HomeMy WebLinkAboutPermit Mechanical 1999-2-1
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: 36QO
ASSESSORS MAP:\g(''J2C.'''io\ 4-
OWN~,1 \~f\~~" f'\'~\'1Y\ ,~
AD DR ' " hf) 4 ~ ~J. l ""' ~ -\:-0",- ~
~ ~ STATE: \~)\ G~
DESCRIBE WOR': ~ N n/llJ 'f-() , _ 0 J( (~ /2(: \ {Y\o f\ ~ Jpl?....LlJ/T:i'
NEW REMODEL 4lDITION DEMOLISH <k~ FR
LOT'
CITY:'
CONTRACTOR'S NAME
BLOCK'
.
~~\5\~
JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
TAX LOT:
SU8DIVISION:
\9:PcYj
PHONE: '"'1+1.8~S
ZIP: U\ r\ ~
ADDRESS
CONST,
CONTRACTOR #
EXPIRES ','7' PHONE
GENERAl' .\0
'\leS 'l~~\\,'\\'l
PLUMBING' .rtU _ U ....Y\
_ \. '\ ^ #'v '~~'v,
MECHANI~__.f\ ~ \..1:"\ ~orklV. _ S,n.r::FJ'\',
, ~'.C) v e6 'O~ I~~ - I>-~ ,,~. \eS '"
ELECTRICAl ' _,,\,~\0 "nO~ _~ose ..,Y\ 0 '>0" I~ .~
,,"'f\'(:.. ..\\eSo.-.....\e1. ':"_'n.~ov:"_c.o' \:~~ftO~v'",^(\
'\0.... I, l\ v- '\ ()U ,~ _ r.~- "",,,-IV 4\C....
\0' -0.\,0 n,()' i"- ,";E ~Q"'-
0\'\\\C 9~~'v -0.:-1 0'0\ ~o 0\\'\~ ~AA~'
QUAD AREA: ~ ~~"O~ ~AND\~'-slil"(\ .n.?::.-c'
\\' ~ eC'" OIl:N ::"r
# OF BLDGS: Q()9~~,,\(\9\~O'j;eu~IiT~()()
~el \ell
OCCY GROUP: _(\~(Ci 61)~STR, TYPE:
Il;n...
1).,. ; '~.A.
A/ v,o" ......
To request an Inspection, you must call 726-3769, This Is a 24 liour recording, All Inspections requested before 7:00 a,m, will be
.... . Nn: 1'14/
made the same working day. Inspections requested after 7:02J,a.m...wlll DB/made the following work day.
. '1:4;,. '/~.l'-. uN...
REQUIREDANSRCEC-1'IONS' ~
. F; v'~ ":t
D Rough Mechanical ~4i~or ttfly lJ 101,0') Final I'lumblng - When all
cover, i ~,'f I..s Ai 01-8 A~'f,lumblng W9rl< Is complet,e,
-9-,., \9-1~ ~..9, It~ 14_
D Rough Electrical - Prior t~ Z>O;td~FJ~a(fE~~ctrrcal _ When all
cover. ~v ^ e"leC1rlcal work.ls complete.
"0-9 'Ul'
D Final Mechanlca' - When all
mechanical work Is complete.
# OF STORIES:
WATER HEATER:
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
D 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 filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
HEAT SOURCE:
RANGF'
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
FLOOD PLAIN'
ZONING CODE: _
# OF BDRMS:
SECONllARY HEAT:
SQUARE FOOTAGE:
D Final Building - When all
required Inspections have been
approved and building is
completed.
D Framing - Prior to cover, Yi
./ ther
D Wail/Ceiling Insulation - P;lor to _." OWl (1 'Z:..
cover, ~ Lr:afJ .,~ J
D Drywall - Prior to taping, , ~., q~
MOBIL HOM INSPECTIONS
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Af>proach - After
forms are erected but prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base materIal In place.
D Fence - When completed.
o Street Trees - When all required
trees are planted.
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.
Lot faces
Lot sq, ltg,
Lot coverage
Topography
Total height
BUILDING PERMIT"i
ITEM SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
L~t ~yp.
Interior
Corner
,.
Panhandle
Cul.de-sac
I" "~
X $/SQ, FT,
(A)
I PL.
IN
Is
VI'
----
..s...----L- I
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
FT,
FT,
FT,
(C)
Wood Stove/lnsert/Flreplace Unit
NO
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Mlscellaneou~ Permits
(E)
FEE
\~,~
P5
l/;9i6
TOTAL AMOUNT DUE (excluding electrical) LiJ; .:J()
(A, B, C, 0, and E Combined)
; :,.. ~1': ,"
..
_S THE PROPOSED WORK IN THE _
..'.HISTOi;lICAL DISTRiCT, OR ON
THE HISTORICAL REGISTER?
It yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
HSEIGAR
I
ACC I
I
I
1_,_.-'
APPROVED:
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
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:
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.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have ca'refully 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 Ordinances of the City of Springfield, and the Laws
of the State of Oregon perlalnlng to tho work described
herein, and thai NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certHy 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 str at the permit card Is located at the front
of the p erty, an the approved set of plans will remain
'-
on the at all Ii es durinJ1 construction.
/'---,:?~
. ,-";;..--/ ~
- "7 ...... -====-
VAi.lDATION:
RECEIPT NUMBER
_ f>:JGTOc6
'-'\'~
DATE PAin
AMOUNT RECEIV .0
RECEIVED BY