HomeMy WebLinkAboutPermit Mechanical 1997-12-17
OWNER: IJ4/1:E ~t.~-f
ADDRESS' tb97 M/./.J-'T/./AwJ:::.
-5?/2-/,N/'/::) Et':/l
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
/7/} '?
ASSESSORS MAP'
LOT'
,.
',' \'1 '.0,.
CITY'
-
697
27
,
BLOCI<"
STAT~' .
(J-/8
DESCRIBE WORK'
bAs L-N,c.;:! &.4.5 .5/"CJ/F
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
~
9)/ 7~j>
JOB NUMBER
225 Flllh Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
nJh~
PHONF'
72 to - 6t'o;?.s-
ZIP'
97~77
CONTRACTOR'S ~ME ADD~SS
GENERAl' fiyY) F".e./C'-"!d ~.5 ~~Pw.4A/C~
/o/f3~/L.rt>-tl.rl. ~;c.n
CON ST.
CONTRACTOR #
') ?(P 2-/
.... PHONE
- ~571-1"(, RC-
FLOOD p~~:
# OF UNITS: -t.. "ol?t.a&jlj~\Nco~:
1:\.\01\\1.... ~\.\. t.I" ~nUI' IS \'l
CONSTR. TYPEl" ""N-r!;\-\ ,ellS 'fIOP"BD8.MS'
I-\IS ?t:I'\' ,. toIOt.?" "'~o fUI'I
HEAT SOURCE: ' -.<',"71"0 \l .o.~'S~CONDARY HEAT:
~f\I'IU' ,,- ? IS """
RANGE: '" 'J(;",r.E.OO 00 SQUARE FOOTAGE:
(',01'111" r" l)~f\1 .
~i\\l'" I
To request an Inspection, you must call 726.3769. This Is a 24 h~dc:lrdlng. All Inspections requested belore 7:00 a.m. will be
made the same working day, Inspections requested aller 7:00 a.m. will be made the following work day.
PLUMBING'
MECHANICAl'
ELECTRICAl'
QUAD ARE'"
# OF BLDGS:
OCCY GROUP'
# OF STORIES:
WATER HEATER'
D Temporary ~Iectrlc
D SUe Inspection - To be made
after excavatlon, but prior to
setting forms.
D Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o 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.
D 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 mllng
trench.
o Water Line --frlor to filling
trench. ~
D Rough Plumbing - Prior to
cover.
- OFFICE USE -
LAND USE:
REQUIRED INSPECTIONS
~ Rough MechanIcal - Prior to
~cover.
D Rough Electrical - Prior to
cover.
D Electrical Servlca - 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 Stove - Aller Installation.
D Insert - Aller fireplace approval
and Installation of unit.
D Curbcut & Al>proach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is compiete, forms
and sub.base material In place.
D Fence - When completed.
DISlreet Trees - Whtm all required
trees are planted.
EXPIRES
9-9A
D Final Plumbing - When all
plumbing W9rk Is complet,e.
D Final Electrical - When all
electrical work Is complete.
D Flnel Mechanical - When all
mechanical work I s complete.
rv:1Flnal Building - When all
~ required Inspections have been
approved and building Is
completed.
J2f Other ~~ ,"/'"Cr' T
~ ~ ~N~t"~
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 - Aller all required
... Inspections are approved and
porches, skirting, decks, and
venting have been Installed.'
. --, ' i; I ; ;~4
"-{: ~ .1... ~',;,.i~.;. '\! ~{~:~'!t :tit.:'
~,~. :~ "I.. . ~" .:~J;j:,'(,,'.
Lot faces
L~i~p4
Interior
I P.L.
IN
Is
Iw
IE
Lot sq. fig.
Lot coverage
Corner
Topography
Total height
,.
Panhandle'
Cul-de-sac
BUILDING PER~IT 11
~
~
.~
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'
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT.
- "
Mobile Home
..;,
"
'..
"....>,. :tt~t.
,
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
-/.-ff "n~ ( /i/fr?;Ge!-
_. ... _ r
Mechanical Permit
/t) ,H)
/0 o-a
/2 ()
~,~
Issuance
State Surcharge
Total Permll
, ~rf'fF
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
It
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined) .
/..h 2..<>
Setbacks .
HSE GAR Acc'l
I
"-
'____IS THE.PROPOSED WORK tN THE.,
HISTORICAL DISTRICT, OR ON
THE HISlORICAL REGISTER?
/I yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I
BUILDING Vhu1E, PLAN CHECK
AND BUILDING PERMIT
APPROVFn.
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 tlmo
upon violation of any provisions of saId ordInances.
Plan Check Fee:
Date Paid:
Receipt Number.
Received By:
Plans Reviewed By
Date
Systems Developmcnt Charge Is due on all undoveloped
properties within thc City limits which are being Improved.
ADDITIONAL COMMENTS
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 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 wllh ORS 701.055 will be used on this
prolecl.
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 pcrmlt card Is located at the front
of the property, and the approved set of plans will remain
X:~g:::u:~e 41;;iljnstructlon.
Date
/-v-/7--97
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY