HomeMy WebLinkAboutPermit Mechanical 1992-5-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: 126.3769
Office:: 726,3/;;9
.
SPRINGFIELD
LOCfiflON OJ PROf'OSi:D wonK: ~~ ~o_;l,r/f.,l/e,t; T t-4~~
ASSEssom; 1,'IAP:.j 7'.:13--~- ':-L~
LOT__.,
BLOCK: _..~n'
OWNER:_, Ftfl#/'It( .o;~,rA'to
ADDHE,,5:, J-.F'O ~/f;f()~&.T t..4'1'L.
CITY: _>ltd ~/P'~ E(cC~ ...QA t' STAW
DESCRIBE WORI" 1'/'I57"'&C ~'-iV
NEW _., REMODEL
ADDITION
CONTRACTOfrs NAME
GENERAL: ..
I'LUMnING:
D~~
!.l NUMBER _ 92c:::>~_~
225 Fifth Streel
Springfield, Orcuon 97477
TAX LOT:
Q::)Y~
SUBDIVISION:
PHONE: 7 V?- <;"':2- 'T Y
ZIP: 7'7 ~,~_...
,.,.".s F...~-Y#ct'.
,P..... 7" <-oJ I)..,-,,-r.
t;.", s C";''''e
DEMOLISH
OTHER
ADDRESS
CONST,
CONTRACTOR'
EXPIRES
PHON!:
MECHANICAl: .(,t4d/8"!Jt!"~T/;"i_. i{;:0 T <-v ~
EL!:CrRICAL: ~.4"!kC{ fC4!'c7/9...!C
QUAIJ AnEA_SB-,JJLG--
" OF BLOCS
OCCY Gnnul':
" OF ~norlll':;: ..___. ~
WATER HEAr lOR: _._
70S'( .>
- OFFICE USE -
LAND USE: _n_.:
n OF UNITS:
CONSTR, TYI'I::
l'IEAf SOUnCE:
RANGE: __
/J.-:zr?Z
-!....O'.,Z >2".[
FLOOD PLAIN:
ZONING CODE:
" OF BDRMS:
SECONDARY HI,AT:..
SQUARE FOOTAGE: _.__
To request all inspection, you lllust call 726-3769. This Is i1 24 hour recording. All Inspections rcquestceJ before 7:00 .Ull. will l)c
made the salllC worl,ing day. inspections requested after 7:00 a.lll_ will be made the following work day.
Cl Temporary Electric
D Site Inspection - To be made
afteF '~.'~';;:JValion, 1,llll prior to
scttin~J lorms.
D
Undcfslab PlumhingJ Electrical/
Mechanical - Prior to cover.
D
FootillO - Afler trenches are
excav3lf:d.
D
Masonry - Sled location, bond
beillll:'>. l]rOulillt].
[]
FoulHj.llion - A/ltn forllls arc
erected t)ut pliOI to concrete
JJlaCUII+I~nl.
o
Under{JlOund PlullIbing - Prior
to filljn~l trench.
CI
Undl!llloor Plul1lbing/Mechanical
- Prior to insulation or decking.
o Posl and Beam - Prior IO.f1oor
insulation or cJecl<ing.
o Flool: Insulation - Prior to
dccklrlU. "
CI
Sanitary Sewer - Prior 10 filling
trench.
o
Storm Sewer - Prior to filling
trench.
o
Waler Line - Pdur to filling
tronell. t
o Rou{jh Plumbino - Prior to
cover.
REQUIRED INSPECTIONS
'I~ Rough .Mechallical - Prior to
cover.
l~' Rough Elcctl"ical - Prior to
cover.
I~ Electrical Service - Must be
approvecj \0 oblain permanent
electrical power.
D Fireplace - Prior to facing
materials amJ flaming Insp.
I~ Framing - Prior to cover.
[~ Wall/Ceilino Insulatio~ - Prior to
cover. -
!~ Drywall - Prior 10. taPin?._
I~ Wood Slave - After installation.
o Insert - Alter fireplace approval
anc1lnstallatlon of unit.
o Curbcut & Approach - After
forms arc ereeted but prior to
placement of concrete.
[~ Sidewalk & Dliveway - After
excavation is complete, forms
ancj sub-ba:;e lllatcrlal in place.
D Fence - When completed.
[J
Street Trees - When all required
trees are planted.
,
o
Final Plumbing - Wtlen all
plumbing WOII< is cOFllplt":te.
~ Final Eleclrical - WhUll all
~~~~;;;;7/~,
o Final Mechanical -"'When all
mechanical work is cOlllpletl:.
o
Final Building""': When all
required inspections have bet']n
approved onc\ building is
completed.
IZJ Other~....8~~
" ,
MOBILE HOME INSPECTIONS
o Blocking and Sel.Up - Wh(:1I all
blocking Is completc. .
o Plumbing Connections ~ WIl(:Fl
home has been connectl:d to
waler and sewer.
o
Electrical COllnection - WI\l~1l
blocking, set-up, ami plumbinu
inspections hnve becn npprov,)d
and the home is connl]ctcd It I
the .servlce panel.
o Final - Afler all raquifec1
inspections are approved and
porches, skirting, decl(~" and
venting have been in~tt1l1ccl.
Lol laces
Lot Type.
Lot sq. fig.
Interior
Lut coverage
Corner
TC.1poorapllY
Panlwndlc
Tolal height
Cul.de.sac
BUILDING PERMIT
ITEM
SO, FT.
X $/50, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
Stale Surcllarue
TOt;11 Fee
(A)
-. THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, 011 ON
THE HIS'IORICAl REGISTEr\" ____ '
11 yes, thi::; application 1ll11:;1 be signed
and approved IJY 1t1C Hi~;torical
Courdillator priur to permi t i~_;~~llanGC.
_, Selbi.1CI\s _,_.
P.L HSE GAR ACC
--------
J::l___.___
_5_ ___ _.... _ ___
Y"-___
E
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
S.mitary Sewer
FT.
Water
FT.
Storm Sewer
FT,
Mobile Horne
Plumbing Permit
State Surcharge
Tolal Char~le
(C)
MECHANICAL PERMIT
Fllrll;lce ~/'5" ~
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFircplacc Unit
DrYI~r Vent
4r--J-,;q~~
/'&~
Mechanical Permit
Issuance
Stnlc Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Stale Issuance
Statr;'! Surcharge
Sidewalk
II
Curbcut
II
Dl!/llolilion
~:;I:ltl,~ SurcllarfJc
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 0, C, D, and E Combined)
FEE
h.--
/C7_ """""'"
.?S
25:75"
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on (he ex prest; condit"ion thaI the said
construction shall, in all rcspccls, conform to ttle Ordinance
adopted by Ihe Cily of Springfield, including the
Development Code, regulating the conslruction and use of
buildings, and may be suspended or revoked at any time
upon violation of ;1ny provi~ions of said ordinflncos.
Plan Check Fce:
Date Paid:
Receipt Number'
Received By:
pr;lI1s R!!viewed By
Date
Systems Development CI1;lIge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, thallllave carefully examined
the completed <lpplication i1nd do heleby celtify IIlal all
information hereon is true amJ correcl, and I furlllCr certify
ttlat any i1nd all work performed shall be done in accordance
with the OrdinancC3 of the City of Sprinofielcl, ;u1(1111e l;IWS
of the Stale of Orc~Jon pertaining 10 the wOlk dcscribcej
herein, and that NO OCCUPANCY will be 11I;l(jC 01 ;my
structure willlOUI permission of the Building Safety Division.
I further certify that only conlractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree 10 ensure that all required inspections arc
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
of the prop~rlY~ the approved set of plans will remain
on the sile at .11 t mes dfr9 con/7ction.
Signalurn .eu <</ ~ ~ff
- /'-
Dale ~- '?-cO - r z
VALIDATION:
IlECEIPr NUMBI,R ___ __ '-/.ZI"I_ ____.
DATE PAID __~gp...::..22..
AMOUNT RECEIVED _ _25 ;?/,
RECEIVED BY ~