HomeMy WebLinkAboutPermit Mechanical 1993-5-5
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
LOT'
/70'\
OWNER:
ADDRESS'
CITY'
/!;. lU. f I J() ve 15
. /~ ~O IYlClAlle I-
SPfll11.4 H e./J.
,
DESCRIBE WORK' /IJ}STA U.
bAB
NEW REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
&nJtJ/"'/~AJJtV(J, L.;/ -1011)
,~
EXPIRES ~NE
SPRINGFIELD ....
-.
BLOCK:
f3R/G6S
S./,
STAT'"
DR
, .
Foff!NAe6 .Y k/Je
DEMOLISH
OTHER
~ (P 5IJO
JOB NUMBER
q ~/.'.<:"Y&'
225 Fifth Street
Springfield, Oregon 97477
,:y.
TAX LOT: ~J 29 t:P'1
SUBDIVISION'
PHON'"
1'1iR. ..,J.553
ZIP:
7'1</ /1'7
ADDRESS
CONST.
CONTRACTOR'
PLUMBING:
MECHANICAl' ~l'f\~"t ~\llvJ ~ S5 u), IS;' G'U6@J~ ~'1iJM..
,,-.,.!"'"
ELECTRICA' . L-' )
OO(.u~o
%'1/93
atl{J.~81D/
- OFFICE USE -
OUAD AREA: LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG!="' SOUARE 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.
D Temporary Electric
D Site Inspection - To be made
after excavation. but prior to
setting forms. .
D Underslab Plumbing/Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
D Foundation - After (orms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to tilling trench.
o Underlloor Plumbing/Mechanical
_ Prior to Insulation or decking.
D Post and Beam - Prior to floor
insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
'tCARough Mechanical - Prior to
~cover.
m Rough Electrical - Prior to
~covcr.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stove - After installation.
D Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are erected bu~ prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub.base material in pl<;1ce.
D Fence - When completed.
D Street Trees ~ When all required
trce~ arc pianted.
D Final Plumbing - When all
plumbing work Is complet.e.
rvt'Final Electrical - When all
~rectrlcal worK is complete.
R/r'Final Mechanical - When all
~echanical work is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
k8(Olher C:A<t;, J I/.r~
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is ~omplete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
inspectlons are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot Type
Lot sq, ftg,
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de.sac
BUILDING PERMIT
ITEM '~-'..~, SO. F:T:
~.. \ ~. ~ oJ
X $/SO. FT.
Main
Garage
,. . "
I '
Carport
. ~'.
Total Value
Building Permit Fee
State Surcharge
Total F:ee
(A)
. . . .,' ..'\. ' ".. ; ~ . . " ,]"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAJ.. PERMIT
Furnace ;3f (!:;5"a?". _.::>
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
.
I P.L.
IN
Is
Iw
IE
VALUE
. .,
FEE
~~
J5"o~
/ /J eN)
.7J
2C::;-.7.r
?_C7S
<:-
Setbacks
HSE GAR
.
IS THE PROPOSED WORK IN THE
.. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Ace I
I
APPROVEP'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
-', ..' ,~~ # .. . . ,
This permifjs grantecfon the ex'press-condition that the said
construction shafl,:in all..respects, conform. to the Ordinance
\. . "..
adopted by the City' of Sp(ingfield, inc,ludlng the
Development Code, regulp-ling the cqnstrl!ction.and use of
buildings, and may be suspended or revoked at any time
upon ~iolati?n of any provisions ,of said ordinances.
"
PlanChe,,'k Fee:
, '-
Date Paid:
Receipt Number
Received By:
Plans ~cviewed By Date
, - . . . . . ;. ., . ~ . ~.. ..... .
Systems Development .Cnarg"e' is due on'all undeveloped
properties within the 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 thai all
information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
Witll tile Ordinances of the City of SprJngfield. and the Laws
of the State of Oregon pertaining to the 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
arc In compliance with ORS 701.055 will be used on this
project.
I further agree 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 tile front
of the property, and the approved set of plans will re
on the site at all tim during const)c~n,
Signature /~_
Date
VALIDATION:
J\i'S'~
S=--S '93'
AMOUNT RECEIVED ~::...-":::>
/' 4~- ~"1 _-=-,
// ,p-
RECEIPT NUMBER
DATE PAIr>
RECEIVED BY