HomeMy WebLinkAboutPermit Mechanical 1999-2-23
7
/ RESIDENTIAL
V PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK' ~S'3o ti?~c.
ASSESSORS MAP' n Os I S ~
.
.
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: '3 I CS"L:>
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LOT:
BLOCK'
SUBDIVISION'
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~>'30
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PHONE: --19-. c.s - q 2a.3
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OWNER'
ADORES'"
CITY:
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STATF' '
ZIP:
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DESCRIBE WORK'
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR .
CONTRACTOR'S NAME ADDRESS
GENEM,r<=~ITII"lN.nrAOon law reguires you to
Inllow rules adopted by the Oregon utility
PLUMBING: 'fl '-5 aF8 6s1'",..."
ME~o=~~~~I:JJ~R 95~~-; I ~
ELEBlWP-A\Qu may obtai~ COPie,~~~~~~~~~~: oy .
. , c'alllny U1tH,;t;lllt:a. \N....l.... ..,_.~ -.'f-, -.
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numoerfUT Ult;lVI'O''!::iV'' ....1:....) .._.. --
Center is 1-800-332-2344).
.
QUAD AREA' . LAND USE:
EXPIRES
PHONE
.~
NOTice:
--- -
L( rlllt) 1-'tt}\t'T. SHA ~e:~PIRE IEJ$@WORKiiit') '08
AU r HORIZ~ ~F -. i~IS PERMIT 181/IDf 7- ll.{'1r
vVI\'IiVlti\,U L' Uti J~ ,:.\tJANLJONED FOR .
- OFFICE USE ~r\''. ~.~ ,.: Cql(\i.
FLOOD PLAIN:
ZONING CODE: _
. OF BDRMS'
.'
. OF BLDGS:
~fOF UNITS:
CONSTR. TYPE: _
I' .
OCCY GROUP'
. OF STORIES:
WATER HEATER:
HEAT SOURCE:
SECONDARY HEAT:
SQUARE FOOTAGE:
RANG'"
To request an Inspection, you must call 726.3769. Ttlls 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.
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
~over.
D Temporary Electric
D Final Plumbing - When all
plumbing worl< Is complete.
, .
D Site Inspection - To be made
after excavatIon, but prior to
setting forms.
D Rough Electrical - Prior to
cover.
D Final Electrical - When all
electrical work Is complete.
~ Final Mechanical - When all
~chanlcal work Is complete.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fooling - After trenches are
excavated.
D Flnat Building - When all
required Inspections have been
approved and building is
completed.
D Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting.
D Framing - Prior to cover.
DOther
D Foundation - After forms are
erected.but prior to concrete
placement.
D Wail/Ceiling Insulallon - Prior to
cover.
D Underground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Wood Stovo - After Installation.
D BlockIng and Set.Up - When all
blocking Is complete.
o Post and Beam - Prior to floor
Insulation or de~k1ng,
'"
. .
D Floor Insulation ''':'' . Prior to .: . I
decking. .
D Insert - After fireplace approvel
and Installation of unit.
D Plumbing Connections - When
home has been connected to
water and sewer.
. D Curbcut & Approach - After
.". forms are erected but prior to
placement of concrete.
D Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Sidewalk & Drlvewav - After
excavation Is compiete, forms
and sub-base material In place.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Fence - When completed.
D Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
D Rough Plumbing - Prior to
cover.
D Streel Trees - When all required
trees are planted.
. . l,': .\,,: '~ . . ltl'THE PROPOSED WORK IN THE.
Lot ~pe. ',t
Lot faces Setbacks
Lot sQ. fig. Interior PL. HSE GAR Accl HISTORICAL DISTRICT, OR ON
I THE HISTORICAL REGISTER?
Lot coverage Corner N II yes, this application must be signed
\ Is I and approved by the Historical
Topography Panhandle Iw I 900rdlnator prior to permit issuance,
". ,
Total height .. " ~. Cul.de.sac "
'. . I~ ..<oJ
APPROVEI"
'i 'f
BUILDING PERMIT
ITEM sa. FT. x s/sa. FT. = VALUE
Main
t. _.
Garage
Carport
"
....i
,
.
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYS!~~S DEV,~L?PMENT .C.':i~~GE (?DC) ,
'. , " ~ (8) .
PLUMBING PERMIT
ITEM
FEE
Fixtures
Resldenllal Bath(s)
N'
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Fu mace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
I~~T-~P
I S. c;-v
Mechanical Permit
Issuance
10,crv
'75
..e:::.. .
,
\jJ 2.Jr}O
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
fI
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
,,; '. .,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted ,on the express condition that the said
construction shall, In 'ali're-spects, conform to the Ordinance
adopted by the City 01 Sprlngflel.d, Including the
Developnient Code,' regulating the construction and use of
buildings, and may be suspended ,or revoked at any time
upon violatIon of any provisions 0'- said ordinances.
Plan, Check F,ee:
"". '.
Date Paid:
Receipt Number
Received By:
Plans Reviewed By
Date
1 .
_ ~ys,t~m~1 De~e!opment Charge,ls;d.ue 90 all undeveloped
properties within the City '11';'1 ts which are being Improved.
ADDITIONAL COMMENTS
V 4J L<\. c... t"l.f- ""! d.b
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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 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 tile street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Date
Signature
VALIDATION:
RECEIPT NUMBER OS::;2- <f q~
DATE PAID .;9-{ d-:~ I CJ9
AMOUNT RECElv~n,'J1 ;;;... (p . (jO
RECEIVED BY..tJ ' YYlr1 (1JrrJe!C\