HomeMy WebLinkAboutPermit Mechanical 1998-1-16
OWNER: MY's. U. :1<. ('.A((~Y
ADDRESS" 23lfJ CJnr:\(:\y IANp
CITY: ~pn()tj-\..Idd
DESCRIBE WORI<: ln~~at; ~(P. IIJSef.t~F(...I"_ ~1llj ~ S-1D\1~
REMODEL -L... ADDITION DEMOLISH OTHEfl
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL: f.om+nr--!:. R~_IEt5J 1)()1\I s-J.-!..' .sl~ 'k- 0
C"1?=
OFFICE USE~ ~ 9
w I- ~
:J:-O
LAND USE: -.----..t::..~--UJ-
!:!:: W Z
# OF UNITS: II' ~ 0
a:CJ)~
0..- - Z
.,... ...
-t-cil
W <C.
HEAT SOURCE: _---L~
-Ie-_
RANGE: ___ f: Z q: ffi
OO"""'''-'Q..
;...~~.-
To request an Inspection, you must call 726-3769. This Is a 24 hOWCa:sr<~9.~II2j::;PCCllons rcqllCSIC(.I before 7:00 ::un. wIll be
made the some working day, Ins pee (Ions requested ortor 7:00 a.4l)wffi bIa:~cctflc following worl( day.
-o..O~CX)
REQUIRED IN&~-go~~
o ROllgh Mccl1iHli~ .l:-PffGr k) <c
cover.
RESIDENTIAL
PERMIT APPLICATION
Inspeclions: 726-3769
Olllce: 726.3759
LOT:
NEW
ELECTRICAl'
QUAD AREA:
# OF BLDGS'
OCCY GROUP:
# OF STORIES: ___
WATER HEAT En:
o
Tcmpornry Electric
o
Site Inspection - To bc made
after excavation, but prior \0
scltlng IOOllS.
o
Undcrslnb Plumbingl ElcctricnlJ
Mcchnnlcal - Prior to cover.
o
Footing - Atter trenches arc
excavated.
o
Masonry - Sleel locallon, bond
beams, grouting.
o
Foundntlon - Afler forms arc
erected bul prior to concrele
placement.
o
Underground Plumbing - Prior
10 filling trench.
o
Undcrlloor Plumblng/Mechnnicnl
- Prior to InsulatIon or decldng.
o
Post nnd Beam - Prior 10 floor
Insulation or decl<Ing.
o
Floor Insulnlion - Prior to
deckIng.
o
Sanll..ry Sewer - Prior to filling
Irench.
o
Storm Sewer - Pdor 10 ruling
trench.
o
Waler Line - Prior 10 filling
trench.
o
Rough Plul11bing - Prior 10
cover.
.
$PRINCr-IELD
BLOCI<:
STATE:
OR
ADDRESS
CaNST.
CONTRACTOR #
ODl!k[)
~I::-
CONSTn. TYPE:
o
Rough Electric..' - Prior to
CQver.
o
ElcctriC<11 Service - Must be
(lpprOvcd 10 oblain pcrmanent
electrical power.
o
Fireplace - Prior 10 (tlclng
materials and framing Insp.
o
o
Framing - Prior 10 cover.
Wall/C"ciling Insulntion - Prlor to
cover.
o
Drywnll - Prlor 10 taping.
o Wood Stove - After tn5talln:fon.
o
Insert - After fireplace approval
and Inslal/nllon of unit.
o
Curbcllt & Approuch - After
forms arc crected but Drior 10
placement of concrcle.
o
Sidewnlk & DriVCW:I\, - After
excavation is complete, fOllllS
Dnel Sul).b.1SC rn..tcrlil/ in pl;H;C,
o
Fcnce - WIlen cornpleted.
o
~;troo1 Tree:; - When all required
lrees arc planted.
.
JOB NUMoEn!:t1-@ (p i
SUBDIVISION:
PHONE: _!1!ifo -b31io
ZIP: ilJ!:fL7
l'XPII1ES
PHONE
"
to- Z7 -'1~
1.7Io-DIOO
FLOOD I'LAIN:
ZONINC CODE:__
If Of' 80nMS:
SECONDMIY HEAr: ____..
SQUAnE FOOTACE: ._"'_'_'
o
Fin,ll PIllIllbing - When nIl
pruml)lng w9rl< is compICl.C.
D
Firlul Eleclrlcal - V"11en all
electrical worle is complcte.
~echilllicill - When all
IIH.::cllOnlcnl worl< 15 complete.
o
Fin<ll Ouilding - W"Cn all
required in~pectlons have been
approved and bui/cllng 13
completed.
~ crlt?~._
MOBILE HOME INSPECTIONS
o
Olocking nlHI Sel.Up - Wilen nil
blocl<lnu I:; complele.
o
PIUl1\bil1~) Connections - When
11Ornr.:: Ilil$ been corll)eClcej to
wnlcr <111(1 sewer.
o
EtcclliGtll COtlllCCtiOIl - When
blor.ldnO, SCHlp, ol1d plumbing
inspections Il:wc l)ccn approved
illHI IlIe hOlllo Is connectod to
lhe service panel.
o
Fillnl - Arlor ull required
Inspection::> <:IrQ approved nnd
porellc5, sl<irling, decl<:;. and
venllno hnve been Instilllcd.
Lot faces
Lot Type
Lot sq. rtg,
Interior
Lol coverage
Corner
Topography
Panllandlc
Tolal helgllt
Cul.{Jc.sac
BUILDING PERMIT
ITEM
SO. FT.
X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fcc
State Surcharge
Total Fcc
(A)
.
SetbaGlc;
P.L. HSE I GAR
I
N
----
-~--
1 "
~THE PROPOSED WORI, ;N THE.
....HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be sIgned
and approved by the Historical
Coordinator prior to permit issuance.
'.
ACC I
I
W
.---..- --- ----
-'
APPROVED:
E
L___1-.... .J
VALUE
'.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8)
PLUMBING PERMIT
ITEM
Fixtures
Residential O<.Jth(s)
N"
SanltDry S~wcr
Waler
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permil
Slate Surchargc
Tolal CI1LHge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Venl Fan
N'
Wood Slovc/lnscrt/Flrcplacc'Unil
Dryer Vent
Mccllanici11 Perllli I
Issu,;)nco
Stille SurChalfJC
Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Horne
State Issuance
S\alo Surcl1aruo
Sidcwalle
II
Curbcut
II
Demolitlon
~Iate Surcharge
Totill Mlscellaneou$ Permits (E)
TOTAL AMOUNT DUE (exclulling electrical)
(A, 8, C, 0, and E Coml)lned)
-'
FEE
.'T
.
l'
.'
\' :l
"'
,"
.-
'.'
( 1 ,.
'- ;
:."{". .,
~~ '. .
;;
.:fis. -
-tJ~L--
.~+,=tS
.:fs O-{,. 0-<>
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permil is granted on the express condition that the said
conslruction shall, in all respects, conform to 1I1C Ordinance
adopled by Ihe Cily of Springfield. including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked a\ any time.
upon violation of any provi~ions of said ordinances.
Plan Ctlcck Fcc: _
Date Paid:
Receipt NUlllbcl':__.
Received By:
Plans Revic~ed--'O-y-'--"'----
Date
Sys.lcms Ouvclopmcnt Charge is due on all undeveloped,
properties within the City limits wtllcll arc being improved.
ADDITIONAL COMMENTS
By signature, I stalc and agree, thai 1 have carefully examined
tho completed applic<Jllon and do hereby eertHy Ihat all
InformatIon hereon i::; true ane! correct, and I further certify
that .-:lny and all VJork performed shall be done in accordance
with the OrdinancL:::; of tllr; City of Springfield, and the Laws
of the Slate of Oregon pertaining to the worle described
hen:dn, .1nd tllal NO OCCUPANCY will be macJe or any
structure witllOut pt:rmission of 1110 Buildlnu SrJfety Division.
I furllWf cerli fy tllat only contractors and employees who
arc in cornpliance'with QRS 701.055 will be used on this
project.
I further agree tQ ensure thaI aJJ required Inspections nre
reQue31ed at the proper lime, that each address Is readable
from the street, that tile permit card is rocated at the fronl
of the IJropcrty, tlnd the approved set of plans will remain
on the site /a.llli~:':conslrUCtlOn.
4"",,",, tV?
~Ie L-/r; -78'-
VALIDATION:
RECEIi'T NUMBEI.l ?-. f6 4'1/
I-lie - '1 <t
DATE PAIr>
AMOUNT f1ECEIVf.D --1,:}.t,. a-o
"'I< u.:J
FIECEIVED BY