 263 '7
zIP:~r77
OTHER
ADDRESS
CONST,
CONTRACTOR'
'.~
EXPIRES
PHONE
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Servlco - 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 InsuJallon - Prior to
cover.
D Drywall - Prior to laplng,
D Wood Stovo - After Installation.
D Inserl - After fireplace approv81
and Installation of unit.
D
Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
- 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: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. Ttlls Is a 24 hour recording. AI/Inspections requested before 7:00 a.m. wIll be
made tho same. working day. Inspections requested after 7:00 a.m. will be made the following work day.
D Tomporary Eloctrlc
D Slto Inspection - To be made
after excavation, but prior to
setting forms.
D Undorslab Plumblngl Electricall
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 UndorUoor Plumblng/Mochanlcal
- Prior to Insulation or decking.
D Post and Boam - Prior to tloor
Insulation or decking.
o Floor Insula lion - Prior to
decking,
D Sanllary Sewer - Prior to tJ/llng
trench. ,
D Slorm Sewer - Prior 10 filling
trench.
D Walor Line - Prior to tilling
trench.
D Rough Plumbing - Prior to
cover.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
D Street Treos - When all required
trees are planted.
'~Flnal Plumbing - When all
~IUmblng wc;>rl< Is campJct,e.
D Final Electrical - When all
electrical work Is complete.
~lnal Mechanical - When all
~hanlcal work Is complete.
D Final Building - When all
required InspectIons have been
approved and building Is
completod.
~Othor~~
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MOBILE HOME INSPECTIONS
D Blocking and Sol-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,
I
,~
Lot facos
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':!; \....." ,.., '..;; ":.;./S ~~ "
Lot Type
, ' Setbacks, '
I PL. I HSE I GA;) ACC'
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W_ ----L-J
E . ~-.J
Lot sQ, ftg,
Interior
Lot Coverage
Corner
Topography
Total height
','
Panhandle
CUI-dc-sac
BUILDING PERMIT'
ITEM SQ, FT.
'I
'f
X $/SQ, FT, =
VALUE
Main
Garage
'.
Carport
Total Varue
Bui/ding Parmi I Fee
Stale Surcharge
Total Fee
(A)
I
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
FEE
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
TOlal Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust HOOd
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
IM.'ll./\.-
\ (;.!rt)
Mechanical Permit
Issuance
JIlJJIJ
,7<;
,'1Y'
d.0,~
State Surcharge
13'10 {.~ adU1f11
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
ft
Curbcul
Demolition
State Surcharge
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C, D, and E Combined)
2..0 ,:J. D
I
'; IS THE PROPOSED WORK IN THE,
'''''HISTOI;1ICAL: DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, Ihls application musl be signed
and approved by the Historical
. .Coordinator prior to permit Issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on. the express condition Ihalthe said
construction shall, In all respects, conform 10 the Ordinance
adopted by the City ,of Springfield, InClUding the
Development Code, regulaling the construction and use of
buildings, 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
Dale
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
I
I
ADDITIONAL COMMENTS
By signature, I otato and agree, that J have carefully examined
the completed application and do heraby oertlfy that all
Information hereon Is true and correct, and I further certify
thai any and all work performad ahall be done In accordance
with the Ordlnancua or tho City of Sprlngflold, and tho Laws
of the State of Oregon pertaining to tho work doacrlbod
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
prolect.
I further agreo to ensuro that all required Inspoctlons are
roquested at the propor tlmo"that oach addross Is rosdabla
from tho street, that the pormit oard Is locatod at tho (ront
of tho property, and the approved set of plens will romaln
on the g;jtlmeS{J?jdurln o.nstr,;/7
nature '1 _
e tJ: q;
(
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VALIDATION: ::!57's- /
RECEIPT NUMBi;R -,2,g- r17
DATE PAIl" &) ::..y )
AMOUNT RECEIVED -2ftz, _
RECEIVED BY vt.L--