HomeMy WebLinkAboutPermit Mechanical 1999-10-19
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
ASSESSORS MAP:
LOT'
.en
SPRINGFIELD
BLOCK:
OWNER: 'Don ~ TUr\ Vav1~j
ADDRF""" P 57 .!ta VY\ I l-to n Sf,
CITY' S f-P-Irt STATI"
DESCRIBE WORK:' I Y\slr.d.1
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v
NEW REMODEL
ADDITION
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IV!
DEMOLISH
OTHER
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11 It.; ~ ?(
JOB NUMBER
225 Fifth Street,
Sprlnglleld. Oregon 97477
TAX LOT:
0022...8'-
sueDIVISION'
PHONE:
7 LJ- '7 - 7 079
ZIP' 97 q.. 77
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CON ST.
CONTRACTOR'
GENERAl'
CONTRACTOR'S NAME ADDRESS
OWy)U' (m Irlf)II'l.1:s,)
oJ J
PLUMBING'
MECHANICAl'
ELECTRICAl'
QUAD AREA: K
t O:r~Vi~DGS.. \ \ 3'PIQ!= IFiHEWOR iT
, c::, pE.RMIT bt1~.. ERMIT IS 1'l0
.I-IIOCC'y..GSewOcQTHISP
Ml:!OR~QllQI\~ AOANOONEDl'"uR
;OM?KEfi.iVt:'''''''' "" /W
~~5WOD. .
EXPIRES ,~ PHONE
- OFFICE USE -
LAND USE: _. ATTENTION:Oreqon law Fl"OCil)'fPl',II(IN"
---rollow rules adopted by the Oreaon Utility
· OF UNITS: ~'c''''--''--' ~_.., T ZONING COD"'.
~...................,' .......... .,...... nOS? rLlI~~c-rc:: ~blnJILlI
CONSTR. TYPl'in OAR 952-001-0010 t:~rOI!r".0-F.JBifFfMS~n1-
U090. You may obtain copies of the rules bv
HEAT SOURCE: _,,-1"-- ,,-- ..,.L ('101-' SECONI)A~Y .HEAT:
.............~ ........ ........\'-'1. ." ..... Ult:.: l':l~fJlhJI18-
RANGE: _ numberforths Oregon UtiSQ~ARl!jI;;()QmGE: __
Center is 1-ROn-~~~-?:<.!14\
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 afler 7:00 a.m. will be made the following work day.
o Rough Electrical - Prior to 0 Final Electrical _ When all
cover. electrical work is complete.
D Electrical Service - Must be ~Fin I Mechanical - When all
approved to obtain permanent m hanlesl work Is complete.
~trlcal power. t1 /11'
/Vln..r I!+:;~ (....C?7 D Final Building - When all
D Fir place - Prior to facing required Inspections have been
tcrlsls and framing Insp. approved and buildIng Is
completed.
D Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taPI~g.
D Underlloor Plumblng/Mechanlcsl
- Prior to Insulation or decking. D Wood Stovo - After Installation.
D Post and Beam - Prior to floor ~
Insulation or decking. Diose t - After fireplace approve!
a Installation of unit.
D Floor Insulation - Prior to
decking. D Curbellt & Approach - After
forms are emcted but prior to
placement of concrete.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. \
D WeIer Line - Prior to filling
trench.
D Rough Plumbing ~ Prior to
cover.
D Sidewalk & Driveway - After
excavation Is complete. forms
and sub-base material In place.
D Fence - \-Vhen cOi"llpleted.
D Street Trees - When all required
trees Bre planted.
D Final Plumbing - When all
plumbing w9rk Is complet.e.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connoctlons - When
home has been connected to
water .'lnd sewer.
D Electrical Connecllon - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, sklrtlng, decks, and
venting have been Installed.
I~'
~
Lot faces
L~t TYP'
Interior
Lot SQ. ftg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de-sac.
BUILDING PERMIT"
ITEM sa. FT.
1
X $/SO. FT. =
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
I PL.
IN
Is
W
--- ----
E
----
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanl tary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/~ePlace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcul
Demolition
State Surcharge
Total Mlscellaneou~ Permits (E)
""I
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Cpmblned)
"
FEE
/\:0"
(0.00
/. Sv
26. .YO
. ,',:: ,"
.
Setbacks
HSEIGAR
I
H.l
IS THE PROPOSED WORK IN 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.
ACC I
I
I
I
J
APPROVE['l'
. ", '/
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thai the saId
construction shall, In all respects, conform to the Ordinance
adopted by the City 01 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
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
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
with the Ordinanc~s 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 lo ensuro thai 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 ~urln~~nstructlon.
Signaturp V-UI? Ud/1'/Mf?~
Date /() J /0 /qq
VALIDATION:
3 02-Cf
RECEIPT NUMBER 0 , .
DATE PAID /U/ r1 I 'f7
I .
AMOUNT RECEIVED. Ii 26. rn
RECEIVED BY t(J/ WW