HomeMy WebLinkAboutPermit Mechanical 1998-9-29
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: --1l.)
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ASSESSORS MAP'
LOT:
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ADDRESS' ) I) C. .ref'v'\\l~ \e..
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DESCRIBE WORK' J./PO"+
OWNER:
CITY:
t(Yi
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TAX LOT'
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5PRINCFIELP
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BLOCK:
Tht.,~~"\",
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STATE: _i1~
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"51S~JIY\
DEMOLISH
NEW
REMODEL v ADDITION
CONTRACTOR'S NAME
C'
GENERA' .
PLUMBING'
MECHANICAL: r ""'i"<"\~,..,.l Clli l '>
ELECTRICAl'
.
JOB NUMBER
CfY-/f'lf
225 Fifth Street
Springfield, Oregon 97477
ThI'7 '7
()/2-dl>
SUBDIVISION'
PHONE: 7oiJ'7-Z'8' JZ,.
ZIP:--97!J77
On-IEIl
ADDRESS
CON ST.
CONTIlACTOIl .
PHONE
REQUIRED INSPECTIONS
o Rough McchnnicnJ - Prior to
cover.
o nough ElcclriCOlI - Prior to
CQver.
o Elcclricnl ServIce - Must be
approvccl to obtain [)crrn()I1Cnl
electrical power.
o Flrcpl<1cc - Prior \0 filclng
materials and framing Insp.
o
D
Frnmlnu - Prior to cover,
WalJ/C'ciling Insulntion - Prior to
cover.
Iqf5I_1li'f\~ ""-< ;,l..t> ~
EXPIIlES
DOl/ion
/,,)?.?.k9 ?Z/c-iJaJ
- 0 FFffiEr!:!R1lj'leN:Qregon law requires you ~c
d ted by the Oregon Utility
QUAD AReA: _- LAND USE: _, follow rules a op '-1" ose rulescatlPSelklR\l .
NUIICE" NotificationveJlll:lI. "' -001-
. OF SL'DG!3: " II OF UNITS: --m-&'\P. n,,.,-nr)1-0010thrOU9~1'l&~~ifJY
THIS PERMIT SHALL EXPIRE IF THE WORK @D9ll y~~ may obtain copies ~oj'i)\e'ru ---
OCCY ~Df~ORIZED UNDER THIS-PERMIT IS C~OrR, TY P cailing me cenll". (Note: .t~e<\WI~::~ -
. OF SIQ[lJE~: _ _ tlEAT SOURCE: uFfll3orfo~th,,()rA'10n Utlh!YJ1!\ll~8MIY HEAT: ._________
L;UMMt:NCEDDRlS AtJANUuNEO FOH , " Center Is 1-80o-332-2344). __
WATER'AClEAT;.E~: RANGE, ___ SQUARl', FOOTAGE:___,..,
NY l~U 'J!',y r't:I1IUIJ,
To request an Inspection, you must call 726.3769. Tills Is n 24 hour recording. AlIlnspccti0/15 requested bclorc 7;00 a.m. will bc
made the same working day, Inspections requested afler 7:00 a.m. wifl be made the following worl< day.
D Temporary Electric
o
Sile Inspection - To be made
afler excavation, but prior to
setting furrns.
o
Undcrsfnb Plumbingl Electric.,l!
Mechanical - Prior to cover.
o
Footing - Atter trenches arc
cxci1vatcd.
D
Milsonry - Steel locatlon, bond
beams, grouting.
D Foundfltlon - After forms arc
erected but prior 10 concrete
. placoment.
o Underground Plumbing - Prior
to fllJlng trench. .
o
Undcrlloor PlumbIng/Mechanical
- PrIor to Insulation or dccldng.
D
Post and Beam - Prior to fJoor
InsulatIon aT dqcl<lng.
o Floor Insulation - Prior to
decKI ng. . ,
D
Sanitary Sewer - Prior 10 fllling
trench.
D
Storm Sewer - Prior to Iilling
trencl1.
D
Water Line - PrIor 10 filling
trench.
o Rough Plumbing - Prior to
cover.
o Drywall - Prior 10 l.:tping.
o Wood Stove - Aller lnstalla:ion_
, 0 Insert - After (Ireplace approval
.' and Installation of unIt.
o
Curbcut & Approach - Afler
forms arc erected but prior 10
Illnccrncrlt of CQrlcrelu.
o
Sidewnlk &. Drivew:l\, - Aflor
cxcnvntion is complete. forms
nne! sub.base ma~t!ri<lJ in place.
o Fence - WIlen completed.
o ~;troot Troe:> - WIlen all required
trees arc planted.
D
Final Plumbing - When all
plumbing worl< is complct,c.
D r-ilHlI Eleclkcnl - VO/hen all
cJcctricnl worJ< is complele,
~(
- Fil.1I Mechanical - When <lll
D r cclwnical worlels complete.
o Final Uuildintl - Wilen all
rcquired Inspections have been
approved and building is
completed. . \
o Other
MOBILE HOME INSPECfIONS
o Olockillg Clnd Sel-Up - Wilen Llll
bl()cl<ln~J is complete.
o Plllmbin~J Connections - When
IWlne llil:.i been connected to
Willer <l1lc.l sewer.
o
Electric;l! Cotlnection - Wilen
blocJ<iIlU. set-up, Jnd prlHTlbing
11l~;pccljon$ h:wc l)ecn Llpproved
and tlle tlOlnC is connected to
tl1e service panel.
o
Finn[ - After oil required
Inspections ore <lpproved and
porches, sldrtlng, dccl<s, and
venting ~l<lVC been Installed,
Lot faces
LOl sq',llg,
Lot coverage
Topography
Tolal helghl
Lot Type.
Interior.
Corner
Panh.1ndlc
Cul.de-sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, 1'1.
Main
Garage
Carport
Tolal Value
Ouilding Permit Fee
State Surcll':Hgc
Total Fcc
(A)
SelbaGlc~
~ HSE GAR
N
-L-__
ACC I
I
I
. THE PF1OPOSED WORt, iN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
.11 Y,es, Ihis application must be signed
and approved by Ihe Hlslorlcal
Coordinator prior to permit issuance.
W
----..- --- ----
APPROVED:
E
'---<---.-'
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Oatll(s) N"
Sanitary S!Jwer
Water
FT.
1'1.
Storm Sewer
FT
Mobile Home
Plumbing Permi t
Swte Surcllorge
Tolal Charge
MECHANICAL PERMIT
Furnace
Exhau::.;1 Hood
Vent Fan
N"
Wood Stove/Insert / Flref)lacc' Unij
Dryer Vent
jJ/.J f2k'_~---
Mecllanical Penni t
Issu.:lnce
Stute Surcharoe
Total Perml!
(El)
(e)
MISCELLANEOUS PERMITS
(D)
Mobile Home
State lssunncc
Slalc SurCharge
Sidewalk
II
Curbcut
II
Demoll lion
?tate Surchnrge
Totul Miscellaneous Permits (E)
TOTAL AMOUNT OUE (cxclueling ciccI deal)
(A, B, C, D, .:md E Combincd)
FEE
. ,~~ .J
Ii( 0 i:J
hoc
-'ifL?L
2C J:h_
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perrnil is griJnled on tile express condition that the said
conslruction shall, in all respects, conform to the Ordinance
adopled by .Ihe ,Cily of Springfield" including lhe
Development Code, regUlating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of ..my provisions o! said ordinances.
Plan Check Fcc: ~.
Date Paid:
Receipt Number:
Received By:
Plans Revicwed-.'8-y-._._~_._-
Date
Systems Developmenl Charge is due on all undeveloped
proper,tics wilhln.tlic c'Jly limits wtlich arc being Improved.
ADDITIONAL COMMENTS
..,.
"
(
By signature, I stale and agree, that I h<3:ve c..ucfully examined
the complelcd application and do hereby cerllfy that all
Informallon hereon i3 Irue tinct correcl, and I further certify
thaI .:my and all work performed $haJl be done. in accordance
with Ihe Ordin':lrlCU:.i of ltw City of Springfleld, and Ihe Laws
of tllC Slale o[ Oregon perlaining to the worJ< described
herein, and lhal NO OCCUPAI...sCY will be made of any
struclure willlout permission of the Building Safely Division.
] [urlller cerli fy Hlal only contractors and employees who
arc in compliance.with GRS 701.055 will be used on thIs
project.
I further agree 10 ensure thai all required inspections arc
requesled at the proper time, that each address Is readable
from tile streel, Illat the permit card Is localed at the (ront
of ttle property, <:Ind the approved set of plans will remain
on Ihe sile ~I anime~ conSlr~n"
Slgnalur('~t?XA ~
Oat...
9- z;qI-9R'
VALIDATION:
o ~I )' /9'
DATE PAID '1/zq (11-
AMOUNT RECEIV[',O t&f 2 t, ul)
F,ECEIVED ElY W W
RECEII'T NUMElEfl