HomeMy WebLinkAboutPermit Mechanical 1998-6-29
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RESIDENTIAL
PERMIT APPLICATION
JOB NUMBER
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED W.R~K: I U~
ASSESSORS MAP' I ')0 :"'0.53-.:J
n~ 'SOO
TAX LOT:
SUBDIVISION:
LOT'
BLOCK:
OWNER' ~ t \SJ.. w, \ \ \n 1Y\ ~ - PHONE:
ADD:^Sn~ ~ W~ 0 Y"\ \_')(\ ~ o. l \h l )~
CITy:~'\flJr:f STATE: (UAP ~
DE;CRIBEWORK:--'oo'f:\ \illJDrt"'; 0{ l~ '4 a~
NEW REMODU - ADDITION DEMOLISH OTHE~
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ZIP: qr}47r;
~/(lP ~
CONST,
CONTRACTOR .
CONTRACTOR'S NAME
ADDRESS
EXPIRES .;:. 'PHONE
GENERA' '
A /
COI~I~~
PLUMBING' ,j IV\
MECHANIC~I\OYiC(jf1 <:rtll
ELECTRICAL'
1'O)f OFFICE USE -
L~ U~.c-.
-'9(j ,Q'~ 4,
Ca' ~~01
<I~/,. ~JSU>T~c1l'tP~-1~ '
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J?i~AT ~f61....~~~) iO/<9(:
.'it, :'<.1>9:; ISl ~
WATER HEATER: RAN~9~ {S>4e'1 v.s-~! ~'\';>,--,- SQUARE FOOTAGE:
01'1 WI\ 19J..~' ~,..,
. VIIt. ',/,. -'TA-
To request an Inspection, you must call 726.3769. This Is a 24 hour re'~c;ttn6$'~tn!)pectlons requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a,m. will 6'ClfaCltlthe following work day,
. RE.9lJIRED INSPECTIONS
~~.~~~h Mechanical - Prior to
cover.
QUAD AREA'
FLOOD PLAIN'
. OF SLOGS'
ZONING CODE:_
OCCY GROUP:
. OF BDRMS'
. OF STORIES:
SECONDARY HEAT:
D Temporary Electric
D Final Plumbing - When all
plumbing w9rk is camp/et.e.
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Rough Eleclrlcal - Prior 10
cover.
,
D Final Electrical - When all
electrical work is complete.
~al Mechanical - When all
mech~nical work Is complete.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After trenches are
excavated.
D Final Building - When all
required Inspections have been
approved and building is
ro>::~:'I:roJ) ~ tr1)(l~
u.r (j)lV ,
D Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting.
D Framing - Prior to cover.
D Foundation - After forms are
, erected but prior to concrete
placement.
D Wall/C"elllng Insulation - Prior to
cover.
D Underground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underfloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Wood Stovo - After Installation.
o Blocking and Set.Up - When all
" blocking Is complete.
D Post and Beam - Prior to floor
Insulation or decking.
D Insert - After fireplace approvlIl
and Installation of unll.
D Floor Insulation - Prior to
decking,
D Plumbing Connections - When
home has been connected to
water and sewer.
D Curbcut & Approach ~ After
forms are erected but prior to
placement of concrete.
D Sanitary Sewer - Prior to. filling
trench. ,
D Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place.
D Storm Sewer - Prior to filling
trench.
D Fence - "\lhsn completed.
D Water Line - Prior to filling
trench.
D FInal - After all required
Inspecllons are approved and
porches, skirting, decks, and
venting have been installed,
o Rough Plumbing - Prior to
cover.
o Street Trees - When all required
tree,s are planted.
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Lot faces
L~t ~yp.
Interior
I PL.
IN
Is
Setbacks,
HSE I GAR,
Lot sq, flg.
Lot coverage
Corner
Topography
,
Panhandle
Total height
Cul-de-sac
w__,_
E
BUILDING PERMIT "I
ITEM SO, FT, X
.~ "t
$/SO, FT. =
VALUE
Main
Garage
Carport
"
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
FT,
Storm Sewer
FT,
~ ,'.
Mobile Home
,
..'
~.
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
J~.a)
/0 PO
. 1..[10
a/}7o .61D
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrlcalr::::!.". {JiJ
(A. B, C, 0, and E Combined)
" ,.".; ~::/t~"\ir.~'}
'~S THE PROPOSED WORK IN THE.
"HISTOI;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
" yes, this application must be signed
end approved by the Historical
Coordinator prior to permit issuance.
Acc'l
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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 by the City of, Springfield, Including the
Development Cod~, regulating the construction and use of
oulldings, and may be suspended or revoked at any time
upon violation of any provisions of saId ordinances.
Plan Check Fee:
Dete Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties wllhln 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 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 State of Oregon perlalnlng 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 ensuro 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
~e site at all times durl~~nstructlon.
/'~ture~.;7L'~
, Dato /;-z.9-ff
VALIDATION:
RECEIPT NUMI1ER /
DATE PAID (0'
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AMOUNT R
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RECEIVED
,