HomeMy WebLinkAboutPermit Mechanical 1999-5-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
.
JOB NUMBER ~~
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: _05.">0 GBme ~(J1l m ~rl :/k..;L:>,
ASSESSORS MAP' I >-,,!:>~ -/c!:)' ',o/'n TAX LOT-
OWNER: \hall bnAt1 I-lrIIlI't"
ADDRESS' . ~ S.30 Gaml h.MYJ--;<'d
. ()
CITY:"""-)(lIU ~J ~prl
DESCRIBE WORK' I'nSlf\ u... AI H a. H J P
LOT:
NEW
REMODEL
BLOCK:
#.23
STATE:
f)l2.
ADDITION
DEMOLISH
OTHER
~~L:!il~
SUBDIVISION'
PHON'"
") 1./ ?-x. ~.2.
ZIP:
q '7<17')
ADDRESS
CON ST.
CONTRACTOR'
,~.,
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
. .
MECHANICAL:'A~"orIAi1:rI H~flnn<:tQ Ale.
ELECTRICAL: W#,,~p.a
. / ,. ?/
QUAD AREA:
. OF BLDGS'
OCCY GROUP:
. OF STORIES:_.
WATER HEATER'
EXPIRES
PHONE
P.O, T;xJ)r "{ 1.1.
FI1Q (()~ q'<No tI:'(J(".;l.75
1
REQUIRED INSPECTIONS
rvt Rough Mechanical - Prior to
~ cover.
D Rough Electrical - Prior to
CQver.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to,cover.
D Wall/e'alling Insulation - Prior to
cover.
D Drywafl - Prior to taping.
D Wood Stovo - After Instal/all on.
D Insert - After fireplace approv~1
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When corr1pleted.
D Street Trees - When all required
trees are planted. .
9;--">1-.:1..000 ~IoA>'-:L"CK
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
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 aHer 7:00 a.m. will be made the following work day.
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE: _
D Final Plumbing ~ When all
- plumbing w9rl< Is complet.e.
D Final Electrical - When all
electrical work Is complete.
0!'lnal Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
DOther
MOBilE HOME INSPECTIONS
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 connecled to
the service panel.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electricall
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 Undorground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post anC;! 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.
o Final - Aller all reQuired
InspectIons are approved and
porches, skirting, decks, and
venting have been Installed.
J
Lot facGS
~t ~p"
Interior
Set becks
I P,L. HOI! GAR
Lot SQ. fig..
Lot coyorage
Corner
.!:!---..
S
Topography
Total height
Panhandle'
Cui-dc-sac
W
----
E
BUILDING PERMIT"
ITEM SO. FT.
u
'>~
X $/SO. FT. =
VALUE
Matn
Garage
"
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
tTEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit /11/# /~,-
Issuance f; /~.-P
State Surcharge ,'~
Total Permit (D) ..:2 t....2cJ
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
.'., ~::, th ~..;::\:)
~,l.' ..,
.5 THE PROPOSED WORK tN.THE .
'HISTOr:\IOAL DISTRICT, OR ON ~
THE HISTORICAL REGISTER?
If yes, this application must be signed
aod approved by the Historical
Coordinator prior to permit Issuance,
Accl
I
I
APPROVED:
- ',\", 'I
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on tho express condition that the saId
constructlon shall, in all respocts, 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:
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 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 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 at ~I J\es dr'llg constr~ctlr'
Slgnat~{L} (~. A ~
Date .<;"" - / q- ?7'
VALIDATION:
RECEIPT NUMBER -=3 t./ /t?P
DATE PAIP ~~ ;-;.'3
AMOUNT RECEIVED ..-,~.:2 t:/
RECEIVED BY 0 -( "/t' ~, -'
,:/;./~ -~~
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