HomeMy WebLinkAboutPermit Mechanical 1999-9-7
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP:
LOT:
SPRINGFIELD
I I..""
JOB NUMBER
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BLOCK:
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225 Fillh SIreet 99/225
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
.rJl1 SO I
OWNER:(\)o\:Dr\c,~ \~W\ ~Q, PHONE:~
ADDRE~~ln I ~(i( ,) f\r,
CITY: \. vV"' lI?q{I.c.L. ;TA~ 'l_I(\r~n ZIP:
DESCRIBEWORK:~~~t-UJ(nrAM. onJ~
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
Olld+J
Y l~(ft > fJillDP
~ ~ ~ CONST.
CONTRAcr R'S NAM, E, ). 'WERESS I .. . A _ 2?~TRACTOR # EXPIRES
GENERAl. R<; On flC\,/C liP) lo.u.l!1111L~)r ~7,~qt 0
PLUMBING' 'J
MECHANICAl'
ELECTRICA' .
~
h, I L..I... I IVI'III.....n-cl:::SVII !ClVV '0"-11.111'0':' yv","~,
- oFlfl5llOlloIrnles adopted by the Oregon Utilit~
QIi}~9t~~: kAND USE: _Notification Center. Those rU'f"(o15liWl!~lNl'
# ~1~E~ITSHALLEXPIREIFiHEWOR OF UNITS' inOA~.~52:0~1-001~thro~g~0~~952-00~:
rlRJ:7EDUNDERTHISPt:HIIJl\TISNOt . 00::10. .'vu ,'l.:.,-ootein copleJ& ,..,,cPl.olkQ.C\!j
OmJ:lb'lTP: . ED FOR CONSTR. TYPE: calhna the center. (Note: th/3<1iFlrBlSFlIJIS.
COMMENCl::U UH I~ 1\oI\NDON number for the Oregon Utilitv Notificatio!'
# ~'N~1<85'DAYttffilC:. HEAT SOURCE: 8",(.,:,. ;.:, ~ .r,nO-33;>-~.I;.9Q!'ll.)ARY HEAT:
WATER HEATER: RANGE: 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.
o Temporary Electric
o Slle Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Fooling - After trenches are
excavated.
o Masonry - Steel location, bond
beams, groutlng.
o Foundation - Aftor forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior 10 filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough MechanIcal - Prior to
cover.
D Rough Electrical - Prior to
CQver.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are emcted but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - \Nhen cO."'lpleted.
o Street Trees - Whun all required
trees are planted.
o Final Plumbing - When all
plumbing w9rl< Is complet,e.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
DOthsr
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, sel.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspectlons are approved and
porches, skirting, decks, and
venting have been Installed.
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.
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l~t ~y_
Lot faces
lot sQ. Itg. Interior
Lot coverage Corner
Topography Panhandle
Total height Cul.de.sac
BUILDING PERMIT .',
ITEM SQ. FT.
..
'.~
X $/ SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
,
State Surcharge
\ .
Tolal Fec
(A)
!;"
I P.L.
IN
Is
w
----
,E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s) N'
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 Stove/Insert/Fireplace Unit
Dryer Ve;t
Jk ~ fJWr1fJ
Mechanical Permit
Issuance
State Surcharge
Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbeut
It
Demolition
State Surcharge
Tolal Miscellaneous Permils (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
IS: d D
/0, dv
l.st>
2rb. So
",,' . ~.:.t ;'. .i~,~;
'.' -I.:." ;:'~;;. .';Iii.
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.THE PROPOSED ~ORK IN THE.
HISTORICAL DISTRICT, OR ON
'THE HISTORICAL REGISTER?
II yes, Ihls application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks.
HSE GAR ACC'
APPROVED'
BUILDING VALdE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granled on Ihe express condition thai the said
constructJon shall, In all respects, conform to the Ordinance
adopled by the City of Springfield, Including the
Development Code, regulating the construction and use of
oulldlngs, and may be suspended or revoked at any time
upon violation of any provIsions of said ordinances.
Plan Check Fee:
Date Paid:
Recelpl Number'
Received By:
Plans Reviewed By
Date
Syslems Developmcnl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS '/l
/I. -0f'.? ."t EZ D- 7/Zv..Y
I tv/! /h , 'I af1~ /#
By signature, I stalc and agree, Ihall have carefully examined
the completed application and do hereby certlly that afl
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 01 Springfield, and the laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Dlv/slon.
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 Ihe streel, that the permit card Is located at the front
of the property. and the approved set of plans wi/I remain
:~g:::u:~n~~u~~ ')
Dale 9/7 If'} U
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VALIDATION:
RECEIPT NUMBE'f fJ3 5' L/(.. L{
DATE PAID tiff 7/11'
AMOUNT RECE'IVED ~:t 0
RECEIVED BY At/IV,