HomeMy WebLinkAboutPermit Mechanical 1999-11-14
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
SPRINGFIELD
LOCATION OF PROPOSED WORK: '22::Z..2.
ASSESSORS MAP' /?t!!!:J ,.':32~/.:3
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OWNER~ p~ }-/q A/-('rr' ~
ADDRESS: 9 d--.d-d- ~ ~ ~ "-
CITY: Sf" \ If\(\~~~-p_,l ~.
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LOT'
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BLOCK:
STATE:
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NEW
REMODEL
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ADDITION
OTHER
DESCRIBE WORK:
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
ELECTRICAL:
SckP/,^_'iv~~
~
QUAD AREA:
DEMOLISH
_!f1'-
JOB NUMBER ~4'
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225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
~/~
PHONr=.
") L) ~- LJOG 2-
ZIP: C1 / Ll "7 I
,
ADDRESS
CONST.
CONTRACTOR II
EXPIRES.~ PHONE
II OF BLDGS: II OF UNITS:
. OCCY GROl~pTICE: CONSTR. TYPE:
THIS PERMITSHALLEXPIRE IFTHE WORK
II OF STORIEc)" . HEAT SOURCE:
AU I HUHILI=U UI\JUI=H 1 HIS PERMIT IS NOT
WATER HE~e/\}1MENcEDORISABANDON~:
J.' _. -
1"\1 I CI\II IVI\l:uregon law requires you to
follow n 1113~ :::Irln:--,t~0. ~~~ C':-::;;::.:;~ ~t;;;~y'
eJv T~/1.~ ~otif!<:..a!i~~ Genter. Those rules are set forti
III GI-\rl :1O"::::-UU'/-UUl U mrough OAR 952-001-
oo~o. Ynll m::l\f nht!:lin t"/'w.ir.", ^f' .h,~ ~. .l~,_ f...
. .. __n___ -~..r_'--""'. ....""" ''Wol,,,,,,,,,;r uy
r.AIl:rn tho I""-'.",t",.. il\l^+~.. ~I_~ ~~I~....J_.... ..
- ,- --'0_- .......... .._I-......~.Vll...,
- OFFICE It1J1$SbQrforthe Oregon Utility I\lotification
Center is 1-800-3~2-~1;14d \
LAND USE: FLOOD PLAIN:
--"
ZONING CODE:
II OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAG E:
ANY 180DAY pl=~l()n
To request an nspecrrbh, y<m 'fr'TU13t 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.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Vnderslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting. .
o Foundation - After forms are
erected but prior to concrete
placement.
D Underground PI4mblng - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam ...... Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench. .
D Storm Sewer '-, Prior to mllng
trench. '
o Water Line - Prior to filling
trench. '
o Rough Plumbing - Prior to
. cover. '
. . ,
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover. .
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Final Plumbing - When all
plumbing W9rl< Is complete.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building is
completed.
o Fra~ing - Prior to cover. @ / . ..f2,...."., A
ther (.::7~ __/,&.r
I V
o Wail/Ceiling Insulation - Prior to
cover.
o Fireplace - Prior to facing
materials and framing Insp.
D Drywall - Prior to taping.
. ,
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub-base material In place.
tJ Fence - When cor,lpleted.
D Street Trees - When all required
trees are pla':lted.
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer:
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot sq, Jt9'
Lot coverage
Topography
Total height
BUILDING PERMIT 'i
ITEM
sa. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fec
Lot Type~.
Interior
Corner
,.
panhandle .
Cul-de'sac
,{
X $/SO. FT.
(A)
',t , ',. ,{ "1~ ; ,~
'. ".:, :~ .~'
. <'
,," .
h~L. '
N
S
\AI
E
, VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
FT.
FT.
FT.
NO
(B)
(C)
Wood Stove/Insert/Fireplace Unit
Dryer Vent
_ G,.f-5 ,~./
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)"
FEE
/5
10 cu
('"""0
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;2 ? S7J
.. . : ~-.......
, \; '4 ;'. t~"~'
".,." ,I 'I ,~,,' }t",;~ ,'.' \',
. . , . .. . .~.;:t ."',
Setbacks '
I. .1'
HSE GAR ACC'
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..
IS THEPROPOSED WORK. tNTHE .
'HIST081CAL DISTRICT, OR ON
. THE HISTORICAL REGISTER?
If yes, this appliCation must be signed
and approved by the Historical
Coordinator ~rlor to permit Issuance.
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
oulldlngs, and may be suspended or revoked at any time
upon violation 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 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:ali work performed shall be done In accordance
with the Ordinances of the City of Springfield, and the Laws
of the Stat~ 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 tha't 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 plans will remain
on the site riJ times during construction.
SlgnaturJ ~ .Un ..I~eA--{.. r-
Datt3 II ~/ if - //9
VALIDATION:
RECEIPT NUMBER 03~! 0 ,~
DATE PAID I( ! l</ q i' /l
AMOUNT RECEIVED ]f;z, ~)CJ '/
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RECEIVED BY f..,j