HomeMy WebLinkAboutPermit Mechanical 1998-4-27
Vc$?1
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK' 2 \ 1.9> Lil~
ASSESSORS MAP' /7~~, "2.r;;-,/'?
LOT'
BLOCK:
OWNER'
ADDRESS'
CITY'
f4 \.Ok l$frf'\ e""-,, '"
.-
'2-\ 'i 'B y,""'-<) ~
c::..bc.J.,
DESCRIBE WORK:
C I-v I'V# e
J
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
STAT'"
0-(2.,
.
JOB NUMBER 9~ Y'9/
225 Fifth Streel
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
&n'-~
O>cT
-H ,q1"
f'-lr"l.p -/W)
. PHON'"
72..t, - '86<{o
ADDITION
DEMOLISH
OTHER
ZIP: qllf 7 7
tl\cJ ~ ; CA. t ~ -r-~
(J -<T
e K jl.i,'~
""'<><1'
,
ADDRESS
. CONST.
CONTRACTOR .
,~
EXPIRES
PHONE
MECHANICAl'
t'V\<(.(J~lG H("o.t.'...~ l/1I6 OI_'7Mt~c.: S/~
ISO>>r )...~71o \'LI2-Jl't'8
q.') Y7 9-
! lj 7 -7lflf.\
ELECTRICAl'
- OFFICE USE -
QUAD AREA- LAND USE: FLOOD PLAIN'
. OF BLDGS' · OF UNITS' ZONING CODE:_ ~t;;.
OCCY GROUP' CONSTR. TYPE: _ . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT: .It t\\
WATER HEATER: RANGE' SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recordIng. All Inspections request.cd 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.
o Temporary Electric
o Site Inspoctlon - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Eleclrlcal/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Sleel location, bond
beams, grouting.
o Foundallon - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
-.Prlor to Insulation or decking.
D Post and 8~a.m - prior tp floor'
Insulallon or decking. .. I
, . '.
D Floor Insulation - Prior tq,~,....~.
decking. '
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to (lllIng
trench. '
D Water L1na - Prior to filling'
trench.
D Rough Plumbing - Prlor to
cove~ .
REQUIRED INSPECTIONS
rn Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover:
o Wail/Ceiling Insulation :- Prior to
cover. .
o Drywall - Prior iO'laplng.
D Wood Stove - Alier Installallon.
D Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - Alier
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is compicte, forms
and sub.base malerlal In place.
D Fence - \-Vhen completed.
D Street Trees - When all required
trees Bre planted.
D Final Plumbing - When all
plumbing wc;>rk Is complet.e.
D Final Electrical - When all
electrical work Is complete.
r7/1 Final Mechanical - When all
J{:--J mechanical work Is complete.
o Flna' 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.
o Plumbing Connections - When
home has been connected to
water and sewer.
o 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 Jaces
Lot sQ. IIg.
Lot coverage
Topography
Total height
.,
BUILDING PERMIT
ITEM SO. FT.
Main
.,
Garage
Carport
\ .. j .
, .
Total Value.
Building Permit Fee
State Surcharge
Total Fee
Lot ~ype.
Interior
Corner
,.
Panhandle'
Cul-de-sac
X $ISO. FT. =
(A)
Setbacks
I PL. HSE GAR
N
----.
S
. . ,,'; ;..:;: :~;;:
~,l. ,
;(e THE PROPOSED WORK IN THE _'
HISTOI'lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit issuance.
Acc'l
I
I
W
--- ------
. APPROVED:
..s....-._
VALUE
"
I'. .
SYSTEMS DEVELOPMENT CHARGE (SDC)
./-
PLUMBING PERMIT
ITEM
Fixtures
Res/denllal Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust HOod
Vent Fan
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permll
. , . (B)"'
N'
FT.
FT.
FT.
(C)
N'
/7/#
~
MISCELLANEOUS PERMITS
(D)
Mobile Home
Slate Issuance
State Surcharge
Sidewalk
II
'11
Curbcut
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, 0, and E Combined)
-- .j
l.
FEE
/5:~
" -,
//:7.
, .22:.
~F
::2?::~""",
. q..
BUILDING VAtuE, 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 'Sprlri'gfleld. Including the
Development Code,-regulating the co'nstruction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisio,:",s of s.~ld. ordinances.
Plan Check Fee:
Dail' P~id:'
ReceIpt Number
Received By:
Plans Reviewod By
Dale
Systems Development Charge Is due on all undeveloped
proR,e!tics within tho City limits whIch are being Improved.
ADDITIONAL COMMENTS '
\ " '11
V, ! '-\. e... T <. > <t ).., ()D
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 lhe Ordinances of lhe City of Springfield, and Ihe Laws
of the State of Oregon perlalnlng 10 the work described
herein. and that NO OCCUPANCY. will be made of any
structure without permission of the Building Safety Division.
I further certHy that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree 10 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
ot the property, and the approved set of plans will remain
on the site at all tlirS during const:uctl~.
Signature ~1lN~
'1 Ii l-ttt
Date
VALIDATION:
RECEIPT NUMBER 2q9.t;'d;;
L/-:< '> 9~
, '
AMOUNT RECEIVED -:::<.<('.;;;. co
~~.
. , //"' -
DATE PAID
RECEIVED BY