HomeMy WebLinkAboutPermit Mechanical 1997-10-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
ASSESSORS MAP:
LOT'
OWNER.\V)i(\_~~\ ,\.
ADDR~"'" (0 Of) C; 1 MrA-,'./\
CITY- <::/)(',' M\ L \A
Y'I
DESCRI~RK: --::z:: ~T~JIfZ- d
NEW REMODEL AODITION
CONTRACTOR'S NAME (.' "
GENERAl' 5",_ ---;
PLUMBING'
MECHANICAl'
ELECTRICAL:
QUAO AREA:
· OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
STATE: ( 1)(2. .:f~ ZIP:
-r:;,f~"r.p ~~J:wt-<kr
~~~,*9
E".c;, N
v)~ ""
it ~~ACTOR .
(' ,.if ~ ~~ ".
~v ~- ~" cr ~
L"'I: .Q:l .<i. l'> ,~
". r.V "'~ &' ,,-
$z' ~~ .~,~ ~
',,::::~' _~ ',l'
, ~-fff;
(", -~
, "
- OFFICE us'E -
,
BLOCK'
"A'>.Or/A
(;c'I"I
DEMOLISH
ADDRESS
LAND USE:
· OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
I
JOB NUMBER q l H'17
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
PHONE:
70210 -R99?
Cj7C17R-
.H~ 1",.
EXPIRES
,~
PHONE
6
~/
~
\IQ
.
FLOOO PLAIN:
ZONING CODE:_
. OF BDRMS'
SECONDARY HEAT:
SQUARE 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.
REQUIRED INSPECTIONS
D Temporary Electric
o Slto Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab PlumbIng/Electrical I
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
,
o 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.
o Rough Plumbing - Prior to .
cove( .
~9h Mechanical - Prior to
cover.
~ough Electrical - Prior to "r
cover. " . \
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior t,o cov~r:
D Wail/Ceiling Insulation"": Prl),r to
cover. ..
'\',' c
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
c=J Insert - After fireplace approv~1
, and Installation of unit.
o Curbcut & Approach - After
, forms are erected but prior to
placement of concrete.
D Sidewalk & Drlvewav - After
excavation Is complete. forms
and'sub-base material In place.
D Fence - When completed.
o Street Trees - When all required
trees are planted.
D FInal Plumbing - When all
plumbing w9rk Is complet.e.
~al Electrical - When all
electrical work Is complete.
lJ2r!lnal Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
complet~d. "' ' .'. '" ,
R'lOther G-t4s L./1'7.-L-
;.= (r4~ ::5RzJ//~
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
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 al/ required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.'
Lot faces
Lot sq. Itg.
lot coverage
Topography
Total height
BUILDING PERMIT "I
ITEM
SO. FT.
Main
Garage
Carport
Total Val ue
Bul/ding Permit Fee
Slate Surcharge
Total Fee
L~t~ypel
Interior
Corner
,
Panhandle "
Cul-de-sac
.~ '-t
X $/SO. FT.
(A)
~~I
"".... -,~
/. '" 'I; '1," -\~.
~ "..; -" ;,"~ .'\,.~ ,j , ~ ~ V4:~ ~d ~~ t .'
." I , : .~_. .:;.1:],'::\..
Setbacks .
P.L. HSE GAR Acc'l
N
Is
Iw
IE
"
VALUE
'.
,
,
-,
,\
->
r,
>
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
TOlal Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent .
G1:1'S, I; /Ltz..., fA)/U
/
Mechanical Permit
Issuance
..-
State Surcharge 0,03
Total Permit
(C)
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
FEE
#- ' ra
(p.
96 6, o-V
$/S.-
<J /0. -
'75r-.'16
1:- ~{,. CL'"
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. D. and E Combined)
, .._S THE PROPOSED WORK IN THE.
.....HISTO!'iICAL OISTRICT, OR ON '
THE HISTORICAL REGISTER?
If yes. this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVEP: '
BUILDlN'G VhLdE, 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 01 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
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I stalo 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 tho 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 ti~" dUDi onstruron., n
Signature -.:fY\ 1.J')h '1 (/~_,t::J~flj)JI-,
. V V-l '
Oat" /0- L3 -"(7
VALIDATION:
RECEIPT NUMBER tfl. 7 (p q 0
OATE PAIr> In - /3 -'77
AMOUNT RECElv"n .z/i,;)C" d-<fJ
~
RECEIVED BY