HomeMy WebLinkAboutPermit Mechanical 1998-3-10
-:S...c ~ <:. -\ a ~ lc
n "S- LA oN "" .. ;J..c; e-
~
S f ~ STATE: _() (L .
DESCRIBE WORK: .-~ \ ~
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
OHlce: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP' I { () ::,
LOT'
; ,
'(';
j'
OWNER:
ADDRESS:
~,
CITY'
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' .
PLUMBING'
MECHANICAl'
- ZIP: Q7'f 1-7
(-r~ .,jQr~_~~\
-d- "..... ,^f":.r <r t-\ -ca. i e ;... . .
OTHER ^,,..,. ~ (;t14 S pri! I~ c...
o
.
SPRINGFIELD
.
JOB NUMBER 98 0 J.. 'is'<i''
~w."... (",~~~
':2 J-
,
BLOCK'
r:..a-!1
r::: r (' f lAte-
i""te{1""
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:
nSLf.O(j
ADDITION
DEMOLISH
PHON~'
- ...~..
CONST.
CONTRACTOR .
EXPIRES .::,> PHONE
.
.
LAND USF'
ADDRESS
V'r\.M~Wt.l\'.t \-t""U-r.'v-J- \.flU) CJl"'iM(:L
CCa.....2..-S-iq{) '/\.{i-7<r!/,J"
I 2.. I-..A 14 '^
- OFFICE USE -
eb[CI"1XI18M'
QUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
, '
,
S '" Cr.J.
q'/ ~7~
sh
FLOOD PLAIN:
. OF UNITS' NOTICE: ZONING CODE:_
~ONSTR. TyplHIS PERMIT SHALL EXPIRE If J~EB't}'~~~:
AUTHORIZED UNDER THIS PERMIT IS NOT
HEAT SOURCE:' SE;,CO..N.OARY HEAT:
COMMENCED OR IS ABANDONED I-UH
RANGE: _ SQUARE FOOTAGE:
ANV 1 (In nt\V PF.AIOU.
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.
REQUIRED INSPECTIONS
D Temporary Electric
D Site Inspection - To be mado .
after excavation, but prior to .
setting forms.
D Underslab Plumblng/Electrlcalt
Mechanical - Prior to cover.
D Footing - After Irenches 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 Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking. I
,
I.
D Floor;ln"suhiUori._1 Prldr te ". \. ~ "
decKing. '. '.
"\,..
.,
D Sanitary Sewer - Prior to tilling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D WalltCelllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvlll
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D SIdewalk & Driveway - After
excavation 15 complete. forms
and sub.base material In place.
D Fence - When completed.
D Street Trees - When all requIred
trees are planted.
D Final Plumbing - When all
plumbing work Is complete.
. ,
D Final Electrical - When all
electrical work Is complete.
~MechDnlc81 - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
G:j'6iher '-.-A-=> ~
MOBILE HOME INSPECTIONS
D 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
Inspecllons 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."
Lot faces
lot sq. flg.
Lot coverage
Topography
Total height
,
BUILDING PERMIT
ITEM sa. FT.
Main
Garage
Carpqr(
, '
....';.. ,)'.J.
7:",,:,
J~\ ' ., '..
. ". ~ (:
.~ I...
'-' .
. T6tal Yal ue
Building Permit Fee
State Surcharge
Total Fee
lot Typee
Interior
Corner
'f
Panhandle
Setbacks
I PL. I HSE GAR
I N I
I S I
I. I
I;'l
Cul.de.sac .'
X $/SO. FT. ~
.J,
, .
\ .:
"f
VALUE
"
'.
,- ~ .
(A)
, \ ',.
SYSTEM~ DEVE~OPMENT CI;!ARGE (SDC)
, ' ,
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
, (B)'.
,:' iJ'.' .-ij-iT :,
N'
Sanitary S~wer
Water
, FT.
'fl, ~'I-:', tJf,'1 ;'~ ...~
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
i' .:.',1".'.
FT.
(C)
Dryer Vent
Wood StovellnserttFlreplace Unit
N'
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
FEE
,
,.
..'.
jl. I; l . ,r', '/ ~ VI oj,
.$ I~, ~
fID.-
.7S-l.If)
~!O. 0<>
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
.
1\'1'
,=.,,,,
',,'
",
'IS THE PROPOSED WORK IN THE,
''''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Accl
I
I
I.,.
I
" APPROVED:
. .., , '/
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permH,~~ gr?'1.ted'on the express: condition that the said
constructlbn'shall, In-all respects, conform to the Ordinance
adopted. ,by the City' of SPringfield, Including the
Oevelopment'Code, regulating the construction and use of
buildings, and may be suspendecFor revoked at any time
upon violation of any provisions of sa"ld ordinances.
"
. Plan Check Fee:
.....~ '.... .. I .
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
. .
SystemS.Developmc~t Charge 15 'due on all undeveloped
properties withIn the City limits which are betng Improved.
. ~". , .. ~,-
- .
, . : J\DDITIONAL COMMENTS
\J,(\~~ (Sf- S;i1n
h
f ~ 3 Y}' GD
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 or Springfield, and the laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made or 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 Inspections are
requested at the proper time, that each address Is readable
from the street, th~t the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all fm:s during constructl:?n.
Signature ~.iP.. II ^ ~~
U 3> -I O...q<6
Dat~
VALIDATION:
RECEIPT NUMBER 8.. '1 O~ '7
3~16 -'7<t
AMOUNT RECEIVEI' {pd-fo. ')-()
c?\W
DATE PAin,
RECEIVED BY