HomeMy WebLinkAboutPermit Mechanical 1999-9-8
RESIDENTIAL
PERMIT APPLICATION
..
.11'"" ,
Inspections: 726-3769
Ortlce: 726.3759
LOT'
SPRINGFIELD
BLOCK:
OWNER: _H A...l..!d E .( (b;~/}.J.. /I.. )j J tI t3:.p./ ~ R
ADDRESS" /.tj);.;j --2AU)A)RjDc;,~ jJl/~ _ '
CITY: .s PJe/ JJrSF/,::j /) . STATF' ' ' ~.A2..
,
DESCRIBE WORK'
I?t.tAJ /lJ)t?77/be... C/l.'5 V,UP- ;:.hJ~
,
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' .
PLUMBING:
MECHANIC' , .
)..{ / P~.L:E. Y '5
ELECTRICAl'
ADDITION
DEMOLISH
OTHER
-
99(:;.1 J ~
./
SUBDIVISION'
PHONF'
'l.J/7-&'47%'
ZIP'
CJ7'/7-7
EX.:SIS-r/,A)faA5 J./;{)p~
ADDRESS
CON ST.
CONTRACTOR .
EXPIRES ,~ PHONE
REQUIRED INSPECTIONS
D Rough MechanIcal""':' Prior to
cover.
D Rough Electrical - PrIor to
cover.
- OFFICE USE -
QUAD ARE'" LAND US". FLOOD PLAIN'
. OF BLDGS' . OF UNITF" ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES' HEAT SOURCE: SECONDARY HEAT'
WATER HEATER' RANGE: SQUARE FOOTAGE:
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 Undorground Plumbing - Prior
to filling trench.
D Underfloor PlumblnglMechanlcal
- 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 mUng
trench. .
o Water Line - Prior to filling
trench. .
D Rough Plumbing - 'Prior to
cover.
NtoI
~-asf
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 8.m. will be made the fOlloWing work day.
D Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab PlumblngrElectrlcalt
Mechanical - Prior to cover.
D Final Plumbing - When ell
plumbing w9rk Is complet.e.
D Final Electrical - When all
electrical work IS complete.
D Final Mechanical - When all
mechanical work Is complete.
D Electrical Service - Must be
approved to obtsln permanent
electrical power.
cP 7 D Final Building - When all
. Fireplace - Prior to facing required Inspections have been
materials and framing Insp. approved and building Is
645 f;""fJ~ completed.
D Framing - Prior to cover. @j~' cf'/fS ~
D Ot er r -f
D WallrCelllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
o Insert - Arter IIreplace approval
and Installation of unit.
D Curbcllt & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is completo, forms
and sub-base "1Rterlal In place.
o Fence - \-Vhen cOfi'lpleted.
D Street Trees - When all required
trees are planted. .
MOBilE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - ~hen
homo 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.
D Final - After all required'
Inspections are approved and
porches, skirting, decks, and
venting- have been Installed.
(
Lol faces
~t~
Lot sq. flg.
Interior
Lot coverage
Corner
Topography
Total height
';,
Panhandle
Cul.de'sac
I PL.
IN
\S
~~-]-
BUILDING PERMIT" ,;it
ITEM sa. FT. x S/SO. FT. = VALUE
Main
Garage
Carport
Tolal Value
Building Permit Fee
State ~urcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanllary S~wer
Water
N'
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permll
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
Wood Stovellnsert/~Iace ~
Dh~ent /M1/ '&~
I ,
Mechanical Permit
Issuance
State Surcharge
Total Permll
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
'fl
Curbcut
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E <?omblned)
"
FEE
Ic (j J
/ o. Q ,)
/.}/
2,( .rb
, -: : '..: ft: '~:',i::i..\:;
dHEPROPOSED WORK IN THE.
'...HISTORICAL DISTRICT, OR ON
. THE HISTORICAL REGISTER?'
II yes, this applloatlon must be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
Setbacks .
HSEIGAR
i
Accl
I
I
I
I
APPROVEI"
,
BUILDING VALtJE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, 01 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 Fee:
Date Paid:
Receipt Numb~r'
Received By:
Plans 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 application 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 Sprlngrleld, 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 OAS 701.055 will be used on this
prolec!.
I further agree 10 ensure that all required Inspections are
requested allhe proper lime, 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~)tlmes during con~tryctlon. /)
'Slgnature (j;fl ~ ~/h/ A>>
9'-%-9'9
Date
VALIDATION:
RECEIPT NUMBE~ IJ3 'i'c.f (" r
DATE PAID 'f 1'6 (., '7
AMOUNT RECEIVED /1 LbIJS6
RECEIVED BY ?Y fA) ,..Y