HomeMy WebLinkAboutPermit Mechanical 1998-10-2
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SPRINGFIELD
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RESIDENTIAL
PERMIT APPLICATION
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JOB NUMBER
Inspections: 726-3769
Office: 726.3759
225 Fifth' Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORt<' ;;<./~. :5
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ASSESSORS MAP'
TAX LOT:
SUBDIVISION'
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LOT'
BLOCK:
OWNER' '.?:./JAlTL IA/ wAIfZ.;J
ADORESf" . ;;< 7 .3 <. ;Jf,,; IZ CO LA
CITY: (/}/i/v'/-,;::/rc. /) ~
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PHONE:
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STATE: -&
97Y'77
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ZIP'
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DESCRIBE WORK: ~T/1(TA-/ /
A.lew-
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NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR'
CONTRACTOR'S NAME
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ADDRESS
J..</j) ..s('J/7'
EXPIRES
<::I PHONE
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GENERA' '
PLUMBING'
MECHANICAl'
ELECTRICA' '
ATTENTION:Oregon law requires you to - OFFICE USE -
QUAD ARSilpw rules adoDted bv the Orego~.MliAt'USE: fJ "'T.'J'" :ii.. FLOOD PLAIN'
Notification Center. Those rules are set forth ~v v..
· OF BlRWiI'lil5z'OOl "oO*t,,,ou;jh OAR !W'OOIlIHS: ,iilS Fl:nMIT SHACE&X7>rRg?ffHE WORK
OCCY ~:vou may obtain cop~s of thec~\q!l-& TYPE: .oE,aOI3J S
calling the center. (Note: the telephone -At.;71IC;iIZED UNDEH I HIt; f'~RMrr IS NOT
. OF STOlil.JTfibmio, t1,tl DrageR Utility NotiIi\fulTol\OURCE: GSrm::N€ED OR 18EJillAWO'tffi'E~WR
WATER HEATER: Center Is 1-800-332-2344)'RANGE: "'V ~ ~~ ':.', y PERltl13~ARE 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.
~UIRED INSPECTIONS
. ough Mechanical - Prior to
cover.
o Temporary Electric
o Final Plumbing - When all
plumbing work is complete,
O Slto Inspection - To be made
after excavation, but prior to
setting forms.
D Rough Electrical - Prior to
cover.
D Final Electrical - When all
electrical work Is complete.
h 21 Mechanical - When all
~~~hanlcal work Is complete.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
, 0 Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After trenches are
excavated.
o Final BUilding - When all
required Inspections have been
approved and building Is
completed.
o Fireplace - Prior to facing
materlais and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
o Framing - Prior to cover.
o Other
o Foundation - After forms are
erected but prior ,to concrete
placement.
o Wall/e'elling Insulation - Prior to
cover.
o Underground Plumbing - Prior
to filling trench,
o Drywall - Prior to taping,
MOBILE HOME INSPECTIONS
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stovo - After Installation.
o Blocking and Set. Up - When all
blocking Is complete. .
o Post and Beam - Prior to floor
Insulation or decking.
o Insert - After fireplace approv41
and Installation of unit.
O Floor Insulation - Prior to
decKI ng,
o Plumbing Connections - When
home has been connected to
water and sewer;
o Curbcut & Approach - Atter
forms are erected bllt prior to
placemont of concrete.
o Sanitary Sewer - Prior to flIllng
trench.
o Electrical Connection - When
blocKing, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service psnel.
O Sidewalk & Driveway - After
exca....atlon la compioto, torms
and sub-base material in place.
o Storm Sewer - PrIor to filling
trench.
o Fence - \-\lhen COiYlpleted.
O Water Line - Prior to filling
trench.
o Final - After all' required
inspections are approved and
porches, skirting, decks, and
venting ha....e been Installed.
o Rough Plumbing - Prior to
cover.
o Street Trees - When all required
trees are planted.
BUILDING PERMIT '!l
.~ "1
ITEM
SO. FT.
X $/SO, FT,
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fec
(A)
. ,.;
;. ',.' ..".; :::.,;}~~.~.t::"~"
Setbacks .
I P.L. HSE GAR ACC'
IN
Is
'IS THE PROPOSED WORK IN THE.
....HISTO~ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Goordlnator prior to permit issuance.
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E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
Storm Sewer
FT,
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(0)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Drrer Vent
6-41 f~
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
b.OD
J.ai:>
IS-OJ
/0. ()~
If Ii 75
U.UJ
I
APPROVED'
"
BUILDING "ALOE, 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, ~egulating the construction and use of
ouildings, 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 I
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 rhave carefully examined
the completed appllcallon 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 perlalnlng to the work described
herein, and that N() OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify thaf 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 t~mes during onV.tructl n.
L----"~ ,/./ /
Signature. ""l?:;/ ~'"
./~,-~' C--
DateV' / /J r..2, 9/-:
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
6 '5/6 tfl
It) / :;'/'7y
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RECEIVED BY