HomeMy WebLinkAboutPermit Mechanical 1992-6-10
RESIDENTIAL
PERMIT APPLICATION
Innpectlono; 726,3769
Of lice: 720.3759
..
SPRINGFIELD
LOCATION OF PllOPO~ED WORK: 514 LoU:~UI..A
ASSESSORS MAP: 1103::17 1 ~
LOT'
BLOCK'
..
JOB NUMBER
9!3J () ?;~<d
,
225 Filth Stroot
Springfield, Oregon 97477
TAX LOT: ( ) I LQ/Y')
-~,,4-
PHONE: '1.:J.L..=J~5(, ,~
SUBDIVISION:
OWNER: _Arxk~u, 1-\ ~21h,\
ADDRESS: _5_"1~ Lo~ ~
CITY: _~\~, STATE: (') R ZIP: q-:L4::.7~
DESCRIBE WORK ~~ h.J.."t p~. ~ tIH". lO~Oiliffi.lC' ..,cALD,,;-)
NEW REMODEL ADDITION DEMOLISH OTHER Q.J oOJ\QX..J
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL: (1_1.. +-.JI~dU.;J;--...
,. ~,
ELECTRICAL'
QUAD AREA'
II OF OLDGS: _
OCCY Gnoup:
II OF STOHIES:
WArEn HEATER:
ADDRESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
85.5 /i). I!! &u.a
.
blJ(t.{d)
.'
3!62. - 8'&'--
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS:
SECONDAny HEAT: __.
SOUARE 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.
D Temporary Electric
D Site Inspection -' To be made
aUcr excavation, but prior to
setting forms.
D
Underslab Plumbing/Electrical!
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Sloel -location, bond
boarns, grouting.
D
Foundation - After forms arc
cructc(J lJut prior 10 concretc
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing! Mechanical
- Prior 10 insulallon or decking.
D
Post and Beam - Prior to floor
Insulation or decking.
D Floor'lnsulation - Prior- to
dockinU. " '.
'.
D
Sanitary Sewer - Prior to titling
Irench.
D Storm Sewer - Prior to filling
trench.
D
Water Line ~ Prior. to filling
trench.
D Rough Plumbing - Prior to
cover.
- OFFICE USE -
LAND US~'
. OF UNITS:
CONSTR. TYPE:
HEAT SOUnCE:
RANGE:
REQUIRED INSPECTIONS
~OU9h Mechanical '- Prior to
r 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 Wall/Ceiling Insulation - Prior to
cover. ;
D Drywall - Prior to !aping.
D Wood Stove - Aft~r installation.
D Insert - After fireplace approval
and Installatlon of unit.
D Curbcut & Approach - After
forms arc erected but prior to
placement of concrete.
D Sidewalk &.Driveway - Aller
excavation Is complete, forms
and sub-base material in place.
D
Fence - Wtlen completed.
D
Street Trees - Whem all required
trees are planted.
D
Final Plumbing - When all
plumbinG work is complete.
D Final Electrical - When all
electrical work is complete.
rWinal Mechanical - Wilen all
r mechanical work is complete.
D Final Building - When all
required inspections have been
approved and building is
compleled.
, \
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.
D Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected 10
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been installed.
HSE GAR Accl
I
I
Iw I
I~___~
Lot faces
Lot Type. "
Interior
I P,L,
IN
Is
Setbacks
Lot sq, ltg,
Lot coverage
Corner
Topography
Panhandle
Tolal hcight
Cul.dc-sac
BUILDING PERMIT
ITEM
SO, FT,
X $/SO, FT_
VALUE
Main
'':'.
Garage
Carport
..E PROPOSED WORK IN THE
H~ORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
C<;lordinalor prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the c~prcss co~dilion thai the said
construction shal!, in all respects. conform 10 the Ordinance
adopted by~ the City of. Springrield, including the
Development Code, rcgulat(ng'l!lc.construclion and use of
buildings. and may be suspended or revoked nl any timo
upon viol:1tion of any provisions of said or(lillanccs.
;, PI~nCh.cck Fcc>-:-
Dale Paid:
lolal Value
Building Panni! Fcc
Slale Surcharge
Tolal Fcc
(A)
SYSTEMS.DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plull1bing Permit'
Slate Sutch:noe
Tolal Ch:llHG
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StoveflnscrtlFireplacc Unit
, f'{\Drycr rn U1lU1UJ'
\ --
'-' - -
1fr~
~ ,''IS
an. 'lS
Mechanical Permit
Issuance
Slate Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Slale Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demoli lion
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (cxcludlng clcctrlcal) c!J0~
(A, B, C, D, and E Combined)
Receipt Number'
Received By:
Plans Rcviewed By
Dalc
Systems. Dc~'Gf:OPIIl8.f2-!- Ctwrgc',ls due on"all undeveloped
~properties within tlie City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stale and Llgrce, ttlal I have carerully examined
the completed application and do hereby certify Ihat 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 Slate of Oregon pertaining 10 the worl\ 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 inspections arc
requested at the proper time, that each address is readable
from the slreet, thClt Ihe permit card is locnted ilt the front
of the property, and the <lpproved set of planr; will remain
::":::":~7"'1~~
Dale _1\ ~ 6- f'.L
VALIDATION: h:7\IO
RECEIPT NUM,ER \....l..) /" ....
DATE PAID -Lt/. ) ( ). q!.)/
AMOUNT REC~~"/ ~G'~
RECEIVED BY( ')'l/. ~ .
~I _ ,-:':/r./~___