HomeMy WebLinkAboutPermit Mechanical 1999-8-9
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759 I
.
SPRINGFIELD
.11.." ,
LOCATION OF PROPOSED WORK: 32 7 '7
/7 63~z.1 I
ASSESSORS MAP'
LOT:
OWNER'
ADDRESS'
CITY'
C Lt PrO/l-d
327"i'
'3v, W
,
DESCRIBE WORK'
IIF/f7
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL'
PLUMBING:
MECHANICAL'
Pntlf
fh, t, ~
ELECTRICAL:
D Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab PlumbIng/Electrical I
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.
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.
D Rough Plumbing - Prior to
cover.
BLOCK:
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ADDITION
DEMOLISH
OTHER
.
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JOB NUMBER
225 Fillh Street
Springfield. Oregon 97477
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TAX LOT: ()()].O{)
SUBDIVISION:
PHONF'
7'1C.- )'r)fp
ZIP'
ADDRESS
CONST.
CONTRACTOR'
EXPIRES "" PHONE
II)"
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prlor 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
cove~ .
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvel
and Installation of unit.
D Curbcut & Approach - Aller
forms are erected but prior to
placemont ot concrete.
D Sidewalk & Driveway - After
excavation Is compiete, forms
and sub-base material In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing w~>rl( Is complet.e.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
D Final Building -. When all
required Inspections have been
approved and building Is
completed.
DOther
MOBilE HOME INSPECTIONS
D Blocking end 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 Flnel - After all required
Inspections are approved and
porch os, skirting, decks, and
venting have been Installed.
I
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Lc. ""'~ t.fC.I ~ Z/o/
M I , t:NTION'Ore
tnI/O'" rl:Jl- - '. goo law reqllir,,~ ye .
I . .. ~~ QUuprea bv th l.. 'v
1\ nh/;':"......:. _ A n,.oz....- '-\'\,.
- OFFICE USE '.Q.OAR-952~oo;~~~i~ nose rUles are~;t t~~h
QUAD AREA' LAND USE: 0090. YoumaYObte~hrou,g_hOAR952-001~
"all/"g me Center~N ~ld:^Wrl,t: rUleS by
· OF BLDGS: - -'~"," · OF UNITS: numh"rfQrtheo~ NmG.tt&~s
~y 1l1\.[S;; Creon Utility NotT .
OCCY GROUP:THIS(3Ehf/.:-:-SII.'~l:bEXPIRE~IOOIfE: enter is 1.(J01f-:~U>d3~/ Icatlon
. OF STORIES:AUTHORI2'Er:>lIl\1nI=RTHISPj:iM~: SECONDARY HEAT:
WATER HEATE~C>>~Mi=NCEDORISABANo<mm~R .. SQUARE FOOTAGE:
.... -eeaU/PEnl/"\!."'
''''JIll I IU -
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 (ollowlng work day.
,
,.
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Lot faces
'.
.,
L~t ~y.
Interior
Lot sq. fig.
lot coverage
Corner
Topography
Total height
.
Panhandle
Cul-de.sac
BUILDING PER~IT "1 " 'f
ITEM SQ. FT. X $/sa. FT. =
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fec
(A)
~,1,
~ ,,; :1
"..
"
I P.L.
1L-__
S
:t!.___
.E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(Bl
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S!3wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertl Fireplace Unll
Dryer Vent
f/e11-T /fA.....#
MechanIcal Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcul
fl
Demolition
State Surcharge
Total Miscellaneous Permits (El
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
/s-~
/O~
I.S~
2. C $#'
, i: , i. ,~~.
~."'_' r.' 'I ~:l;'f'H-~~i" ~t.'
. ',.: .:!N:.~
Setbacks.
.IS THEPROPOSED WORK IN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
HSE GAR Acc'l
I
I
I
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BUILDING VALl!JE, PLAN CHECK
AND BUILDING PERMIT
APPROVED'
This permit Is granted on the express condition that the said
construe'tlon.shall, In all respects, conform to the OrdInance
adopted 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 vlolatlon 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 wlthln'the City limits which are being Improved.
ADDITIONAL COMMENTS
>q;eJ14-7t5 tiLec-rJ j'?-4t.,,,o.,.J-
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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 cerllfy
that any and all work performed shall be done in accordance
wIth the Ordinanc~s of Ihe City of Springfield, and the Laws
of the State of Oregon perlainlng 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 lime, 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 constructlon.
jSlgnature ~1J.1l OAG ,t\o G _0 .D~ ~
Date 8! 11 ~ 7 U
VALIDATION:
O,?5/'1?
DATE PAIr> ~ / If / Cf~
AMOUNT RECEIVEr> () ],t.;j /)
RECEIVED BY --L fJ W/
RECEIPT NUMBER