HomeMy WebLinkAboutPermit Mechanical 1999-5-5
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RESIDENTIAL
PERMIT APPLICATION
Q10'd3
JOB NUMBER
Inspections: 726-3769
Office: 726-3759
225 Filth Street
Springfield, Oregon 97477
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ASSESSORS MAP'
LOT:
TAX LOT:
BLOCK:
SUBDIVISION'
OWNER:-P-f-P(J n{l-m r,,-~b-f!~tj_/
ADORESI" '7 j 0 I;z t/}1 ni #\ <;3t-'
CITY: S r..f-I r! .
'1S//- :~:3k, 7
PHONF'
STATE: of!.- ZIP' cV1W2
ftVY"l ~
DEMOLISH OTHER
CONST.
CONTRACTOR . EXPIRES ':':' PHONE
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
ADDRESS
GENER.^' .
PLUMBING'
. ~ I "
MECHANICAL: JlI) /J,.{'cJ.1I1J.( ('
l../ f{O OflJJ'YJni f'15r{k( -:J7fiCJcJ
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ELECTRICAl'
- OFFICE USE -
QUAD AREA-
LAND USE:
_._' .' UN\It~ requires youto
/,\1 ,~N110N.t:fiUll b the oregoll U"'''1
I^II"~ rules a~~Tef'tJies-a!:o .At forth
Notification Center. s ~ OAR 952-001-
In u/'\i'\ 952-00~~~ies 01 me rUt"" 1:.,
nnQo~ You ma~~~~~ e;-tM-lolArhOne
I""Ujno the cen . Not, ';'''h' ~'^tili""lion
..~h for tne UI ':'\lv" - ......
To request an Inspection. you m[lM"c'l!f1~7..7.6rirJfl!; lIB~Q;n~4:h'M.4)recordlng. All Inspections requested belore 7:00 a.m. will be
made the same working day, Inspectlons'PreqUested after 7:00 8.m. will be made the following work day.
FLOOD PLAIN:
. OF BLDGS:
ZONING CODE:
OCCY GROUP:
. OF BDRMS'
. OF STORIES:
SECONDARY HEAT:
WATER HEATER:
SQUARE FOOTAGE:
REQUIRED INSPECTIONS
D Temporary Electric
D Rough Mochanlcal - Prior to
cover.
D Flnat Plumbing - When all
plumbing w9rk Is complet.e.
o Site 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.
~nal Mechanical - When all
U ~~~chanlcal work Is complete.
o Undersleb Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Footing - After trenches are
excavated.
o Final Building - When all
reQuired Inspections have been
approved and building Is
completed.
o Fireplace - Prior to lacing
materials and framing Insp.
o Masonry - Steel location, bond
beams. grouting.
D Framing - Prior to cover.
DOther
D Foundation - After forms are
erected but prior to concrete
placemont.
D Wail/Ceiling Insulation - Prior to
cover.
o Underground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stove - After I~stallatlon.
D Post and Beam - Prior to floor
Insulation or decking.
D Blocking and Set.Up - When all
blocking Is complete.
D Insert - After fireplace approv~1
and Installation or unit.
D Floor Insulation - PrIor to
deckl ng.
D PlumbIng Connections - When
home has been connected to
water and sewer.
D Curbcut & Approach - After
forms Bre erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Sidewalk & Driveway - After
excavation Is compieto, forms
and sub.base material In place.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Fence - When completed.
o Final - Alter all required
Inspections are approved and
porch os. skirting, decks, and
venting have been Installed.
o Rough Plumbing - Prior to
cover.
D Street Trees - When all reQuired
trees are planted.
Setbacks
I P.L I HSE GAR ACC
IN
I S I
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Lot faces
Lot 'TYpe
Lot sq. ftg.
Interior
Lot coverage
Corner
Panhandle '{
Topography
Total height
Cul-de-sac
BUILDING PERMIT
ITEM SQ. FT.
"!
X S/SQ. FT. ~
VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
State Surcharge
TOlal Fec
(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
TOlal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
j,C::;:OO
,
/t20d
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Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcul
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding ole.l)
(A, B, C, 0, and E Combined)
" . , ,'; .' "I~ "
I.t.
IS THE PROPOSED WORK IN THE"
. '''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
It yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED'
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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
properlles within tho City limits which are being Improved.
ADDITIONAL COMMENTS
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By sIgnature, I state and agree, that I have carefully examined
the compleled 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 Ordlnanc~s of the City of Springfield. and the Laws
of the State 01 Oregon perlalnlng to tho work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I lurther 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 pormlt card Is located at the front
of the property. and the approved set 01 plans will remain
on the site at all times during construction.
SlgnatureOLiA~R P~\~T
Date S~~ lCl~
VALIDATION:
RECEIPT NUMBER
DATE PAIr>
AMOUNT RECEIV,a
RECEIVED BY __
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