HomeMy WebLinkAboutPermit Mechanical 1997-7-11
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Oflice: 726.3759
LOT'
.
spnlNcr:IELO
BLOCK:
OWNER: LLWZ/7 rI mt1!lJG (~!1.tLb11Jlv
'''"''', . ~~.f;//J"" &u.dau IU-
CITY: xl-. . dE:! (J STATE: _IJU
DESCRIBE WORK: ~iM.P.LLL ,~M
NEW REMODEL L ADDITION
CONTRACTOR'S NAME
GENERAL:
:-:l.u-t ../7 /U.L .
DEMOLISH ___ OTHEIl
.
JOB NUMBER
~7/o37
. P I'
225 Fiflh Street
Springlleld, Oregon 97477
TAX LOT:
(Q~ $" b-~
SUBDIVISION:
PHONr..
.1tfb -O()J(P
ZIP:
CJ1tf11
ADDRESS
CON ST.
CONTRACTOR'
PHONE
PLUMBING'
MECHANICAL:&tnj./JIdJtlJtJ /15/ f)/JnS.J SllJ)
ELECTRICAl'
_ CONSTR. TYPE:____ ~
1::. HEAT SO.u~~!\fI\-\\:, -NO;01
Oit\C~' ~\"-''- \:,'f..\'\ "\1 IS
WATER HEATER: - __~___ ~II 'jmI'rGE' .(' ?>'~\" SOUAIl!: FOOTAGE:
11 \lC p\:,~ \.) J\\r>'R \\'1,.... ;j.\,:n I'UI" ..- -,-.
To request an Inspection, you 1'T\.l{~~fj)pql~'37~'@J~~~4 hour recording. All fn~[)cctlon~ rcqllC~lcd before 7:00 n.rn
made tho same working day. In5))ccl~~~~Mltc~O'\)t~.H 7:00 a.m. will be made the following worl< doy.
CO~ ,a()\)r>.'1A'~t5UIRED INSPECTIONS
r>.~1 .
D Rough Mocll<1mcal - Prior \0
cover.
'-,
QUAD AREA:
. ..
;-..,
. OF BLDGS'
OCCY GROUP:
. OF STORIES: ____
D Tompornry Electric
D Site Inspection - To bc made
aHer cxcavnllon, but prior to
setllng rorms.
D
UncJcrslilb Plumbing I Elcctricilll
Mechnnlcill - PrIor to cover,
D
Footing - After trenches arc
c:xcnva!cd.
D Masonry - Steel locatIon, bond
beams, groutlng,
D
Foundntlon - After forms arc
erected but prior to concrete
placement.
o
UndergrolJlld Plumbing - Prior
to filling trench.
D
Underfloor Plumblno/Mech~nlcnl
- Prior to Insulallon or decking,
o
Post nnd 8eam - Prior to floor
Insulation or decl<lng.
o
Floor Insulnlion
deckln9.
Prior to
o S~niti1ry Sewer - Prior to rtlling
trench.
D Storm Sewer - Prior to Illling
trench.
D W~lcr Line - Prior to filling
trench, '",..
o
Rough Plumbing - Prior to
cover,
...
OOf/ft;o
- OFFICE USE -
LAND USE:_
. OF UNITS:
o Rough Electric", - Prior to
cover.
D Elcctricnl Service - MllSI be
approvcel to obl.iln perrn:Jncnt
electrlc.)1 power.
o Fireplace - Prior 10 fneing
materials and framing Insp.
D Framing - Prior 10 cover.
D Wall/C'elling In:>ulntio.n - Prior to
cover.
o Dryw<l1I - PrIor 10 laPin?, .
D Wood Slave - Afler In5talln:lon.
D Insert - After fireplace approval
and InslnUatlon of unl!.
o
Curbcut & ^ppro,lcl1 - After
forms are erected but prior 10
placement 1)( c:oncret<:,
D
Sidcwalk & Drivcw:I\, - After
excavation is complete. rOrrll:J
anel sub. base mil!<:rial in place.
D Fence - WIlen completed,
D Stroot Trees - Wllcn nil requIred
trees arc plantcd,
l,XPIIlES
~tl7-qf'
7Jb-()/OfJ .
FLOOD PLAIN:
ZONING CODE: ____
II or- BDRMS'
SECONDAflY HEAr: ___'..
will be
D Finnl Plumbing - When all
plumbing worl~ IS complelc
~Fillnl ElcclriCOII - VJhen all
~ clectrical worl( is complete.
~iJHlI Mcclwilicnl - When all
/~ ~'eCh!Jnlcor worr, Is complele.
D Fin"l fJuilclino - WI1Cn all
required in5pectlons h<lvC been
approved and building is
completed,
~OlhCr _~~ LaJ~
MOBILE HOME INSPECTIONS
D Olockillg nnd Sel'Up - Wllcn all
blocl<lnU is complete.
D
Plul11binU Connections - Whcn
tWine 11il$ been con/lccted 10
Willer :lflcl sewGr.
[J
ElcclriGHI COllncction - When
blor:l~i"O. sct-up. am] plumbing
lll~;pccllon~ hnve been ~pproved
allel tile IlOllle is connecled 10
II1G service pane!.
[]
Finnl - AflQr uJJ required
Inspections ':He approved and
porches, sl<lrling. decl<s, and
ventIng tlilve been Instnllcd.
.
Lot faces
Lal Type
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Panllilndtc
Total 11Clght
Cul.dc<.><:l.C
BUILDING PERMIT
ITEM
so. FT.
X $/SO. Fr
Main
Garage
Carport
I
i
Tolal Value
Building Permi ( Fcc
Slate SurchLlrgc
Total Fcc
(A)
~"';',,~.l!:'~'."+ tr. !.t9i.':E,~-
i, tTHE PF10POSED WORt< iN THE,
. .'.I-IISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
1l yes, this app1icalion must be signed
and approved by the Historical
Coordinator prior to permit issuance.
P.L,
Sctbncl(:5
HSE GAR Accl
I
N
S
---
_~___.J
w
---_.'- --- -----
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APPROVED:
VALUE
"
SYSTEMS DEVEL9~MENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential OiJlh(s) NO
Sanitary S~wcr
Water
FT.
----
FT.
Storm Sewer
FT.
Mobile Horne
Plumbing Parmit
Stale Surcharge
Total ChLlrgc
(C)
MECHANICAL PERMIT
Furn.1Gc
Exhaust Hood
Vent Fan
N'
Wood Stovc/ln::;crt/Flrcplace'Unil
Dryer Vent
~ (.;11L~___
McclwniC<lr Parmi I
)'It /C ,
Issuance
Stale Surcharnc
, 7S- +- >- 4-S-
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Slale Issunnce
Slale Surcharge
Sidewalk
It
Curbcu l
I.
Demoll lion
?tate Surcharge
Tolnl Miscellaneous Permi lr; (E)
TOTAL AMOUNT DUE (axclutling alectric"I)
(A, 0, C, 0, and E Combined)
,"'; ""
I; ',. ',l,~. .' "
.. ( I'":!,.- ; ...., ~
.~d' '.'...
'l. "
FEE
~.. I ",-,Ii'l' ,/I
... 'f". .:
Ih~
-2- Cl 0
-,-~~---
I s-,o--D
/D~
-'-~~
7.L~
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granled on the express condition lhallhe said
construction ~h(1ll, in all respects, conform to ttle Ordinance
adopted by Ihe City 01 Springfield. including Ihe
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time,
upon violLltion of any provisions of said ordinLlnces.
Plan Check Fcc'
Date Paid:
Receipt Nlllllber:__.
Received By:
Plans Revi.cwC(i-.Oy-'---....-._-
OLlte'
Systems Development Charge Is due on all undeveloped,
properlies within the City limits whicll are being improved.
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carefully cxamlned
tho completed applicalion and do h~reby certify that all
Information hereon i$ true ancl correct, and I further cerUfy
thilt Llny ilnd all work performed t;hall be done in accordance
wilh the Ordin<lncL:s of the City of Springlleld, nnd the Laws
of tile StCltc of Oregon perlaining to the worl~ descrlbed
hel'(dn, and Ihal NO OCCUPANCY will be made of any
struclurc willloul permission of the Building Safely Division.
I furlher cerlify Itlat only conlractors and employees who
LIre in compliancc'with QRS 701.055 will be used on this
projcct.
I further Llgree to ensure thaI all rCQuirod inspections arc
rCQuested althe proper time, lhat each address Is readable
from 1I1e street ilt ttle permit card Is located ilt thc front
of tile prop y, ill the approved set of plans will remain
:::::" ~ I~~ :' ;]);;:,'(
VAll D/ITI ON:
z&~.:Ig
7/1~97
-;?jr_ ,2..0
:~
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RECEII'T NUMBEe1
DATE PAID
AMOUNT RECEIVED
FIECEIVED BY