HomeMy WebLinkAboutPermit Mechanical 1997-12-3
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
1\." ,
:>(bCATION OF PROPOSED WORK: {;1qz..t-I c;~'py
ASSESSORS MAP' 1'((0 ;2 0 L '22.. 0 37 crt;
LOT' f5 . " BL.OCK' 5
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ADDRESS:
CITY'
x&'SCRIBE WORK' ~o.LJ Go..<,
NEW 'I- REMODEL ADDITION
x60NTRACTOR'S NAME ,
GENERAL' .t",,- ('A"-\ll.(,\,,
,PLUMBING'
MECHANICAl'
ELECTRICAl'
QUAD ARE'"
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
Vtl ,L't"..J. M,.!-;Jm.A, It,,;+'
DEMOLISH OTHER
.
JOB NUMBER q 10 6 3 C;; 0
225 Fifth Street
Springfield, Oregon 97477
SUBDIVISION:
C4-c~~- IIcl[j!.cts
PHONE: ..f31r: - ;"O!Jt.,
ZIP: C['fL17.8
(~$f.,<,-JJ ')
CONST.
CONTRACTOR .
ADDRES~n
q\'6~"Jl:J#(~ st..
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C'OA"t, ~~"'~ Sf..;,d...
"'1\1 "~i1& 'v(;. ~~12
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LAND USE: . 'j:'~'$ fIIO?, FLOOD PLAIN:
. OF UNITS' ~ ZONING CODE:_
D Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o 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/Cellln9 Insulation -'Prior to
cover.
D Drywall - Prior 10 taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
. forms are erected but prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and'sub-base material In place.
D Fence - When cori'lpleted.
o ,Street Trees - When all required
trees are planted.
EXPIRES
PHONE
Aql. - '),oti..
CONSTR. TYPE:
HEAT SOURCE:
RANG~'
""
. OF BDRMS:
SECONDARY HEAT:
SQUARE 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.
REQUIRED INSPECTIONS
D Temporary ~Iectric
. 0 Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Sleellocallon, bond
. .beams. grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Pfumblng - Prior
to IIl1lng trench.
D UnderUoor Plumbing/Mechanical
-.Prlor to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
D Floor Insutatlon - Prlort10
deckl ng.
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. ~
D Water Line - Prior to filling
trench. .
D Rough Plumbing - Prior to
cover.
D Final Plumbing - When all
plumbing work Is complete.
o Final Electrical - When all
electrical work Is complete.
~al Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
D Other
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, end 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.'
Lot faces
l~t ~yp"
lot sq, Itg.
Interior
Lot coverage
Corner
Panhandle p'
Topography
Total height
Cul.de,sac
BUILDING PERMIT \', '& ."!
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Comb'lned)
~:
'.'.....
I PL. I HSE
I N I
I S I
I
W I
-;-1
VALUE
"
.r"
I \'"\ ~FEE .
. i~ ,.,,'-. ' \'\ ~
. \ ) ,,~..\ 0 . \"~
, '
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4)0., -
, 7~+'1.f5-
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1
Setbacks '
~S THEPROPOSED WORK,tN THE,
"'HtSTORICAl DISTRICT, OR ON '
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
GAR I Acc'l
I
.1
t-
APPROVED:
~ .!<',..,~ 't,
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 by the City, of Springfield, Including the
Development Code, regulating the construction 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
I
Date
'.
Systems, Development Charge Is due on all undeveloped
,,'
. properties within the City limits which are being Improved.
,.,_." ol'.[J
ADDITIONAL COMMENTS
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 'I
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to tho 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 all times during construction.
XSlgnature ~L D f}J~~
Date I 2../5 I dJ 7
I I
VALIDATION:
RECEIPT NUMBER ..)q:, / S q
DATE PAID 3 U(L~.-..,~J}.Vv 1<1 C, 7
AMOUNT RECEIVED _ :!f,,:;,c.. ~
~
RECEIVED BY