HomeMy WebLinkAboutPermit Mechanical 1999-6-11
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JOB NUMBER 9707fi7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
225 Fifth Street
Springfield, Oregon 97477
71'/7
1/
LOCATION OF PROPOSED WORK'
ASSESSORS MAP' /?O 262-
TAX LOT' (J2-oo
LOT' .
BLOCK:
SUBDIVISION:
bot>> \-\ R("r<..
ADORES'" f') ~ 41(. ~Ol~,Sl{ +1--. I A
CITY: ~ 0(.1., \ (\(}b' oOrl
PHONE: lfJ.\ b - );-()q .:J
OWNER:
OA.
ZIP: q 14 7'i5
STATE:
DESCRIBE WORK' .I115\ F\ lLAnClYl (} 1= )-\ 1 p
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR'
CONTRACTOR'S NAME
ADDRESS
EXPIRES "~ PHONE
GENERA' '
PLUMBING'
I?o 000)1, 41~
MECHANICAL:R:;s(\('I~A'\()(1QA!" Pl/7,n,ORQ7Ll<JO \kIOI..n<; !i'-31-JOaO (,Sl/I)b8,3-;J.S90
ELECTRICAL: TlJ'2 P=P.MIT~H^l:... ~rJ1lE :rTIi::'-i' '~ny.
MV I nvn'LC:U u,vuc:n I nl'::> ...~n~\!oI=\i3/;,,'dSE _
COMMENCED OR IS ABANDONED FOR ATTENTiON:Oregon law requires yoU IU
':'NY i60 D':'YPERIO/f.ND USE: lvl;v", ,,,,Ieo> acrepted by tf,b09,~!lll;f,\L~jl;+!'
. OF UNITS' Notification Center. Thosrz5~INiFcoD',f.orth
in OAR 952-001-0010 through OAR 952-UU1-
CONSTR. TYPE: ~(;. \\..", ",.:<y-ebtain coJfIt9.folfl!?f!~ei(,~ hy
HEAT SOURCE: callina the center. (NotSE86~lt\~'R~n'EAT:
number for the Oregon Utility Notltlcali'on
RANGE: - SG:'IteHs 1-800-::!~R;!~~~)fOOTAGE:__
QUAD AREA:
. OF BLDGS:
OCCY GROUP'
. OF STORIES'
WATER HEATER'
To request an Inspect/on, you must call 726.3769. Ttlls 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 (ollowlng work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Rough Mechanical - Prior to
cover.
o Final Plumbing - When all
plumbing w9rl< Is complet.e.
/?' D FIJ.I Electrical - When all
ctrlcal work Is complete.
O Site Inspoctlon - To be made
after excavation, but prior to
setting forms.
D Rough Electrical - P~lor to
cover.
D Under.lab Plumblng/Electrlcall
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After trenches are
excavated.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
o Framing - Prior to cover.
o Other
O Foundation - After forms are
erected but prior to concrete
placement.
o Wail/Ceiling Insulation - Prior to
cover.
o Undorground Plumbing - Prior
to ClUing trench.
D Drywall - Prior to tapIng.
MOBILE HOME INSPECTIONS
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Wood SloVO - After Installation.
o Blocking and Set.Up - When all
blockIng Is complete.
D Post and Beam - Prior to Cloor
Insulation or decking.
o Insert - After fireplace approval
and Installation of unit.
o Floor Insulation - Prior to
decking.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sanitary Sewer - PrIor to filling
trench.
o Electrical Connection - When
blocking, set.up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base mat~rlal In place.
o Storm Sewer - Prior to filling
trench.
o Fence - When COi-rlpleted.
o Water line - Prior to filling
trench.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
D Rough Plumbing - Prior to
cover.
D Street Treos - When all required
trees are planted. .
Lot faces
lot ~yp.
lot sq. flg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle "
Cul-de-sac
BUILDING PERMIT ',',
'& "~
ITEM
sa, FT.
X $/so. FT, =
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fcc
(A)
I PL.
IN
Is
_"Y.__
..L_ _
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
Storm Sewer
FT.
FT.
Mobile Home'
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
DrYr:e;:Jt /J
If r W'tw'K)
I
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
",
.'
State Surcharge
Total Mlscella.neous Permits (E)
TOTAL AMOUNT DUE (excluding clcc/rlcal)
(A, B. C, D, and E Combined)
FEE
/)',00
/,0 Ou
.'r[/7J
,
2( 7A
" " ::~.- t;.,.~.(:f..\(')
,\
il
Setbacks
HSE GAR Acc'l
I
I
'.'S THE PROPOSED WORK IN THE,
"'HIST08ICAl DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must 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 tho express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by thc City of Springfield, including the
Development Code, regulating the cons'truction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances,
Plan Check Fee:
Datc Paid:
Recei pt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within thc City limits which are being improved.
ADDITIONAL C~ME~TS ,j
EZ. CZ7/tiJ/ ~
I
I2tfHS
By signature, I state and 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
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
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 imes durl 9 on tru tlon.
::>0
VALIDATION:
RECEIPT NUMBER (j > Lf l( / L/
tI/1 Iff
, '2 t,,, II
AMOUNT RECEIVED Ii c..-v II
RECEIVED BY .(.(I CJv.../
DATE PAIl'