HomeMy WebLinkAboutPermit Mechanical 1998-6-30
.
RESIDENTIAL
PERMIT APPLICATION
Inspecllons: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: hfo
/7/J32. 7 t.f '2-
ASSESSORS MAP'
LOT:
BLOCK:
Sk.I (LV I N
LJ Fn..l fL.\! I .=..L)
OWNER: 30 h "'-
ADDRESS' I" 9of:)
CITY: ,c.f/
DESCRIBE WORK' ; N " ~
STAT'"
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NEW
REMODEL
AODITION
DEMOLISH
OTHER
.:
JOB NUMBER
9'to 7;}
225 Filth Slreel
Springfield. Oregon 97477
TAX LOT'
SUBDIVISION'
1J0 20tJ
PHON'"
9W 9)o.~
ZIP'
~ LJ~/ ~
ADDRESS
CONST,
CONTRACTOR'
EXPIRES .", PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAl' :\" b '^-'^- LC)j~
"70 '-f 0'\
ELECTRICAl'
- OFFICE USE -
QUAD AREA:
. OF BLDGS:
r.'-OTICE:
"I"~. . OF UNITS:
Ill" r<:nM/T SHALL F=lfP
\V-, /", C1iI'SS~.&lErlfp1I:iE.WoaI(
, w, vn'LED UNDER THI~ '
COM'lc"eED 0 !:fEAT sLle~JT IS NOT
... " R 11:1 ABANDO
ANY1SQ DAY PER/&.NG F' NED FOR
LAND US'"
OCCY GROUP:
. OF STORIES:
WATER HEATER:
11-'1f;
:<'Y07~-ir;
FLOOD PLAIN'
ZONING CODE: _
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection. you musl call 726.3769. This Is a 24 hour recording. Alllnspecllons requested belore 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 Rough Mechanical - Prior to
cover.
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Rough Electrical - Prior to
cover.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After "trenches are
excavated.
D Fireplace - Prior to facing
materials and framing Insp.
D'Masonry - Steel location. bond
beams, grouting.
D Framing - Prior to cover.
D Foundation - After forms are
erected but prior to concrete
placement.
D Wail/Ceiling Insulation - Prior to
cover.
D Underground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping,
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Wood Stovo - After Installation.
D Post and Beam - Prior to floor
Insulation or decking.
D Insert - After fireplace approvel
and Installation of unit.
D Floor Insulation -.:. Prior to
decking,
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sanitary Sewer - Prior to III ling
trench.
D Storm Sewer - Prior to filling
trench. "
D Sidewalk & Driveway - After
excavatIon Is complete, forms
and sub-base materIal In place.
D Water Line - Prior to filling
trench. .
D Fence - When completod.
D Rough Plumbing - Prior to
cover. . . .
D Street Trees - When all required
tree:s are planted.
D Final Plumbing - When all
plumbing w9rl< Is complet.e.
D FInal Electrical - When all
electrical work Is complete.
~fnal Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
DOther
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.
o 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.
Setbacks,
I PL. HSE GAR
IN
Is
Lot faces
,
L~t ~yp.
"
Lot sq, ftg.
Interior
Lot coverage
Corner
Panhandle ,"
Topography
Total height
Cul~de.sac
w
----
,E
BUILDING PERMIT 'I 'f, "i
ITEM SO, FT, X $/SO, FT.
VALUE
Main
Garage
"
Carport
Tolal Value
Building Permit Fee
State Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
FIxtures
Residential Bath(s) N'
Sanitary S~wer
Water
FT.
FT,
FT
'1.1;""
,I' -:' \ "
-'
"
'.l .""
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Slovellnsert/Flreplace Unit
Dryer Vent
r;,Au; f'~ I rf.Ao <:H,UI{, /
I I w/!r1bl;.....l....
Mechanical Permit
If: () oJ
fJ.OV
3.~
2.(,. l/J
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrlcal)
(A, B, C, 0, and E Combined)
.' ".j ; ::.'; ~!':.\K,:\:}'
,
IS THE PROPOSED WORK IN THE.
....HISTOI;1ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Ihls application must be signed
and approved by Ihe Historical
Coordinator prior to permit Issuance.
ACe' I
I
I
I
I
APPROVED'
BUILDING "ALOE, 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 of Springfield, Including the
Development Code. regulating the construction and use of
oulldlngs, 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
Systems Development Charge is due on all undeveloped
properties within tho City limits which are being Improved.
ADDITIONAL COMMENTS
,".J
: ..\i',
""11
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 Ordlnanc~s of Ihe City of Springfield. and the Laws
of the State of Oregon perlalnlng to the work described
herein, and Ihat 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 inspections 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 atzar; res during construction.
SlgnalU() J. 0 --
o'al~ Id_ 1:6 ~ 98
VALIDATION:
~,~~0
DATE PAID \n'~l/.l\~"
AMOUNT REfE!fl:E'jr) .)
RECEIVED By1J~JA) .
RECEIPT NUMBER