HomeMy WebLinkAboutPermit Mechanical 1999-6-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
.
LOCATION OF PROPOSED WORK: _ /1;X
" .
ASSESSORS MAP: _ ,_
LOT'
OWNER' t4,,/ ~-<./"
ADDRESS: /q,?CO D,j4Jo~.p
CITY: .yrtvlIJ h'd,./
DESCRIBE WORK:-;C.v; L./~",-_
NEW
REMODEL
ADDITION
BLOCK:
STATF' ~,
01" 1/;:',,} #t/~
DEMOLISH
OTHER
.
9'16 7'15
JOB NUMBER
225 Flflh Street
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION'
() )l(O/)
PHON'"
ZIP' "1-;7<'.,1
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR N rElIlPI.R.!lB,~
GENERA~; /~I!..HflJ1:f/).IU:'T fJlEPr ff~TAL T;..~. 1.51361 v, I .
PLUMBING: . 1/S('D
-r.::: /' A 'It. ">~rJ:;tlr.llt)' SIJalUeo
MECHANICAL: /P-GAlA/rc.A IJ...~ .J#EI=7" , fETAL or.:; rvVl;v! l"(.,'fIo..'- '\ 'OjJ;1'l"lr'"
NnTIICE' uOlle~IIIION ^1.. I " O'V -.,. 6
ELEc'I'ltt:M:, ;,4/.""0 - Od/..,.AO ~ _ ' ," .~'~,~. "", '''lO~l) 'JBIUBO ell) u!I1eJ
TI-lI~ PFRMITRH~XPIRE IFTHE: WUHK , '~'~:.~~. ~:I 19 ~MiM 11I'PlnO AllW no}.. 'UbUU,
AUTHORIZED UNDER THIS PERMIT IS NOT - OFFICE U~\(J""<;R 0\\10 116noJlli moo- WO-ZS6 C1't10 u,
ONED FO!:l ' " "" "-~,,,, "e\nJ asolll 'JBlue:) uOn80!I'ION
QUA(}:~NCEDOR ISABAND . LAND USE: ~ ,1\.",}ld.. ",,, .. A J<aOAAll~tN:/I1IO"OI
.\11111(1 '.I01l':lJU alll Q fJ "lV"T'
N OF~'i!;a~O DAY PERIOD, N OF UNITS: ~':-i>o' ".."nheJ Met U281lHN~e~:!:LV'
OCCY GROUP:
N OF STORIES'
WATER HEATER'
CONSTA. TYPE:
HEAT SOURCE:
RANGF'
PHONE
'f~;' "J-J.n..
N OF BDRMS:
SECONDARY HEI.T:
SQUARE FOOTAGE:
To request ao lospectloo. you must call 726,3769, This Is a 24 hour recording, Alllospectloos requested befc,re 7:00 a,m, will be
made the same working day. Inspections requested alter 7:00 a,m, will be made the following work day,
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcal/
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.
o Underground Plumbing - Prior
to filling trench,.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o 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. '
o Rough Plumbing' - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Eloctrlcal - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Flreplaca - Prior to facing
materials and framing Insp.
, ;
D Framing - Prior to cover.
,
D Wail/Ceiling Insulation - Prior to
cover.
o DryWall - Prior to taping,
D Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
o Curbcut & AIlproach - After
forms are emcted but prIor to
placemont ot concrete.
D Sidewalk & Drlvewav - After
excavation Is compioto, 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
lumblng wc;:>rl< Is complet.e.
fi F 81 Mechanlc!11 - When all
~ "echenlcal worl< Is complete,
D Final Building -- When all
required Inspecllons have been
approved and b\llldlog Is
completed.
D Other
MOBILE HOME INSPECTIONS
D Blocking and S"t.Up - When all
blocking Is complete,
D Plumbing Connl)ctlons - When
home has beeo connected to
water .'lnd sewer:
o Electrical ConMcllon - When
blocking, set.up. and plumbing
Inspections have been approved
and the home hl connected to
the service paM!.
D Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
('
Lot faces
~t ~pe.
Interior
Lot sq, ltg,
Lot coverage
Corner
Topography
Panhandle "
Total height
Cul,de,sac
BUILDING PERMIT '.',
ITEM SO, FT,
"
'it
X $/so, FT, -
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolai Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldeotial Bath(s)
N'
Sanitary S~wer
Water
FT.
FT,
Storm Sewer
FT,
MobIle Home
Plumbing Permit
Stato Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/losert/Flreplace Uoit
Dryer Vent
;r(//!l <::'1((,/'1
Mechaoical Permit tJt! c.- '7 VJ~K. K
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
Slate Surcharge
Tolal Miscellaneous Permits (E)
',I
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, aod E Combloed)
Setbacks
'H5EIGAR'ACCI
I I
I
I
J
". ~ ,~.. 'I.
BUILDING VAL(JE, PLAN CHECK
AND BUILDING PERMIT
p.L.
N
S
W
E
-.-..
VALUE
"
FEE
/5',0<"
/0. pJ
I.K/7 )
2J,. .2-(;)
'.: : .;;: .~" .
',J. '.
'\. THE PROPOSED WORK IN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
It yes, this applicatloo must be slgoed
alld approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
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, locludlng the
Dovelopment Code, regulating the construction and use of
oulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plao Check Fee'
Date 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 Ordloances of the City of Sprlogfleld, and the Laws
of the State of Oregon perlalnlng 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 with ORS 701.055 will be used on this
project.
I further agree to ensuro 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, and the approved set of plaos will remalo
00 the site at all times during construction,
Slgoature,~r'~
Date t,,~ ~4 '
I /~'
.
VAI.IDATION:
RECEIPT NUMBER n,3 4-360
DATE PAID (LJ /:2 J t; q
AMOUNT FlEeEIV~D' 'JJ 2/" dU
RECEIVED BI7. (YJ/J (!~