HomeMy WebLinkAboutPermit Mechanical 1999-12-7
RESIDENTIAL
PERMIT APPLICATION
.
SPRINGFIELD
I,..,,, I
Inspections: 726-3769
Office: 726-3759
. l( LOCATION OF PROPOSED WORK' qkQ
ASSESSORS MAP: ---1~ 0 L () ~
LOT'
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'IOWNER:
,I ADDRESS'
CITY:
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BLOCK:
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JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
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SUBDIVISION'
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DESCRIBE WORK' rf'7;L:nnt'
NEW Y REMODEL ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAl:: ~ f7:-nn-r:-h.cL7
ELECTRICA' .
STAT'" t'Ji<Z-. ZIP: _Q7-7'7 r
i nQeY-I- rY- -raal<....
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR #
EXPIRES '::" PHONE
REQUIRED INSPECTIONS
D Rough Mechanical - 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.
o Framing - Prior to cover,
o Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation 01 unit.
D Curbeut & Approach - 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 cOiYlpleted.
D Street Trees - When all required
trees are planted.
37 (; llLA) I ftlL-r; /'PIle t'lI'Z.. ~
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/0311/(. . /. _"';fq~. 70'(:&'
rz; -r 01
- OFFICE USE -
QUAD AREA: LAND USE:__ FLOOD PLAIN'
. OF BLDGS: . OF UNITS: ZONING CODE:
OCCY GROUP: CONSTA. TYPE: . OF BDRMS'
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
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 FInal Plumbing - When all
plumbing w9rk Is complet.e.
D Final Electrical - When all
electrical work Is complete.
f)?f Final Mechanical - When all
~mechanlcal work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
~ Olher .c:~ U"';,.::..
MOBILE HOME INSPECTIONS
D BlockIng and Sel.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.
r
,.
I
o Temporary Electric
D Site Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab Plumblng/Eleclrlcall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated,
o Masonry - Steel location, bond
.beams, grouting,
o Foundation - After forms are
erected but prior to concrete
placemont.
D Underground PI~mblng - Prior
to filling trench~
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - 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 tHllng
trench.
D Waler Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
4
Lot faces
.
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
;
Panhandle
Cul-de-sac
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BUILDING PERMIT oj
ITEM SO. FT
'of
X $/SO. FT, =
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
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......IS THE PROPOSED WORK. iN THE",'
HISTORICAL DISTRICT, OR ON .
THE HISlORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks .
I P.L. I HSE I GAR I Acc'l
N I ,.I I
~I
L__
IN
--- -- -----
" ... APPROVED' ,.
,.i ',. ,.,\ .__'.j.__
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sani tary S~wer
FT.
FT.
Water
Storm Sewer
FT
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnserllFlreplace Unit
Dryer Vent
4'~ 1.#/0 /~~ /,tJ{'~7
Mechanical Permit
Issuance
State Surcharge )pf T.4;
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
\..~..
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C, 0, and E Combined)
FEE
$/U
/5'00
/0-
/ :rlJ
:20.ro
~S-o
BUILDING VALOE, 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 tha
Dovelopment Code, regulating the construction and use of
buildIngs, and may be suspended or revoked at any time
upon violation of any provisions of saId ordlnancee.
Plan Check Fee'
Date Paid:
Recei 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
.&tJA1(YA/.RfE . /J,.f;}).tdzt;E 77fv.<
JAJ~&} 111/ 71f,3C/9=--
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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 certify
that any and all work performed shall be done in accordance
with the Ordinanc~s 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 pr er time, that each address Is readable
from the street, tflat he permit car Is locate the front
;;
of the pr~per y, an the approved et of p ns III remain
on the site t all me~ during iniuc on
Slgnatur - fJJ Vv
Date
VALIDATION:
30 $6 5'
/2.-7-)'r
2.& }'70
rtp:~l.
(
RECEIPT NUMBER
DATE PAin
AMOUNT RECEIVED
RECEIVED BY