HomeMy WebLinkAboutPermit Mechanical 1999-4-3
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
ASSESSORS MAP'
LOT'
OWNER:
CITY'
DESCRIBE WORK'
NEW
REMOOEL
CONTRACTOR'S NAME
GENERA' .
.
SPRINGFIELD
.
fCfo V'lf,
BLOCK:
STATE' '
Dr
JOB NUMBER
225 Filth Street
Sprlnglleld, Oregon 97477
TAX LOT:
SUBDIVISION'
()O 305
AOOITION
DEMOLISH
OTHER
PHONF'
7 </7 ();7 9L
ZIP,
.97~ 77
ADDRESS
CONST.
CONTRACTOR #
EXPIRES '-' PHONE
RANGF'
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough ElectrIcal - Prior to
cover.
o Electrical Service - Must be
. approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
D Wall/C'ellln9 Insulation. - Prl~lr to
cover. .
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
o Insert - After fireplace approvel
and Installation of unit.
o CurbclOt & Approach - After
. forms are erected but prior to
placement of concrete.
D Sidewalk & DrIveway - After
excavation Is complete, forms
and sub-base material In place.
D Fence - \Nhen cOfi1pleted.
D Street Trees - When air requIred
trees are planted.
PLUMBING'
MECHANICAL; GaribaiUJe.. 't il'lj ~'}'b7 tV ~ ~. '17~() 2.. #7~S"~.r I~ ft ~I'Y~/
ELECTRICAi ',~==~I~:}~::O.~",,,:,, ;u':''''YUII''''' yuu TO ." Ii ~ "II, Isrr.f
NOtifi~aii~~-C;~t;r:Th~~~~~I~~"'~r~~~?fJlffE USE -
QUAD AREA: In OAR 952-001-0010 throu~N'clruSF.?-OOl-
vv"u. TOU may ootain copies of the rules by
# OF BLDGS: ""lIin') tho ~O~'M (Note' #tOF.,,41NljI''''
- --.. . l Iv t::;;II;:~"" IVII'C'
OCCY GROUP: numberforthe O~egon Ut;CO'NSY.Ri~T_?i1E:_
l,;enIer IS 1-800-332-2344).
HEAT SOURCE:
FLOOO PLAIN'
/1/1"1.,.,,,
, ..E:ZONING COOE:
-r::qMrr ~J.4BORMS:
" II <:x.o,I'>_
"l"rSECOfllo'ARyrHEilT:". ..
. "vIJ~r;.'1". -, r'le: VVo
/-//0,,_- RI(
SOUARE FOOTAGE:I'~ ,
'HVr 18t'l/).... ~A^/,",...... -. 'I '0:- .\'01"
. ., r-~Hlnn - --, wc:u t:,,~
To requesl an Inspection, you must call 726,3769. This Is a 24 hour recording. All Inspections (equested 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 Final Plumbing - When all
plumbing w9rk Is complet.e.
D Final Electrical - When all
electrical work Is complete.
~ Final Mechanlcal- When all
mechanical work 15 complete.
o Final Building - When all
required Inspections have been
approved end building Is
completed.
DOther
MOBILE HOME INSPECTIONS
o 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
Inspeclions 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.
(-
# OF STORIES:
WATER HEATER:'
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o UndersJab Plumblng/Electrlcall
Mechanical - Prior to cover. .
o Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
o 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. . .
o Floor Insulation - Prior to
decking, ,
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. '.
D Water Line"': Prior to filling
trench.
D Rough Plumbing - Prior. to
cover.
Lot faces
.
Lol Type
Lot sq, ltg,
Interior
Lot coverage
Corner
Topography
\'
Panhandle'
Total height
Cul,de,sac
BUILDING PERMIT'
ITEM SO. FT,
"
'.
X $/SO, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fec
(A)
, ' SYSTEMS DEVELOPMENT, 'CHARG~,(SDC)
I P,L.
IN
Is
w
E
VALUE
"
(B)
PLUMBING PERMIT
ITEM FEE
Fixtures
Residential Bath(s) N'
Sanitary S~wer FT,
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge (e)
MECHANICAL PERMIT
Furnace
Exhaust Hood ,
Vent Fan N'
Wood Stove/Insert/Fireplace Unit
Drw V'7"
I~ f} ,AftWJ
, f
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E CO,mblned)
/Loo
II), /)v
'fr/. 7(
ie, 'UI
1,',"
, " .,;" '>j': ;,.,~: '~ :
,;: "
.HE.PROPOSED WORK IN THE.
....HISTOI;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcallon must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
Setbacks
I I I I
HSE GAR ACC
ApPROVEO'
BUILDING VAU!1E, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction sliall. In all respects, conform to the Ordinance
adopted by the CI.ty 01 'Springfield, Including the
Development Code, regulating the construction and use of
oulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Recei pt Number
Received By:
Plans Reviewed By
Date
.Systems Development Charge.ls due'ori all undeveloped
properties wlthln'the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed appllcallon and do hereby cerllfy 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 Ordinanc~s 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 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 10 ensure that all required Inspections are
requested at the proper time, that each,eddre88 18 readabl8
from the etreet, that the pormlt oard I. looatod at 11'1. fronl
of the property, and the appr set of plans will remain
on the site at all lIm du nstrucllon.
,
Signature
Date
~/9~
rJ?;, ) 'I z. 7-
()4....9.~::---.'f'7
DATE PAID <./ h /7'1
AMOUNT RECEIVED' l-/;5
RECEIVEO BY J ~
VALIDATION:
RECEIPT NUMBER