HomeMy WebLinkAboutPermit Mechanical 1999-6-8
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
LOCATION OF PROPOSED WORK' 20 2.2..
ASSESSORS MAP' /7 os Z f) )/
LOT:
LDI'l'\Q~
BLOCK'
OWNER'
ADDRESS'
CITY:
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DESCRIBE WORK'
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NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL'
ELECTRICA' .
Vhll {.s '^'" l \ 'S
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.
79 D 7 7/ "
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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7 '2.1.. -01 'fJ
. PHON'"
ZIP' c{7i17
ADDITION
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OTHER {I- e' ff o..c .~ H2O..
CONST.
CONTRACTOR . EX.PI~S ':e-
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DEMOLISH
ADDRESS
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. _ _ ....,.. r.o.nllirA~ vou to
f"',', 1l::lr~I~~'~d~Pi~dbY the Oregon Utili!.v OFFiCE USE -
o ow Th e rules are set forth
QUAD AREAl"tifir:ation Center. OS h o"~lil..iUSEi1-
'OAR952-001-UU1U\IIrOug ',~ "
. OF BLDG\!! .. . .. "j ~..,~;" f'opies ofo-t\:fFrl:Jt&Yi-g,y
llu"u. 'V" ",- .-. e.thetelephone
oCCY GROUp:""lIina the center. (Not '., NOt\\m'<ftiQjYPE:
, numberforthe oregon Utlhty~, ~\ '
. OF STORIES: _. ..,.,~. on'l-332-2'l'fE:AT SOURCE:
V....,'~..... .- -
WATER HEATER:
PHONE
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( Lt7-7'fVr-
N9+lCE: FLOOD PLAIN'
TUI~ OERMIT 8lIb'l>U1>l'GY€'mli!FTHE WORK
AI ITHORIZED J,J~~PERMIT IS NOT
COMMENCEDnRlgABANDONEDFOR
S'EC ~OARY HEAT:
ANY 180 DAY PERI 0.
SQUARE FOOTAGE:
RANGF'
To request an Inspection, you must call 726.3769, Tilis Is a 24 hour recording, All Inspections requested before 7:00 a,m, wlfl be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Undersleb Plumblng/Electrlcell
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected. but prior to concrete
placemont.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and 8eam - Prior to floor
Insulation or decking.
, '
o Floor Insulation ~ Prior .to '
decking, _
'.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Framing - Prior to cover, ~ 6',
01 er /f)
o Wail/Ceiling Insulation - Prior to r{ A4'
cover.
o Drywall - Prior 10 taping.
, "
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover. .
o Electrical Service - Musl be
approved to obtain permanent
electrical power,
D Fireplace - Prior to facing
materials and framing Insp.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unll.
,
,'-. 0 Curbcut & Approach - After
i" forms are erected but prior to
o Sanitary Sewer - Prior to filling placement of concrete.
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to f1111~g'
trench. " \
D Rough Plumbing - Prior to
cover.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are, planted.
o Final Plumbing - When all
plumbing worl< Is complete.
. ,
o Fln~Mechanlcal - When all
~anlcal work Is complete.
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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
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
Lot Type . p.L.
InterIor--
Corne r "I
Panhandle '{ Is
Cul.de-sac W
E
'(
X $/SQ, FT, - VALUE
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Lot faces
Lot sq, ftg,
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM SQ, FT,
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
.
" (B),
SYSTEMS DEVELOPMENT CHARGE (SDC)
, . '
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
"I'
Sanitary S~wer
Water
F.T,
FT, .
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
Wood Stovellnserll~~nll
D;:rer Vent ...
(T/t'\ fMA/J/
, ,
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
,Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
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7': 5'0
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.HE PROPOSED WORK tN THE.
"'HISTOI'lICAL DISTRICT, OR ON
THE HtSlORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
HSE GAR Acc'l
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I
L =-_j
APPROVED:
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BUILDING VALUE, 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 )~y .th,e, ql~ of Sp'rlngfleld.. Including the
Development Code, regulating the c,onstructlon 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 Number'
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
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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 J further certify
that any and all work performed shall be done In accordance
with the Ordlnancos 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.
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 at al times during construction.
I
Signature ~^^ In ^'^ I ~
Date b - I --4.. '1
VALIDATION:
RECEIPT NUMBER 6 ~ If J )' f
DATE PAIl' (.. / f I tf' f
AMOUNT RECEIVE~ ,1'?Z; 2..u-;;>
RECEIVED BY c:v f ~