HomeMy WebLinkAboutPermit Mechanical 1999-9-1
1/4'13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Oltlce: 726.3759
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SPRINGFIELD
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LOCATION OF PROPOSED WORK: _L;;;.5 b
ASSESSORS MAP' / ? n '3 -.: ~
-r-c:: 16. "'I'"D
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LOT:
BLOCK:
OWNER: / ~"'- ,~hu. ~_
ADORE"'" . /;;J. '))." -rc::: /0< I-- ~
CITY: <0:) I"" ,,;.... 1" "",) JL
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STATF" (")Q<..
DESCRIBE WORK: T "-<+" II A 0. S -r- ...<:........+ ) IV
NEW REMODEL 0<.... ADDITION DEMOLISH
CONTRACTOR'S NAME
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7'7 Jill'
JOB NUMBER,
225 Fifth Street
'Sprlngfleld. Oregon 97477
<;' t? r I >A,J;:' J.I/. ,rt <..')0'2.. "iiltll
TAX LOT: CJ 0 2.. / ..
SUBDIVISION:
PHONE:J-6t:./ ~O~
ZIP: 4'1u'"()
t='J r.....IOJAc,-4
OTHER
GENERA' .
PLUMBING'
ABc..
ADDRESS
(' \...., ""' '" 't-'--"- .
'f.tO,4.<f?< 1"8
CONST.
CONTRACTOR #
+-<..~ )..JCAFF-
73~"
EXPIRES .", PHONE
9~ 7-e6/~
MECHANIC! ' .
ELECTRICA' .
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN:
. OF BLDGS' . OF UNIT'" ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG~' SQUARE FOOTAGE:
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 after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
o Footing - After trenches are
excavated. .
o Masonry - Steel location, bond
.beams. grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Posl and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decKing.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to mllng
trench.
o Water Line - Prior to filling
trench.
D Rough Plumbing - Pr(or to
cover.
o Rough Mochanlcal - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Servlco - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing lnsp.
o Framing - Prior to cover.
. ,
o Wail/Ceiling Insulation - P;lor to
cover. ,
o Drywall - Prior to taping..
o Wood Slovo - After Installellon.
~AS
.I'S::llnserl - After fireplace approvel
~ and Installation of unit.
o Curbcut & Approach - After
forms are erected blll prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and "sub-base material In place.
o Fence - When COfi'\pleted.
D Street Trees - When all required
trees are planted. _ _
o Final Plumbing - When all
plumbing warl< Is complete.
D Final Electrical - When all
" electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building is
completed.
~ther ,. 4'k' UUt!=-
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MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer."
o Electrical Connection - When
blocKing, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections Bre approved and
porchos, sklrllng, decks, and
venting have been Installed.
(
Lot~Y. ,',:
"Lot faces,
Lot sq.' ftg. Interior
Lot coverage Corner
Topography Panhandle >:
Total height Cul-de-sac
BUILDING PERMIT;
ITEM SQ. FT.
c, .~
X $/SQ. FT. ~
Main
Garage
Carport
Total Value
Building Permit Fee
~tate S.l!fcharge
Total Fee
(A)
I P.L.
IN
Is
_"'!._-
,E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S!3wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
u~~~ ~ fi/(",
, "
" .
Mechanical P~rmlt _.
,..,
, "
Issuance
r .
State Surcharge
/.tK r .4J'
(D)
Total Permit
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
.,
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D. and Ebomblned)
FEE
JJ?/..u '
/ L:) '"'
/8, o-tJ
j."'''
2c'.SCi
21:, 5"".0
';,'.
. .; ::..~' ~;.:'.;~',iH..,~;-
.'
Setbacks.
HSEIGAR
I
ACe' I
I
I
tiS THEP~OPOSEDWORK iN TH~.
HISTORICAL DISTRICT, OR ON
. THE HISTORICAL REGISTER?
If yes, this applldatlon must be signed
and approved. by the Historical
. Coordinator prlot to permit Issuance.
AP]'ROVED:
, ''':- ",' 't
BUILDING IfALt:JE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construction shall,'ln all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Development Code, reguiatlng the construction and use of
oulldlngs, 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:
Pians Reviewed By'
Date
Systems Development Charge Is due on all undeveloped
properties within tho 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 J further certify
that any and all work performed shall be done in accordance
with the Ordinances 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 agreo to ensure that 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
0'; the'slte at_all times during construction.
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Signature ~ ~ffi
Dateq 1/ /9q
VALIDATION:
RECEIPT NUMBER
DATE PAiD
AMOUNT RECEIVEn
RECEIVED BY
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