HomeMy WebLinkAboutPermit Mechanical 1999-6-2
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RESIDENTIAL
PERMIT APPLICATION
9f67'1 I
JOB NUMBER
Inspections: 726-3769
OUlce: 726-3759
LOCATION OF PROPOSED WORK' ..32 '2>
ASSESSORS MAP' /7 Ii , "2- ~ '] t../
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: tJ5 J OD
A
SUBDIVISION: ~_
PHONE: 2!t...?-(oJ) 67~f.<~
LOT:
BLOCK'
OWNER: ~)(lll,~W*'-\def/v..p.x b.rl"
ADDR="'" -~;::),6 m-A"-'\sM.f'ld ~
S r...f2-ld
DESCRIBE WORK: ~BcJlQ
STATE: ~(.(
ZIP: QrJi/7?'
CITY'
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DEMOLISH OTHER
NEW
REMODEL
ADDITION
CONST.
CONTRACTOR'
CONTRACTOR'S NAME
GENERA' .
PLUMBING'
MECHANICAL: ffi'iK'5hd,(s,l.'flrYl1() f)~lhr'0 ) ~) dS7Cjrj
ADDRESS
EXPIRES .", PHONE
7L/-7--7L/0S-
ELECTRICAl'
- OFFICE USE - . . .
. ATTENTION:Oregon iaw requires you. ~v .
QUAD AREA' LAND USE: l'"~''''' 01"'5 adoplEcti0ti~p'di'IN'.qon Utility
. OF BLDGS: NOTICE: . . ",v~\RE'lIb~RK NoiiiicationCente~b~9~%rg~g;.~e"s=e~~n~r~
'SPERMII ::'111\U-t:I' <::.1\101 inOAH9t><!-001-0UlU\HjutJg,,~... ---
OCCY GROUP: TH - JI,jCO;RTH\SRlG/.MIi"~:-i'YPE: &XC '(~may obt-!liDFt:~RM13t tile rules by
. OF STORIES: AUTH~~~"QI~ABAN~lo<G~CE: ~ailingthecenteJ.El::NoO~~R~lt~~f,~~~~n
vUIVIIVI","U- - numberlorthe Or"yuilll1ilil'y '_,".0
WATER HEATER:AtQ'{ 1SGQtNPF.RIOD. RANGE: "'enteris sdOgRF.l:FoorllcE:
To requ.sl an inspection, you must call 726.3769. ThIS Is a 24 hour recording. All Inspections requesled before 7:00 a.m. will be
made the same working day. Inspectlons requested after 7:00 8.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
D Rough Mechanical - Prior to
cover.
D Final Plumbing - When all
plumbing w9rk Is complet.e.
o SUe Inspection - To be made
after excavation, but prior to
settlng forms.
o Rough Electrical - Prior to
cover. .
o Final Electrical - When all'
electrical work Is complete.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Final Mechanical - When all
mechanical work Is complete.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After trenches are
excavated.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
D Framing - Prior to cover. @ &~
D her ")
D Wail/Ceiling Insulation - Prior to
cover.
D Fireplace - Prior to facing
materials and framl.ng Insp.
D Masonry - Steel location, bond
beams, grouting.
,
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D Foundation - After forms are
erected but prior to concrete
placemont.
D Underground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underlloor Plumbing/Mechanical' .
- Prior to Insulation or deCklng'@OOdStOVO-Afterlnstallatlon.
D Post and Beam - Prior to floor
Insulation or decking. 0 Bert - After fireplace approval
and Installation of unit.
D Floor Insulation - Prior to
decking.
D Blocking and Set. Up - When al/
blocking Is complete.
D PlumbIng Connoctlons - When
home has been connected to
water and sewer.
D Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
D Sanitary Sewer - Prior to filling
trench.
D Electrical Connection - When
blocking, sel-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Sidewalk & Driveway - After
excavation Is compioto, forms
and sub-base material In place.
D Slorm Sewer - Prior to filling
trench.
D Water LIIle - Prior to filling
trench.
o Fence - When cOrllpletod.
D Final - After all required
Inspections are approved and
porchos, skIrting, decks, and
venting have been Installed.
o Rough Plumbing - Prior to
cover. \.
D Stre.t Trees - Whan all required
trees are planted.
. .'t'; .' ..
':."
. ',: ( .HE PROPOSED WORK IN THE.
Lot faces Lot Type Setbacks
I P.L. HSEIGAR Accl ."HISTOI'lICAL DISTRICT, OR ON
Lot sq. Itg. Interior IN I I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
'{ Is I I and approved by the Historical
Topography Panhandle I Coordinator prior to permit Issuance.
Total height Cul-de-sac W --- --
E I APPROVEf"
BUILDING PERMIT
ITEM sa. FT.
.~
X $/SO. FT. =
VALUE
Main
Garage
Carport "
"
, '
Tolal Value
Building Permit Fee
Slate Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
Wood StoveQlrePlace Unit
D~er Vent
().;K. ,~
Mechanical Permit
fS-, 00
(6. 0 v
,l{\/7)
'7 C 2.-r1
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
" - '1
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condItIon that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Development Code. regulating the construction and use of
buildings, 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:
Plans Reviewed By
Date
Systems: Development Charge Is due on all undeveloped
prope'rtles within the City limits which are being Improved.
ADDITIONAL COMMENTS
f Ii} h / .{? -' v({) :?_c::;r:; "oD
.'
By signature, I stato and agree, that I have carefully examIned
the completed application and do hereby certify that all
Information hereon Is true and correct, and I 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 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
are 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 the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Signature J....k.4,~ A/ uf'.b
/ " - ;l
Date f ~/7C;
VALIDATION:
RECEIPT NUMBER 63lf2-C,!
DATE PAir ,/ z./ r'i'
AMOUNT RECEIVED ~~'. ~
RECEIVED BY ty W VIo\..(