HomeMy WebLinkAboutPermit Mechanical 1998-5-7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
.
SPRINGFIELD
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LOCATION OF PROPOSED WORK: ...31'L if
ASSESSORS MAP' I r ~ 1.- 0 ? J 1../
LOT'
J4:~
BLOCK:
OWNER' W~~ J-h:t<'-/-d/
ADDRESS" _S~"- /I-r../h4uU<--
CITY: .~j]K_
STAT'"
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DESCRIBE WORK:
7:ns'Ddl ?k'j' J-/":"i.t: ;'7?..-",,-o
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' .
PLUMBIN""
MECHANICAl .l!m,oL ~~",
ELECTRICA' '
QUAD AREA:
. OF BLDGS'
OCCY GROUP:
. OF STORIES: '
WATER HEATER:
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslsb 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.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to mllng
trench. ,
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover. .
ADDITION
DEMOLISH
OTHER
.
JOB NUMBER
1'r05? 7
225 Filth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:
fr()u
PHON'"
7+'1-7t..07
ZIP:
9?fQ ;(
ADDRESS
CONST.
CONTRACTOR'
EXPIRES .::> PHONE
7a ,t/SCi.V-
N/'L/
· OF UNITSNOTlCr. ZONING CODE:_
CONSTR. T-~", ~r-f.11IT "I..' \' , . . OF BDRMS'
"'n1~, - Of "'nJ\LL CAr-IRE IFTHE WORK
HEAT SOUF\%nl~I'llZEf: Ut-;DG'i T;iIS PERMIf,~~RY HEAT:
RANGE: _COMMENCED OR IS ADANDoNErJfflWE FOOTAGE:
It~'.' ;ov UJ; J r"CNJUU
To request an Inspection, you must call 726.3769, This Is a 24 hour recording. Alllnspecllons requested belore 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.
- OFFICE USE -
LAND USE:
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
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 approvlll
and Installation of unit.
D Curbcut & Approach - Alter
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is compiete. forms
and sub-base material In place.
D Fence - \Nhen cOiY'lpleted.
o Street Trees - When all required
trees are planted.
C/XJ7~
.5f1'S'-;2~ 'i(
FLOOD PLAIN'
D Final Plumbing - When all
plumbing work Is complete.
, ,
o Final Electrical - When all '
electrical work is complete.
~ Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved end building Is
completed.
o Other
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.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot ~ype.
Lot sq. Itg.
In'terior
Lot coverage
Corner
Topography
Total height
Panhandle \
Cul-de-sac
BUILDING PERMIT'J
,., 'y
ITEM
sa. FT.
x $/SO. FT. =
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
'". (J'~ \',;;:'\'
..
Setbacks
I P.L. 'HSE GAR' ACe"
N
I
W I
~---I
S
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s) N'
San i t ary S~wer
Water
FT.
II " _'rl
FT.
;. r I/o,: ,.
Storm Sewer
FT.
"..,
.'
Mobile Home,
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Slovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
'Mobile Home
State Issuance
State Surcharge
,
Sidewalk
It
9urbcut
Demolition
It
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrlcal)
(A, B, C. 0. and E Combined)
FEE
" -'
"
I:)
10
/fs .;.- ,7\~
2~.2. 0
IS THE PROPOSED WORK tN THE ..
'''HISTOI;IICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVFn.
., .!.... 't
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
adopled by the City ,of Springfield, Including the
Development Code, regulating 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 Fe'"
Date Paid:
Receipt Number;
Received By:
Plans Reviewed By
Date
Syslems Development Charge Is due.on all undeveloped
properlles within tho City limits which are being Improved.
ADDITIONAL COMMENTS
.. ,
.<,1.
" 0 YVI'
By signature, I state and agree, that I have carefully examined
Ihe completed application and do hereby certify that all
Information hereon is true and correct, and I further certify
thaI any and all work performed shall be done In accordance
with the Ordinances of lhe City of Springfield, and the Laws
of the Slate of Oregon pertaining to the work described
herein, and lhal 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 wllh 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 lhe 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 all times during const ction. ~
Signature ~~ ./ I
Date_<-- 7-q~
VALIDATION:
RECEIPT NUMBER Q 7- '1 7u "5
DATE PAIC' 5/ 7- I 7<{
AMOUNT RECEIVE~ ~~:-2 oJ
RECEIVED BY /) I f,JfMJ/
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