HomeMy WebLinkAboutPermit Mechanical 1996-04-01LI)
2 Vrtr 3s+\
BLOCK:
PR
2LOT
20
N.
JOB NIJMBER
SUBDIVISION:
TAX LOTr
LOCATION OF PAOPOSED WORK:
ASSESSOFS MAP:
BESIDENTIAL
PERMIT APPLICATION
lnspectlons: 226.g269Olllco: 126.3Z59 225 Fllth Street
Sprlngltetd, Oregon gl 4Tl
PHONE:
I KA
(
o.ra ZIP:B?7 +
C J..t-rf ) r-s
Yts f\
OWNER:
ADDRESS:
CITY;
C+n q_r
!"t
Kh C
f
F.ln F{< C
ADDITION DEMOLIS OTHER
DESCBIBE WORK:
NEW- FEMODEL
ADDRESS
CCq)fB
.r tL
EXPIRES PHONE
-?
CONTBA TOB'S NAME
GENEBAL:
PLUMBING:
MECHANICAL:
ELECTBICAL:
CONST.
CONTHACTOR /
- OFFICE USE -
LAND USE:
FANGE:
WATER HEATER:
r OF BDBMS:
r OF UNITS:
FLOOD PLAIN;
QUAD AREA:
r OF BLDGS:
SECONDABY HEA]:
SQUARE FOOTAGE:
OCCY GROUP:
r OF STOBIES:
CONSTR. TYPEI
HEAT SOURCEI
To requ ost an lns pect lon,you mu st cal 726.3769.Thls ls 24 hou recordl ng.AilmadethoSameworklngday,lnspec rl ons reques ted af ler 7;00 a.rn,wl be made
lnspectlonr
the (oilowl
remporary Etectrtc HEQUIBED INSPECTIONS
a{ig
Mechanlcal - Prror ro
Slte lnspecllon - To
SlfitJ*H!"*,;,',"r?,:ii:ou fl i#r,: Erec,rrcar - prror ro
s requesled belore l:OO a.m. wlll belng work day.
Flnal. ptumbtng _ When ailprumbtno work ls complele.
n H::i:,ii":",' lHi :l 1 S, ::i'j;,,,
[l Footlng - Afrer trenches are
-
oxcavaled.
fl lttrconry - Sreet tocailon, bond
-
Doarnor groullng.
l-l Foundatlon - Afrer forme are._ erecled but prlor to concreteplac6ment.
f-l Unlgrground ptumbtng - prtor
-
lo fllllng trench.
l-l Underttoor ptumbtng/Mechantcat
Prlor lo lnsulatlon or decklng.
l-l Post and Beam - prlor to ftoorH lnsulallon or decklng.
E
tl 5,'l;1,,:'""i*:i,,.
"H ii" il].
iii:,rip,Hli,:;#;:'"ff, E('::l*ffIr,jn',,
"l,ti?"iliolecUloal power.
f] l,l:l,.lce - prtor ro factns
- materlale and lramlng tnsfi
Flnal Bulldlng - When allre-qulred .lnspec llons have beenapprovod and bulldlng lscompteled.
Framlng - prlor lo cover.
I
lnsJlatlon fr Olher f
Wall/Cblttng
cover.- Prlor to C+e
l-l Drywafl - prtor ro taptng.
l-l Wooa Stove - Attor lnsrailailon.
l-l lnaert - Alror ftreplace approvat
- and lnstallatlon oJ unlt.
l-*l Blocktng and Ser.Up - Whon ail,J blocklng ls compleie.
W a*s /t<se@oP*fll0z
MOBILE HO ME INSPECTIO I
n
Floor lnsulallon - prlor to
docklng.
Sanltary Sewer - Prlor to fllilng
trench.
Slorm Sewer - Prlor to lllllng
trsnoh.
Waler Llns - Prlor to fllllng
lrench.
Rough Plumblng - Prlor to
cover.
[-l Curbcul & Approaclr - AfrerlJ forms are orecled but prlor toplacement of concrete.
Plumblng Connoctlons - Whenlrome has boen connected towater and sewer.
Eleclrlcal Connectlon - Whenblocklng, set.up, and plurpblng
tnspocllons havo been approved
an<J the homo ls connooted tothe servlce panel.
Sldewalk & Drlveway - After
excavatlon le comploto, forms
and Eub-base materlal ln place.
Fonco - Whon completed.
Slreet Treeg - When all requlred
trees ale Ptanted.
Flnal - A(ter all requlred
lnspectlons are approved and
porchos, sklrtlng, decks, and
ventlnO havo been lnstalled,
,-.
STATE:
a
E rrl
n
rl
tl
tl
n
'{.
r
." ,, I .r. Y/.,1.
Lot faces
Lot sq. llg.
Lot coverago
TopograPhY
Total lelght
Lot Typo
-.
lnterlor
--
Corner
-
Panhandle
-- Cul-de'sac
S ks IS THE PROPOSED WORK tN TH E.
' HlsroBlcAL DtSTBlgr, oB oN.,THE HISTORICAL BEGISTEFI?
ll yes, thls appllcatlon must be slgned
and'aPProved bY the Hlstorlcal
Coordlnator prlor to permlt lssuance'
APPBOVED:
ACCGARP.L.HSE
N
S
W
E
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express condltlon that the sald
."nt[."tion sirall, ln all respects, conform to the ordlnance
Ii"-p1"'i' uv- the' cltv .oi sprlnsllel.d, lncludlng the
Orrifoptn""t Code, regulatlng ihe.constructlon and ube ol
ouriOi^-s", ""d may ui suspenoed or revoked at any tlme
,pon viof"tfon of any provlslons ol sald ordlnances'
Plan Check Fee:
DatePlans Rovlewed By
Recelved BY:
Date Pald:
Becelpt Nu
BUILDING PERMIT
VALUE
(A)
SO. FT. X $/SO. FT.ITEM
i'.laln
Gar.age
Carpolt
Total Value
Bulldlng Permlt Fee
Slate Surcharge
Total Fee
Systems Developmont Charge ls due on all undeveloped
propertlos wlthln tho Clty llmlts whlch are belng lmproved'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ADDITIONAL COMMENTS
t
{2saq,oo
6
FEE
(c)
N0
FT,
FT,
PLUMBING PERMIT
Plumblng Permlt
Slate- Sutcharge
Total Charge
ITEM
Flxtu rest
Flesldentlai Bath(s)
SanltarY Sewer
Water
Storm Sewer
Moblle Home
Wood Stove/ lnsert / Flreplace Unlt
Oryel Vent t/ ,':qi
Mechanlcal Permlt ,.14.2).
lssuahcd
State Surcharge , ?J' f '4f
Total Permlt (D)
MECHANICAL PERMIT
5.F
/s;d-o
6?
"W
Oo
l.l o
<t ,r 2J.AzO .
Furnace
Exhaust Hood
Vent Fan
By slgnature, I stato and agroe, that I have carelully examlned
the completed appllcatlon and do hereby certlfy that all
lnformatlon hereon ls true and correct, and I f urther certlfy
that any and all work performed shall be done ln accordance
wlth lhe Ordlnances ol the Clty of Sprlngfleld, and the Laws
of the State ol Oregon perlalnlng to tho work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permlsslon of the Bulldlng Safety Dlvlslon.
I further certlly that only contractors and employees who
are ln compllance wlth ORS 701.055 wlll be used on lhle
prolect.
I {urther agre6 to ensuie that all requlred lnspectlons are
requested at the proper tlme, that each address ls readable
from the street, that the permlt card ls located at the front
of tho property, and the approved set ol plans wlll remaln
Slgnature
-t4Date
on the slte at all tl durlng constructlon.
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demollllon
Stale Surcharge
Total Mlscollanoous Porrrrlts (E)
TOIAL Atr,lOUruf DUE (exctudtng etectrtcat)
(A, B, C, Q and E Comblned)
24.b Lo
VALIDATION
BECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY