HomeMy WebLinkAboutPermit Mechanical 1996-3-4
I
RESIDENTIAL
PERMIT APPLICATION
inspections: 726.3769
Otllce: 726.3759
..
SPRINGFIEL.D
Jra:tt;t
-
JOB NUMBER
~~...?9.:;;::-
225 Fiflh Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: /?v:z-<! tfiLr~
5435 High Banks Rd., Springfield, OR 9747B
LOT'
BLOCK:
TAX LOT: ~?~ /'
SUBDIVISION:
OWNER' Dale Ortmann
. 5435 High Banks Rd.,
A DDR ESS: ________._.___ _._______._._____. .._....____
CITY:2e.r~gfield _..___
PHONE:
726-2760
STATE:
OR
_.._---------+_.
97478
_ ZIP:_
DESCRIBE WORI~:
Install oas furnace and gas piping
NEW
I1EMOD~L __ ADDITION
DEMOLISH
OTHER change to.~gasJfurnace
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAl' Comfort Flow Heatino 1951 Don St. Suite 0, Sprinqfield 97477 00460 6/27/96726-01)(
ELECTRICAL:
ADDRESS
CONST.
CONTRACTOR'
PHONE
- OFFICE USE _
QUAD AREA: .
, OF BLDGS: ____
OCCY GROUP: _._
, OF STORIES:
WATER HEATER: _.
LAND USE:
N OF UNITS:
CONSTR. TYPE:__
HEAT SOURCE:
RANGF.: __
EXPIRES
FLOOD PLAIN'
ZONING CODE: _
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:__
To request an Inspection, you must call 726-3769. This Is a 24 hour recordIng. Alllnspecllons requested before 7:00 a,m. will be
made the same working dflY. Inspections requested DOer 7:00 a.m. will bo made tho (ollowlng work day, .
o Temporary Electric
O Site Inspection - To be mado
after excavAtion, but prior to
setting lonTls,
o Underslab Plumbingl Electricall
Mechanical - Prior 10 cover.
o Fooling - After trenches are
excavated.
o Masonry - Sleel location, bond
beams, grouting,
o Foundation - After forms arc
erected but prior to concrete
placement.
o Undorground Plumbing - Prior
10 fJlllnQ trench.
o Underlloor Plumbing} Mechanical
- Prior to Insulation or decking.
o Post and Boa~ - Prior to floor
Insulation or decl<lng,
O Floor Insulation - Prior to
decking.
o Sanitary Scwcr - Prior 10 fl/llng
trench.
o Storm Sewer - Prior to filling
trench.
o
Wator Line - PrIor to filling
trench,
,.
O Rough Plumbino..- Prior to
cover, .~ _
REQUIRED INSPECTIONS
!ZJ Rough Mechanical - Prior to
cover. ~
6j7 /0/7~
o Rough Electr~car - Prior to
cover. ,
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o FIreplace - Prior to facing
materials and framing Insp.
o Fram.lng - Prior to ~over~.
, .
o Wail/Ceiling Insulation - Prior to
cove~ .
'. ,
o Orywall - Prior to l.aPing.
o Wood Stovo - After Installat/o'n.
o Insert - After fireplace approvl:l
and installation of unll. .
o Curbcut & Approach - Aller
forms are erected but prior to
placcmonl of concrete.
o Sidewalk & Orlveway - Afler
excavation Is complete, forms
and sub-base malerlal In place.
o Fence - When completed.
o Street Troos - When all requIred
trees Bre planted.
o Final Plumbing - When all
plumbing worl, Is complete.
D FInal Eloctrlcal - When all
electrical work Is complete.
lZl Final Mechanical - When all
mechanIcal work Is complete,
$4::5 50WC<f ,
o Final Building - When all
required Inspections have been
approved and building is
completed.
, - .
-, ,
"
o Olher
MOBILE HOME INSPECTIONS
o Biocklng 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, sel.up, and plumbing
InspectIons have been approved
and the home Is connected to
the service panel.
o Final - After ali required
Inspecllons are approved and
porches, skirting, decks, and
venllng have been Installed,
,':
_ THE PROPOSED WORI< IN THE
. HiSTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, lhls application musl be signed
ond approved by the Historical
Coordinator prior \0 permit Issuance,
Lot (aces
" Lot 'TYP.
LOI sq. Itg.
Interior
Setbacks
P.L. HSE GAR ACC
N
Is
Iw
IE
APPROVED'
Lot coverage
Corner
Topography
Panhandle
Total height
Cul-de-sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
Carport
"
This pcrmlt Is granted on thc express conditIon that tho said
construction shall, in all respects, conform to t11e Ordinance
adopted by the Cily 01 Springfield, including the
Development Code, regulaling the cOr)struction and use of
buildings, and may be suspended or rcvol<od at any time
upon violation of any provisions of si'lid ordinances,
Main
Plan Check Fee:
Date Paid:
Total Value
Building Permit Fee
Receipt Number:__.____
Received By:
State Surcharge
Total Fee
(A)
Plans Rcvle-wcd -.BY' ...,----.--.
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
propertIes within thn City limits whicl1 are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
FIxtures
Residential Bath(s)
Sanitary Sewer
N'
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Issuance
,M# p-
/tJ.~
~ ~~S-
:2.:6. 2-<:?
By signature, I atalc .md agree, that I t1avc ciJrefully examined
the completed appllcallon and do hereby eartHy that all
Information hereon Is true and correct, and I (urthcr certify
that any and ell work perlormed shall be dono in accordance
with the Ordinances of the City of Springfield, and Ihe Laws
of the Stato of Oregon pertaining to the work descrIbed
herein, and thai 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 GAS 701,055 will be used on this
project. .
Exhaust Hood
Vent Fan
N'
Wood, Stovellnsert/Flroplace Unit
Dryer Vent ,
0~ (7}k~
MechanIcal Pcrml t
State Surcharge
Total Permit
(D)
I rurther agroo 10 ensuro that all required lnspecllons are
requested at the proper time, that oach address Is readable
Irom the streel, that the permit card Is located at the front
of the property, and Ihc approved set of plans will remain
on the site at all times during constructIon.
Signature Q j ~ (!01J=/1
() 3/ tf- 17t, .
Date
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
It
Curbcul
Demolition
Total Miscellaneous Pormlls (E)
VALIDATiON:
RECEIPT NUMBER __ :?.-:>?r:?e
-:r-7I-%:::_______
State Surcharge
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
DATE PAID
2:;; _ ::;>c:>
AMOUNT RECEIVED __// ___
.. RECEIVED BY 4 -:", "...-'-- '
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