HomeMy WebLinkAboutPermit Mechanical 1999-9-2
577/
LOCATION OF PROPOSED WORK: S'7 ~ I
ASSESSORS MAP' ! 00 ')-- OL/ / 4-
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
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DESCRIBE lM?RK:.. ' o/'J:.W7 e,,~;'Jl' 01 the> .t;t;ep;-f- f"'lA.wt,o
""8 ."" ''''mer. (Note: the 1~1~ h . ....,
NEW num~EModEl?r,,~i'~n 'ADDITI6~P one DEMOLISH
. C'onf,....:_ ......;J...-~ _~~~lllY hwll!Jcatl:""....r.
CONTRACTOR'S NAME
GENERA' .
PLUMBING'
MECHANICA' .
ELECTRICA' .
f1,c.' W-'S+
IN: ~ Ale.. - C},,,,dc.. 1-Ju\<Y<>
e."...
JOB NUMBER !J!li.:?-(j S
225 Fifth Street
Springfield, Oregon 97477
$',o-f-(cf.
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TAX LOT:
SUBDIVISION:
NnTI~~' '-rzJo / f? 9'-
THIS PFl=lnArr E' I"J L -
CP JWTHORI7~;"" t:J\/"IM0?fiWoRK
r.OM^ ~IO^'Z- _. E!i'rrFII'WI:HMITI~ W'T
ANY 180 nA~~;;:~;/:jANDONED FOR
OTHER
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,
o FIreplace - Prior to facing
materials and framing Insp,
o Framing - Prior to cover,
o Wail/Ceiling Insulation - Prior to
cover,
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approv~1
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
o ;Street Trees - .When all required
trees are planted,
ADDRESS
CONST
CONTRACTOR'
EXPIRES ,'"' PHONE
1/70</5
9-CiOO
-;7 7"4> S-.2~ <:
STATE:
"U1l.
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
· OF BLDGS' . OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
.. OF STORIES: HEAT SOURCE: SECONIJARY HEAT:
WATER HEATER' RANG~' SQUARE FOOTAGE: _
To request 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 after 7:00 a,m. wIll be made the following work day,
o Temporary Electric
o Site Inspection - To be made
after excavation., but prior to
setting forms.
D UndersJab Plumblng/Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Ste!>I.locatlon, bond
beams. grou~~ng."
o Fo'undatlon .:.... After forms are
erected but prior to 'concrete
placement.
o Underground PIJmblng - Prior
to IIIl1ng trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer;-- Prior to filling
trench.
o Storm Sewer - Prior to Wllng
trench. .
o Water Line - Prior to filling
trench,
hr
o Rough Plumbing - Prior to
cover. '
,
,
.,
o Final Plumbing - When all
plumbing. w9rl< Is complet.e.
~
L~:::r t"lnal Electrical - When all
electrical work Is complete.
/
L::::::r r-inal Mechanical - When all
mechanIcal work Is complete.
o Final Building - When all
. required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Se',Up - When all
blocking Is complete,
o Plumbing Connections - When
home has been connected to
water and sewer,
o 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, sklrtlng, decks, and
venting have been Installed.
I
Lot faces
LOI ~yp.
Lot sq. Itg.
Interior
Lot coverage
Corner
Panhandle t'
Topography
Total height
Cul.de.sac
BUILDING PERMIT "I
..~ 'y
ITEM
sa. FT.
X $/SQ. FT.
Main
Garage
Carport
Tolal Value
Building Permit Fee
State Surcharge
Total Fee
(A)
;., ;;'.,,'
, .
, .
, ,,',~ ~::? ~;,: ~~.~',::"~~ ~ .'
as THE PROPOSED WORK'tN THE., .
--HISTOI:lICAL DISTRICT, OR ON
THE HISlORICAI. REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance,
Setbacks .
I P.L. HSE GAR ACC'[
I N I
I S I
w
----
E
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsertl
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permi ts (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
--;,..
/5,U--o
/ () . ()LJ
/,5'0
U,SO
APPROVED'
.1 ". ~,
BUILDlr;l'G VALOE, ~LAN CHECK
AND BUILDING PERMIT
This permit is granled on the express condition that the said
constructlon shall, In all respects, conform to the Ordinance
adopted by the City .of Springfield, Including the
Development Code, regulating the construct/on and use of
ouildings, 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
Date
Syslel(1s Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully 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 per!9rmed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of Ihe Slate of Oregon perlalnlng 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 to ensure that all required Inspectlons 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 a(jC1all. t es during construction.
Signature --;-; (,V],f1
C F
Date
9-3- qq
VALIDATION: E::::Y., ~C;~
RECEIPT NUMBER 7 ~ - 03Sc...;)u
DATE PAID q ~ ;::)11
AMOUNT RECEIVED ') ~ .SO
RECEIVED BY /J ,muLA cz. {r"
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