HomeMy WebLinkAboutPermit Mechanical 1997-9-30
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LOCATION OF PROPOSED WORK' if.~ "if n ~ ~~Jr I?J.
ASSESSORS MAP' /R--L:>'2 -<> 5', '< "r" '
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT:
.
SPRINGFIELD
I."
BLOCK'
OWNER:~k IlJO-C- &fiA
ADDRF'"'' 4'~\?'O "'7;;...4>ef' R n1
CITY:C<'C.JM....W V
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STATE: -i!)j2.
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JOB NUMBER _9 .::,/.y~
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT' a6 BaD
SUBDIVISION'
PHONE:
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ZIP'
DESCRIBE WORK: 1::-.kr ,zL.dc! ,');/ ..!:irlJC{"/ '., />odd /),.0... ) .../) r /I nor ~ .
NEW REMODEL ADDITION DEMOLISH OTHER 0/k~ ;I;;rl1....c..P --' -c:.~
CONTRACTOR'S NAME CONST.
ADDRESS CONTRACTOR . EXPIRES .", PHONE
GENERA' '
PLUMBING'
MECHANICAl'
,/Afi --r ~r/
ELECTRICAl'
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- OFFICE USE -
QUAD AREA: LAND UP'" 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 requesl 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, Inspections requested ofter 7:00 a.m. will be made the following work day.
REQUIRED INSpECTIONS
o Temporary Electric
o Site Inspection - To be made
. after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundotlon - After forms are
erected but prior to concrete '
f)lacemont.
o Underground Plumbing - Prior
to filling trench,
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam - Prlorto floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to filling
trench,
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench, " .
D Rough Plumbing -:- Prlodo
cover.
[Xl Rough Mechanlcal'- Prior to
?! ~~,,#~
D Rough ElectrIcal ~ Prior to
cover.
io
o Electrical Service':'" Must be
approved to obtain: permanent
electrical power,
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
D Wail/Ceiling In.ulotlon - Prior to
cover.
o Drywall - Prior to' taping,
o Wood Stovo - After Installation.
D Insert - After fireplace approvel
and Installation of unit,
o Curbcut & Approach - After .
forms are erected but prior to
placemont of concrete.
o Sidewalk & Drlvewav - After
excavation Is complete, forms
and sub.base material In place.
o Fence - VVhen COI"l'lpleted.
o Street Trees - When all rOQulred
trees are planted.
o Final Plumbing - When all
plumbing w9rl< is complete,
o Final Electrical - When all
electrical work Is complete.
[X] Final Mechanical - When all
,/ /;;'~o~~ete.
o Flnel Building - When all
required Inspections have been
approved and building Is
completed.
ILl Oiher ~~~v...e-".E"
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connoctlons - When
home has been connected to
water and sewer.
o Electrical Connecllon - 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
porchos, aklrtlng, decks, and
venting have been Installed.
Lot facas
Lot sq: Itg.
Lot coverage
Topography
Total height
BUILDING PERMIT'
ITEM SO. FT,
Main
.~
.-:" i.J
Garage' ' "-,
, ,
Carport
Total Value
Building Permll Fee
Stale Surcharge
Tolal Fee
~t~
Interior
Corner
Panhandle ','
Cul.de.sac
'1
X S/SO. FT. =
(A)
~,
-: 'i "
'.
.. .
", ':.. . ~.: .:. ,-: .:.~.
'\". . ,. " 'I ~ ~ : t/l.:. ',. ~ ~ i
,." '.,,':"
1,1.,
~ IS THE PROPOSED WORK IN THE,
'...HISTORICAL DISmICT, OR ON
THE HISTORICAL REGISTER?
If yes, lhls application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks '
I P.L I HSE GAR A{:C I
I N I
Is
W
, E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Watar
Slorm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan ,..
N'
FT,
FT,
FT.
(C)
Wood Stove/lnserl/Flreplace Unit
N'
.DrY~ent ~
/~~ ./'4zS~/~E"
~/... -:-":~~'
/-5: --=
/&J,-
~ ~~,.:-~
(D) ~ ,~.-:2.~
MISCELLANEOUS PERMITS
Mechanical Perml t
Issuance
Stale Surcharge
Total Permit
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcul
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
---..;
I
1----
APPROVED: .
. ). . .,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition Ihat .lhe said
construction shall, In all respects, conform to the Ordinance
adopted by the City, of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number:
Received By:
.
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properlles within the City limits which are being Improved,
ADDITIONAL COMMENTS
"
By signature. I stale and agree, lhat I have carefully examined
the completed application and do hereby certify Ihat all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordanca
with the Ordinances of the City of Springfield. and the Laws
of the State of Oregon perlalnlng to the work described
herein, and thai NO OCCUPANCY will be made of any
structure without permission of lhe Building Safely Division.
I further certify thai only eonlractors and employees who
are In compliance with ORS 701,055 will be used on this
project.
I further agree to ensure that a required Inspections are
requested at the proper time, t teach eddress Is readsble
from the street, that the perm t card la located at the front
of the property, and the a p ved set of plans will remain
on the site at al m s d r ng construction.
Signature
Oat".
VALIDATION:
"l.
RECEIPT NUMBER 2"?~5
"'?- ~-S --:::>
AMOUNT RECEIVEn, --:::<6.-;;;>-
RECEIVED BY ~rr:.-"'t..--
--
DATE PAID