HomeMy WebLinkAboutPermit Mechanical 1993-6-28
RESIDENTIAL
PERMIT APPLICATION
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Illspucllomi: 1:'(J.37B9
Ollke: 7~(j.]/~19
LOCAlIOH OF 1'I"IOI'OSFIl WOIlK __1.'f
ASSESSOIlS MAP: __._________
LOT:....___....
SI'nING':IELU
OLOCK: _
OWNER: ___Ea: \..\,_\_~; e 10
ADDRESS '~____J_ L.Ji/L~.L !",__j~H :~_-e..._._.
CITY: ....__ _...~.fJ. .__.______ .__ STATE: () ~.
DESCRIBE WORl<: J_(U t.. \ ( &. e...1tJ 'Oo..:;-lf-_1Jjth-r-
NEW..____._ flEMODEI.. ___ ADDITION __ DEMOLISH
OTHER.
CONTRAC101I'S NAME
GENERAL: ...
ADDIlE!;S
CONST.
CONTRACTOIl ·
PLUMB/NG: ..__.._..____....___.. __'n.
MECIIANICAI:._~(-1.1..4 tLL. .__\4 ~t t~Q
ELECTIlICflL: .._.__.__ .__
QUAD AilE A:
. OF BLDGS:
OCCY GIlOUI'
. OF STORIE~;:
WATER ilEAl 1'11: __~._.. _.___'__'__
.
~ .;-d
_.. 3611T.
JOB NUMBEIl _..
~2!j r-lflh Slreot
Spllnglleld, Orcuol1 91477
TAX LOT:
SUBDIVISION:
PHONE:
J <{~ - 6 '{J..2-__....
(9(j,J
Zlp:__.1: 1l{.IL...
t-v.LMir~.._____
EXPIRES
PI/ONE
__...9/3/ "e "_~'k ~r-
~2S iClD
s:. f'J ,-"-'---
-..-i!--- .-..-.--..-..--.--
1l/]-lCf.'{S"
- OFFICE USE -
',LAND USE: __"_"_
. . OF UNITS:
CONSTR. TYPE: __..._
HEAT SOURCE:
RANGE: ___...._______
,
p",,~ 4v
FlOOD PLAIN: . .._._.
ZONING CODE:
. OF BDRMS:
SECONDARY HEAT: __. _.____
SQUARE FOOTAGE: _. .. .
To Icquc~jl ull intlpccllon, YOll Iwwl call 726.3769, Tills 10 3 2<1 hour rocordlng. Alllnspecllol1s rcqueslcd hefore 7:00 a.m. will be
made the ~;allll~ working day. In~pucU(Jns ruqueslcd aHer 7:00 a.lll. will be made the following work day.
o TempO! my Eleclrlc
D SHo Inspecllon - To be made
aller excavation, hul prior 10
selllnH hJrms.
o Underslilb PlulI1blng/Eleclrlcall
Mechonical - Prior to cover.
o Foollnu - After Irenchos are
oxcavalt!d.
o Mosonty - Sleel location, bond
beallls, Uroutlng.
o Foundilllon - After forms are
erected bul prior 10 concreto
placoment.
D Undoruround Plumblno - Prior
10 f11I1IlU Irench.
o Undeflluor Plumblng/Mochanlcal
- Prior 10 Insulation or decking.
D Post 8nd, Boom :- Prior 10 floor
Insulallon ori"dccldng..
[~ Floor Insulallon - Prior 10
decking.
[-I Sanll8lY Sewer - PrIor 10 filling
-. Ircnl:h.
D Slorm Sower - Pdor 10 IIllIng
Irench.
D Waler line - Prior 10 filling
lrunch. .' .
D Rou{Jh Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
l";;z( Rough Mechanical - Pilar to
~ovcr.
~ nOIlOh Eleclrlcal - Prior to
~over. .
o Elaclrlcar Servlca - Must be
approved 10 obtain permanent
electrical power.
I~ Fhoplace - Prior 10 lacln{J
malerlals and framing Insp.
D Frnmlng - Prior to c.over.
D Wall/Cel.llno InsulaUon - Prior 10
cover.
D Drywall - Prior to.laplng."
D Wood Stove - Aller Inslallatlon.
, I~ Insert - Allor flreplaco approval
and Installation. 01 unll.
'I~ C,"bcut & Approach - Aller
forllls ore eructed but prior to
plucemonl of concrete.
[J Shlawalk & Driveway - Allor
excavation Is cornplolo, lorms
and sub.base malorlal In place.
D Fonce - When completed.
D Street Trees - When ~II required
trees are planted. .
.~
o FIIlDI Plumhll1g'~ When all
plumbing worlt Is complete.
f':7f' Final Eleclrlcnl - Whon all
~electrlcal work Is complole.
rvr Final Mechanical - Wilen nil
~mochanlcal work 19,COlllplolO.
D Final Building - Wllon all
required Inspections hilve boen
approved and bulldlnu Is
comploted.
DOlher
, .
MOBILE HOME INSPECTIONS
D Blocking and Sal.Up -:- Wilen all
blocking Is complele. '..'
j,,-
".
I:=J Plumblno Connections - When
home has been connecled '0
wafer Bnd sower.
l--I Elechlcal ConnecUon - WIIOII
- bloddnO, !wt.uP. ami plulI1hlllU
Inspections have boon opprovlHl
and Ihe hOlllo Is connocted 10
the servlco pan~1.
D Final - Aller ell required
Inspections UfO approved and
porchos, sl(lrUng, decl(s, and
venting have been Inslalled.
Lot faces
Lol TYP.
Inlorlor
'.
LOI sq. IIg.
lot coverage
Corner
Topography
Panhandle
Cui-de-sac
Tolal helghl
. .IS lIlE I'FlOPOSEU WORI< IN lIlE
III~n()IIICAL DISHIICT. 011 ON
TIlE IIISroRICAL IIEGISTER? _....._.__
Selbacl<s
,---,---_._,_.__.,--
..fb.... HSS. g~!} .AC~
~---
S ..
----
II YOt;, lllls appllcallon mll~l 1..0 G1Unod
anti approved uy tllo Hislorlcal
Coordinator pi'ior 10 pelmll Is~uance.
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E
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BUILDING PERMIT
ITEM SO. FT. X $ISO. FT. = VALUE
Main .,
.'.
.',
Garage
Carport
\ ;;
,
Tolal Value
Building Permll Fee
Stalo Surcharnc
Tolal Foo
(A)
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
. .
PLUMBING PERMIT
ITEM
Flxlures
Resldenllal Balh(s)
N'
Sanllary Sewer FT.
Waler .~\
Storm Sewer'::
,
FT.
FT.
Mobile ~fome
Plumbing fermll .
Slalo Surchargo
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhausl liood
Vonl Fan
.N'
Wood SlovollnserllFlreplace Unll
Dryer Venl
6M 1-IA5"c
Mechanical Parmi I
/"1/1/
,
Issuance
Slate Surcharge
Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Horne
Slale Issuance
51 ale Surcharge
Sldowalk
It
Curbcul
It
Dumullllon
Slalo Surchargo
Tolal Miscellaneous Parmlls (El
TOTAL AMOUNT DUE (excluding olaclrlcal)
(A, B, C. 0, and E Combined)
FEE
/"" t7Z>
2.<><>
Ie;" tJO
/003
,7S""
2-~.7S"
:?~ C 7,j-
APPROVED: _____.. _..____
BUILDING VALUE, PLAN CHECI<
AND BUILDING PERMIT
This permllls granlod on Ihe expross eondillonllwllhe said
conslrucllon shall, In ~1I respects, conform '10 1110 Ordinance
adopted by tho Cily 01 Springfield. Including the
Development Code. regulaling lhe conslruction Clnd uso 01
buildings, and may bo suspended or revoked al any lime
upon violation of any provisions 01 said ordinances,
Plan Check Fee: _.___ _..
Dale Paid:
.. '
Receipt Numbcr:_._n__
Reeelved By:
Plans Ruvloweel Oy
[J,llc
Syslems DcvclopIIWll1 CllilI'~lC is duo on all 1ll1lhJ\lclopoll
properties wllilln 1110 Cily lilllils whIch art) being ill1plOvcd.
ADDITIONAL COMMENTS
')E.7.7~ A-'TE
_IS .p~d')
c~ ~~/r
o
By signature, I slate and aUree, thai I have carehllly examined
Ihe completed application and do hereby cmlily Ihal all
lnformallon horeon Is tflJO and carmel, and IfwllHlr ccrtily
Ihal any and all work performed shall be dono in BGt;oHJanco
wllh Ihe Ordinances ollho Clly 01 Springlield. ilIl<! 'ho Laws
of the Slalo of Oregon pertaining to the wulle ucsclihcd
herein, and lhat NO OCCUPANCY will be muchl 01 any
structure without permission of the Building Safely Division.
I furlher cerlHy that only contractors and umplpyec5 who
are In compllanco with ORS 701.055 will be lISO(\ on Ihls
projec\.
I lurlher agree to ensure that all required inspeclions are
roquested at lhe proper time, Ihat oach address 1$ readablo
Irom Iho slreel, Iha' tile permll card Is localod al Iho irani
ollbo properly, and tile approved sol 01 plan:; will .omaln
on Ihe slle al all It~s dUrl~g conslrllellon.
Slgnalure _.__.~ 1t(~d_____
6-2..9~J
Dale ' __. ..__,._._. ..~-_. -.-
I
VALlDAI"ION:
f1ECEIPr NUMIlEfI ....._1'2 '<.../---.-.
DATE PAID___..._&/2~~.
AMOUNT RECEIVED u___.._ '.u__U ......-..........-
RECEIVED BY _.__._u._u_.~.._. ...........-----