HomeMy WebLinkAboutPermit Mechanical 1999-10-28
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
SPRINGFIELD".." ,
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ASSESSORS MAP'
LOCATION OF PROPOSED WORt<.
/'7 I; '3 'J- 2.. 0/ z..
0' ,lcbu~
ADDRESS' <~w;:;7 hhe/JAt...&
CITY' ,c;Pd2-/~c;:7l::f..#?
LOT'
OWNER'
.,Pe.re.e-
BLOCK:
-
JOB NUMBER
1"7 (~O
225 Fifth Street
Sprlnglleld, Oregon 97477
TAX LOT:
SUBDIVISION:
(/62/ 'f
PHONF'
'/4/ - .9~(J=?
ZIP:
9'><t27
(J/?
DESCRIBE WORK' -&A 1?/'/F I &/1-3 WA~//t::H-~-:tf &.1k C:;c;
NEW REMODEL ADDITION
STATE:
DEMOLISH
OTHER
CON ST.
CONTRACTOR'
7710 7_/
CONTRACTORY1NAME ~DDRESS
GENERAl' /hn.F7Z/CA?! ~f#.tJL.#b.vCb- C':'1".I~.c-
PLUMBING'
MECHANICA' .
ELECTRICA' .
EXPIRES ,.., PHONE
/LJ~
_ OFFICE USE 1'l.111:~'\J.IUI\!:Uft;YC.t:dW.\"','''II:'':- ''v.
NOTICE: K fo!l?wruleSad(\l)t,:(!bVlhEI}r,,~""li'. 1
QUAD AREA:, "I~\T,,"~PIREIIi.A~'E,\~Q~L Nnt.f,C',:ltlor r;e~::'t. FLOOD'PLAIN' . I,'r.
THI::)t'c:n' ;j . <"RTHISPCCMIJISNOT inOAR9ti2-001-0;)'in>,rO,I'nll(lI'. ..' 1:[1.
· OF BLDGS:-'1":lI""eg 11~ln!:_ ..., 'OF UN--1TS: - - - - .. "t_ZONING CODE:
AU"v' - - DONEOFOR VV::-OU.IUUlIlaVO:JOll"t..rIJ;J!i;..}IJ", '''-..l'
OCGY GROUPOOMMElIlCFnORISABAN CONSTR. TYPE: ""i"r~"':-:"CZn:2:'(OF-!BdRMS.f ",:,lil1l.
. OF STORIESANV 1RO DAY PERIOD. HEAT SOURCE: number:!orttehrE'ISo1reSa!ioc'b~~Wll:l~?~I~R.elltill
. ~II .ovu-..,,,Il::,...:::,...,......,.
WATER HEATER' RANG~' 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.
D Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover. .
D Fooling - Aller trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms Bre
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Poet and B.am ~ Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
deckl ng.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to HlUng
trench.
D Waler Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mochanlcal - Prior to
cover.
D 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 Stove - After Installation.
D Insert - After fireplace approve!
and Installation of unit.
D Curbcut & Approach - 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 cOi"11pleted.
D,Street Trees - When all required
trees arc planted.
D Final Plumbing - When all
plumbIng W9rl< Is camplct.c.
D Final Electrical - When all
eleCl71~r work Is complete.
D Final Mechanical - When all
mecha'nlcal work :s complete.
Final Building - When all
required Inspections have been
approved and building is
completed.
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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
Inspecllons 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.
,-
"
Lot faces
L~t ~ype_
Lot sq. ftg.
Interior
Lot coverage
Corner
Panhandle 'f'
Topography
Total height
Cul-de-sac
BUILDING PERMIT'
ITEM SO. FT.
"
1
X $/ SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
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
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
Wood Stove/lnser~~
Dryer Vent !
(;M~ PW--
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
11
Curbcut
11
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
fA, B, C, D, and E Combined)
~.
,) ,~t -'.' . ~"!1::'-~' ;~ ~'i ~
"
p.L.
N
Is
_"Y.__
IE
VALUE
"
FEE
lS.o~
1'.0./
/. jf)
2b. J()
If.~;~'iij~t.'.
.,M :.!l:-,~ '.
"S THEPROPOSED :ORK IN THE,
"'HISTOI;1ICAL DISTRICT, OR ON
, THE HISTORICAL REGISTER?
Setbacks .
HSE GAR ACe' I
I
I
I
I
BUILDING VAUjE, PLAN CHECK
AND BUILDING PERMIT
If yes, this apptlCallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED'
This permit is granted on the express condlllon 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 time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Dale 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 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 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, anr~C a proved set of plans will remain
on the site at all tI es urlng construction.
Signature aJ~
In "'z g --fY
Date
VAIJDATION:
RECEIPT NUMBER
DATE PAIP
AMOUNT RECEIVED
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Ir)/if/~~
1r'SD/J
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RECEIVED BY