HomeMy WebLinkAboutPermit Mechanical 1996-11-22
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LOCATION OF PROPOSED WORK:_ '70 s----.a~ ,7.."
U(7 3 3Lf../ '?
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Olfice: 726.3759
ASSESSORS MAP:
LOT'
OWNER:
ADDRESS'
CITY:
NEW
REMODEL
PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICAL:~"'" I'J.,mp
ELECTRICAL:
.
BLOCK:
ADDITION
SPRINGFIELD . .~,," , .
,
ilia:
.~
rJ6/'!)S/
JOB NUMBER
225 FilII' Strcet
Springfield, Oregon 97477
STATE:
"-?u'
TAX LOT:
/1 DOn
SUBDIVISION:
PHONE: _
7~~q-c:;l7
7<)(;.,1,- 5(':~AL., ~/.,.,V'
/~
7(":) g- ;-:; V-"-o , I.-
~'5r7VnJ.f;';//
DESCRIBE WORK'
DEMOLISH
~
ZIP:
<97'/77
OTHER
ADDRESS
CONST.
CONTRACTOR'
EX pm ES
&?;';J/oZ...f/o:y'pyjll:&.. /31 ~
L/ - I'
- OFFfCE USE _
LAND USE: _,__
. OF UNITS:
CONSTR. TYPE: ___,
HEAT SOURCE:
RANGE:__
~U~I~ :~~'~~C~IP~~::~t~S
over.
D Rough Electrical - Prior to
cover.
D
ElcClricnl Service - Must be
approved to obtaIn permanent
electrical power.
8"'/& yo ~-1>-97 3Y.s-2;'~
OUAD AREA:
. OF BLDGS:_
OCCY GROUP:
. OF STORIES:
WATER HEATER:
FLOOD PLAIN:
ZONING CODE: __.__
. OF BDRMS:
SECONDARY HEAT:
SOUARE FOOTAGE: .___
To request an InspectIon, you must c811 726.3769. ThIs is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the sarne working day, ln~:;pcclions requested nfter 7:00 a.m. will be made the following worl< day.
D Temporary Eloctric
D
Site Inspection - To be made
after excavation, but prior \0
seltlng forms.
o
Undcrslilb Plumbing} Electric;:lll
Mechanical - Prior \0 cover.
o
Footing - After trenches arc
excavated.
D
Masonry - Steel location, bond
beams, grouting.
o
Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing} Mechanical
- PrIor to Insulallon or decldng.
D
Post and Beam - Prior to floor
Insulation or dccldng.
D
Floor Insula lion - Prior to
decking.
D
Sanitary Sewer - Prior to filling
trench.
o
Storm Sewer - Prior to filling
trench.
o
Water L1no
trench.
Prior 10 filling
D
Rough Plumbing - Prior to
cover.
o
Fireplace - Prior to facing
materials and framing Insp.
D
Framing - Prior to cover.
o
Wall/Ceiling Insulation - Prior to
cover.
D
Drywall - Prior to tapIng.
D Wood Stove - After InstallatIon.
Qnserl - After fireplace approve!
and instalJatJon of unit.
o
Curbcut & Appr::wch - After
forms arc erected but prior \0
placement of concrete.
o
Sidcwalk & Dri\Cw;:lY - After
excavation Is complete, forms
ane] sU~J.basc fTatcrinl In pl,lce.
D
Fence - Wtlen completed.
D
Stroot Treos - When all required
trees are planled.
D
Final Plumbing - When all
plumbIng wt;)rl~ Is compJet.e.
D Finnl Elcclricnl - WIlen all
electrical worl~ is complete.
~t1 Mecha"lcal - Whun all
~Chanical worl~ Is complete.
D Final Building - Wtlen all
required Inspections have been
approved and building is
compleled.
~Olhcr
,~
-
(J?
--.~
wd 0 ~
MOBILE HOME INSPECTIONS
D
Blocking and Sel.Up - Wilen all
blocl~inu is complete.
D
Plumbing Connections _ When
tlOme Ili.lS been connected to
W<lter and sewer.
o
Electrical Connection - When
blocldnu, sel-up, <lnd plumbing
inspeclions tl~vC been <lpprovcd
and tile horne is connected to
the service panel.
D
Final - After all rcquired
inspections are approved and
porches, skirting, decks, and
ventlng have been Installed.
Lot faces
..
Lot Type
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cut-de-sac
BUILDING PERMIT
ITEM SO. FT. X $/50. FT.
Main
,
Garage
Carport
TO\<:11 Value
Building Permit Fcc
Slate Surcl,argc
Total Fcc
(AI
Setback:;
P.L. HSE GAR
N
2-__
W
~
VALUE
"
SYSTEMS DEVELOPMENT CHARGE, (SDC)
(B)
. JO-1li)
-j 370 D~ MMIh L, JJ:7_
(D) . 2(o,J-f;
MISCELLANEOUS PERMITS
PLUMBING PERMIT
tTEM
Fixtures
Residential Bath(.)
N'
S<:1nltary S~wcr
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
Wood Stove/~rCPlacc Unit
Dryer Vent
Y\t1.t~
Mechanical Permit
Issu<:1nce
State Surcharge
Total Permit
Mobile Homo
State Issuance
Slate Surcharge
, Sidewalk
It
Curbcul
II
Demoll tion
State Surcharge
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
is -61J
,-%~
ACC I
I
I
I
~
.
is THE PROPOSED WORK ;N THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be sIgned
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on tl,o express condition that the said
construcli(~m shall, in 'all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, reg'ulating the constru~tion and use of
buildings, and may be suspended or revoked at any time
upon viol.1lion of <lny provisions of s<lid ordinances.
Plan Checl< Fcc:
Dale PC3id:
Receipt Nurnber:__.,_
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties withIn the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I statc and agree, that I have carefully examined
U'e comploted application and do hereby certlry thai all
Information hereon is true and correct, and I further certify
that any and arl work pcrformed shall be done in accordance
with the Ordinances of the City ot Springfield, and the Laws
of ttle Stole of Oregon perlainlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safely DivisIon.
I further cerli fy ll'lat only contractors and employees who
are in compliance wilt, ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspections are
requested at the proper time, tt,at each address Is road able
from the street, that the pormlt card Is located at the tront
of the property, and the approved set of plans will remain
on 010 slle at all limes dUring construction. _-
Signature ~~~ ~~
Dale /;-?;?~~~{/ (I
VALIDATION: ~/7?
RECEIPT NUMBER ;2 ~j') ,I )
DATE PAID . II -'j;)-Cj ~ -
~MOUNT RECEIVED -'2 t? ,;).f')
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flECEIVED BY