HomeMy WebLinkAboutPermit Mechanical 1997-12-10
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
.
JOB NUMBER
q 769o&,
225 Filth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK' /A I '-/ 0 m a , ~ S.J-
/7b:A.3t..f 3LftJo507i
5lLA oL
TAX LOT'
(It, ~i ~I e" -4. Q,^ '0 ,:.. c; ~-<.? "-
ADDRESS" fJC7.~ 2 -/ /J4, hI) f-I- 14 I II LVI
(V _ J,.", c:. =-' rdL
- J
ASSESSORS MAP'
LOT'
OWNER:
CITY:
BLOCK'
STATF' .
(')L
DESCRIBE WORK'
I, J"-+F/2..il.~ ''7 Ln7^ - -
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
MECHANICA' .
ELECTRICA' .
QUAD AREA'
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:
ADDITION
DEMOLISH
OTHER
SUBDIVISION'
PHONE: __<::1"; 2. -9z. '1:: Q
ZIP: 07'-f<..-1
11\
~
. "l
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES ,~ PHONE
D Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
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 Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
o Insert - After fireplace approv~1
, and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
D Fence - VVhen completed.
o Street Trees - When all required
trees are planted.
FLOOD 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
IIIn'1',
"'~I . ;C/::',
'7/80,... .
1l1J.,.~_ ....trP,fl.,. <>,.
m It;">l- 0"1'.'
I"OAA\'l: . <1:7) ~ '\""'" EY~.. .
-1NYl 'VC~lTA~iSJf:"'H~
L~Ni81~ VljlSIlB P~RM. WOR/(
~.q/OD 'INJUN. ~O
. OF UNITS:' 'l:D~ .,.
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
D Final Plumbing - When all
plumbing W9rk Is complet.e.
o Final Electrical - When all
electrical work is complete.
~Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
CZl Other
;:A-<;
SJZVVI'~
D Temporary ,Electric
o Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electricall
MechanIcal - Prior to cover.
D Footing - Atter 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.
D Post and Beam"",,::, Prior to floor
Insulation or decking.
( ,
"
l.-' .~,
D Floor Insulation - Prior to
deckl ng. \
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
cover.
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 all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed..
'.J, ,,',: :~,; t~ ~~:it~;'. "IS THE PROPOSED WORK tN li-lE _
L~t ~p.
Lot faces Setbacks.
Lot sq. Itg. InterIor I P.L. HSEIGAR ACe' I ....HISTOI'lICAL DISTRICT. OR ON
IN I I THE HISTORICAL REGISTER?
Lot coverage Corner I If yes, this application must be signed
. Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height Cul-de-sac IE I
APPROVED'
BUILDING PERMIT '.'i
ITEM SQ. FT. X
"
.(
$/SQ. FT.
VALUE
Main
Garage
Carport
"
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
,.
Residential Bath(s) N'
,.
, \';
'.
.1.'
..~ .'-' ,
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
:><
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
I J I ,a-'1I It,. tLA...
Mechanical Permit
~/":::.
:f!j (J ~
,""X"./- . L{<)
#dc',C>-O
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
II
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, D, and E Combined)
. to", , 't
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
adopled 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:
Recel pt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
"
ADDITfoNAL COMMENTS
. .'
"""_>J~
. .\)'"
.,\'l\b
)\\.....
By signature, I state 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 Slate 01 Oregon perlalnlng 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.
~natur'{f~ ~ ~. , .~. () ~
Date Iv / () - CJI
VALIDATION:
RECEIPT NUMBER
.;l. g d-.J. C,
DATE PAID Id.- - I b -'1/
AMOUNT RECEIVED $;)&. i}-u
~0
RECEIVED BY