HomeMy WebLinkAboutPermit Mechanical 1997-6-18
.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ollice: 726.3759
LOCATION OF ~ROPO~ED W~i<' 2/ j()
ASSESSORS MAP' I 7 O:)~ -; J () .
LOT'
OWNER'
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ADDRF~e.
CITY:
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BLOCK'
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STATE:
".4'.-E.4-r
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DESCRIBE WORK' ,/ .JrJ< 7.4 eLL }O.-(..-
NEW / -- REMODEL ADDITION
CONTRACTOR'S NAME
GENERA" ):)'!;t.TA-T
PLUMBIN'"
MECHANICAl'
ELECTRICA' .
DEMOLISH
OTHER
· JOB NUMBER:tz;2f f(?_
225 Fifth Streel
Springfield, Oregon 97477
22C:-
TAX LOT: 61;C//lt)
SUBDIVISION'
PHONE:
91./7-
=2.~~J'"..'
ZIP'
9"7 .....:;;1-:;1-
A
!~
ADDRESS
;:>O,/~Oy //C; ~ L
CONST.
CONTRACTOR' EXPIRES ':'7> "PHONE
EU~A/.c. c;>o~J?OC9 /,//O/,/.~
9t?e:-- C/Os
- OFFICE USE -
QUAD AREA' LAND U'"'' FLOOD PLAIN:
. OF BLDGS' . OF UNITS: ZONING CODE:_
OCCY GROUP' CONSTR, TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HE"'TER' RANG'" SQUARE FOOTAGE:
To request an Inspection, you must call 726,3769, This Is a 24 hour recording, Alllnspecllons requested before 7:00 a,m, will be
made the same working day. Inspections requested after 7:00 a.m, wlff be made the following work day.
~EQUIRED INSPECTIONS
; R~U9h MechanIcal - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Temporary ElectrIc
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel looatlon, bond
.beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
o Post and 8eam - Prior to floor
Insulation or decking. .
~. . ':....... '.
i'
!
o Floor Insulation - Pr~o.r to
decking,
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
.trench.
O Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power,
o Fireplace - Prior to lacing
materials and framing Insp.
o Fr~mtng - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover. ,
o Drywall - Prior to taping,
o Wood Stovo - After Installation.
. ..
,-"'0 Insert - Aft~r fireplace approve!
- and Installation 01 unit,
" ,
O-Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - Alter
excavation Is compieto, forms
and sub.base material In place.
D Fence - VVhen c~mPleted.
o Street Trees - Whun all required
trees are planted.
o
Final Plumbing - When all
plumbing wC;HI< Is complel,c.
D Final Eloctrlcal - When all
electrical work Is complote.
.401 Moohonlcal - Whon all
~echanlcal 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 Set,Up - When all
blocking Is complete.
o
Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blooklng, sel,up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - Aiter all required
InspectIons are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot Type.
Interior
Lol sq, ltg,
Lot coverage
Corner
Panhandle Y
Topography
Total heigh I
.Cul-de-sac
.BUILDING PERMIT:I; ',il
ITEM SQ, FT, X $/SQ, FT, _
Main
Ga'rago\ ~
Carport
, - '-c, "
Total Value
Building Permit Fee
State Surcharge
TOlal Fee:
. ',- ,,~ ~. . .
(A)
',.:.
~.; ": . ';r':";<~';( .; :~.,;;~~~l}r~.~'.-/.'
Selbacks .
._ THE PROPOSED WORK. iN THE,
..'.'HISTO;:lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
if yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I PL,
IN
Is
Iw
IE
VALUE
"
...' '.
'. -,.... \ -',
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FIxtures
Residential Bath(s)
Sanitary S~wer
Water
N'
FT.
FT.
FT.
Storm Sower
MObile Home
Plumbing Permit
State' Surcharge
TOlal Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
/41LVL--
Mechanical Permit
Issuance
Slale Surcharge t ~ '~7 AdfMT/t1
Tolal Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
II
Curbcut
Demolition
State Surcharge
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electr'cai)
CA, B, C, 0, and E Combined)
FEE
IS /JI)
II) (j{)
, 1f4'
, .
:J1'1 :J-O
20 JU
HSE GAR Ace'l
I
I
I
I
,'.j .~,.. q",
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
APPROVED:
I'
"'.
This permit Is granted on the express condition that the said
construction shall, In all respects, conform tOlthe Ordinance
\.. ," - .' '" \
adopted~by'the City ,of Springfield, Including the
Development COde,regulating theccinstructlon and use of
buildings, and may be suspended or revoked at any time
upon violation of any.provlslons of said ordinances.
Plan Check Fee:
-' ...... ,. .....,
, Date pilid: .
\. .,'....
Receipt Number'
Received By:
. /,
I
", -,
.-, \~. \
Plan.s Reviewed By
Date
Systems 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 applloatlon 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 the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
J further certify that only contractors and employees who
are In compllanoe wllh ORS 701.055 will be used on this
project.
I further agree 10 ensuro that all required Inspections are
requested at the proper time, ~hat 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 all times during construction.
Signature ~ /":5'"~ M'?~
I ' - I
Date ( C - r6'- 7>9
(
VALIDATION:
RECEIPT NUMBER ,) ~f21 ~
(r I fl;- c;7
AMOUNT RECEIVED :J b:,21)
RECEIVED BY \~ ~
DATE PAID
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