HomeMy WebLinkAboutPermit Mechanical 1999-1-28
RESIDENTIAL
PERMIT APPLICATION
Inspeclions: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORI<'
11 03 2...&
ASSESSORS MAP:
LOT:
V I n (lA",
ADDRESS: U,., ~~I'11A rlv
CITY:~
-
5pnlNcr=II~Lp am:
Io~
:z:)
I
BLOCK:
A;ICtlYlrYl\ ~rfiw.f'Drr.l
WDD
,
OWNER'
STATE: ._OR
.
JOB NUMBER qc; 0 I J,. "7
225 Fillll ~trccl
Springfield. Orcgon 97.177
TAX LOT:
SUBDIVISION:
!YO (,,(17
PHON"' '74/-:/S'75
ZIP: QJL/-17
DESCRIBE WORI~: Ins+f1..I Ut~12ti.m~ ~V~.J......cm
NEW REMODEL t/ ADDITION DEMOLISH On-IEIl
CONTRACTOR'S NAME
PHONE
GENERAL:
PLUMBING'
ADDRESS
CON ST.
CONTRACTOR'
MECHANICAL:
ELECTRICAl'
tomforf.. FIO!<LW;/ DOfLS}~11
DD4t{)
EXPlllES
k~?- Oft
1]210-0100
/1'V i il!:;~,: _ OFPICE USE _
QUAD AREA: THIS PE~;vII'r' ~HAll EXPIRE Lr:r.."FiilEl!l~e"'''._
AUTHOR" wnr,
. OF BLDGS: .' 11.,:[, UNDER THIS PIiP0'rfTLlF.lliti$\T
vUj\ljl",F~'Ct '1...," :,lo' t" 'ANDO""~o (""'"
OCCY GROUP: " ._ . C0NSr-Rl TYPE:__
'll,' ..,{f- ,-;, ,I,
. OF STORIES: _'__
WATER HEATER:
"I r t:N IIUN:Oregon law requires you to
fO~I?w ~ules adopted by the Oregon Utility
Notlf/callon CentfrL~tl9MIt!S-!lfe"8Ct-1
~~ OA~ 952-001-Q.OW \t1lP~QAR 952-00;'.'
-~CC-. .Iv.) may 06Pcll~ copies althe rulesby
calling the cenleoi(NIlMHVlfu t^'~_~=- =
numbe~or th~ <;?regon .WililY f'lP.it/;c~ii;n
Jenter 'S"tr;lf6lY-3'3~:2344):~ -_.....
SQUARE FOOTAGE: ..._._
HEAT SOURCE: ____
RANGE: ___
To request nn Inspecllon. you mUGI c~ll 726-3769. ThIs Is ::t 24 llour recordIng. AlllnspccUon::; reqlleslCd before 7:00 n.m. wIll be
made the Silllle worl<lng dOlY. In:.pecllons requested ofter 7:00 <l.m. wlll be m~(je Ihe followlnn worl< dl.lY.
o Tempor.:lry E;:lcctric
o
Site Inspection - To bc made
aller exctlvatlon. bul prior (0
setting furms.
o
Undcrslnb Plumbing I Elcctricilll
Mechanical - Prior to cover.
o
Footing - After trenches arc
excavated.
o
Masonry - Steel locatlon. bond
beams, groullng.
o
Foundnllon - Ailer 'arms arc
erected but prior to concrete
pl.acement.
o
Underground Plumbing - Prior
10 rlIllng Irencl..
o
Underlloor Plumblng/Mechiln;cnl
- Prior to InsulntJon or decl<ing.
o
Post ilnd Oeam - Prlor to floor
Insulation or dccldng.
o Floor Insul.lt;on - Prior 10
decl<lng.
o
S311ilnry Scwcr - Prior 10 filling
Irenell.
o
Storm Scwcr - Pfior to fi/ling
trencl..
O Woter Line - Prior to filling
trench.
D
Rough Plumbing - Prior \0
cover.
REQUIRED INSPECTIONS
o Rough Mcchnnic;ll - Prior to
cover. .
o nough ElcclriCOlI - Prior 10
CQVer.
o Elcctrical Servlcc - MllSI I)e
approvecl to obtain perfl\.:IrlCnl
electrlcol power.
o
Firepl<:ice - Prior to fnclng
materials ~nd frilming Insp.
o
o
Fr'<:iming - Prlor- to cover.
W;J;II/C'clling i1'Slll'l(iOIl,- Prior 10
covcr.
o Dr'y....i<ill - Prior to l:lping.
o Wood Stove - Arter In:>tolln:ion.
o In:iert - AflOr Ilrcpt<1CC approvel
<1nd Installnllon o( unit.
o
ClIrbclIt &. API,lfO:ICh - Arter
form::: .1re crOClcd but prior 10
placement of concrt:l(~.
o
Sidewillk & Drivcw:I\' - After
cxcnviltion is complele. forlllS
DncJ sul)-b:J.sC m~!~rJal In place.
o Fcnce - WIlen completed.
D ~;troot Tree:; - WIH.:n all required
trees arc planted.
o
Fin:li Pllllllbing - When nil
plumbing w~)rl( Is complel,c.
o r-ilWI Elccttic;ll - Whcn ;111
C/'OOI wor;, 15 oor1lplele.
~!~~~,I_ Mechanicnl - When c11l
"lCCl1~nical wOrl< 'l~ complete.
o Fin,11 [Juilc.lillO - Wherl illl
required Inspecllons h.lVe been
approved and building Is
cornplelvd.
o Other
MOBILE HOME INSPECTIONS
o Olockillg nnd Set.Up - When 011
blocl<lnD I:; complctc.
o Plulllbin~J Conncction:; - Wilen
11Om(~ hi.!:> been COlllleclcd 10
willcr ;111<.1 :>Cw<:r.
o
E;:lcctdc:11 COllllectlon - When
()locldIlD. :iCI.up. .:Ind plumbing
In~;pccll()n:i h:wc been approved
ilnd the hOllle if, connecled to
the :iervicc p.l/lel.
I I Finnl - After all required
Inspectlon:j arc opprovcd and
porches, sl<lrlinO, dccl<s, and
venting have been Inslnlled.
LOI (uces
Lol Type
_ Intenor'
Lot sq. Itg.
LOI coverago
TopograpllY
Tolal 110lgl11
Corner
Panh,1nd/c
Cu/.cJe.~ac
BUILDING PERMIT
ITEM
SO. FT.
X $/SO. FT.
MaIn
Gnrnge
Carport
Total Value
Oul/ding Permit Fcc
St~tc Surcl1arue
Total Fcc
(A)
Sctl>ac!c;
~. ' THE Pll0POSED WORt< iN THE.
~ISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, Il1is application musl be signed
and approved by the Historical
Coordinator prior to permH issunnce.
~ HSE_ _GAR ACC
~-----
~~-_.- . -=I-j
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(0)
PLUMBING PERMIT
ITEM
Fixtures
Resldenlial 00111(5)
N'
Snnllary S~wer
Waler
FJ:
----.--
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Pormit
State SurclHuoc
Total Cl1arge
(e)
MECHANICAL PERMIT
Furnnce
Exhnu5t Hood
Vent Fan
N'
Wood Stove/ [nsert/Flreplace 'Unit
DJIJI
- ~---
Mechanlcill Permit
IS5uance
Slate SllrcharOI)
Tot;)/ Permit
(D)
MISCELLANEOUS PERMITS
Mobile Homo
Stale Issuance
Stale Surchnrgc
SidcwOlll<
II
Curbcut
II
Demolition
Slate Surcharge
TOlol MIscellaneous Pcrmils (E)
TOTAL AMOUNT DUE (excluding eleclrical)
(A. O. C. D. ond E Combined)
FEE
_I')", C1 \J
( ~. O!J
-lflJ ~ -
APPROVED:
This permit in gran led on tl1e express condilion lhot the s<lld
construction :;hnll, in all respects, conform to the Ordinance
adopted. by the Cil\' 01 Springlield, including the
Development Code, regulOlting the construction and use or
buildings, and milY be suspended or rcvol<ed al any time
upon vio[iltion of i1ny provisions of snid ordinanccs.
Plan Check Fcc:
Date Pilid:
Receipt Number;
neceive(J By:
- -.."--... .--.-----.--
PI.1r'lS Reviewed lJy
Dote
Systcms Devclopment Charge is due on a[1 undeveloped
properties within the City limits whicll arc being Improved.
ADDITIONAL COMMENTS
(,
(
By ::>10nature, I ::;tote and ooree, thai I h<l:ve carefully examined
llle completed :Ippllc<llion 'and do hereby car!Hy th<lt n/l
Information Ilereon i:.; true al1el t:orrec!, and I further certify
thot ony and all worl< performed .:;hi:1l1 be done in accord<lnce
with the Ordinollcus or the Ci ly of Springfleld, <lnd !he Laws
of the Stf.lte or Oregon pertainIng \0 the worl( described
hervin, and 11101 NO OCCUPANCY will be rnaclc of any
structure without permission of 1I1e Buildlnu Sufely Division.
I furltlcr cerli fy \l"tal only contractors ond employees who
are in complianco'with ORS 701.055 will be used on thIs
project.
I further agree to cnGllfe Iho.l all required Inspections are
rcqueGtcd atlhc proper time, that each addre~~ Is rendn-ble
from lhe .:.lrcet, 1I1at tllC permIt card Is located at the front
of the proper! , . )d the .:lpproved 5et of plans will remain
::"::~:;" ~~ ~;f"Z: 'd
J-.~SUI9
Dole
VALIDATION:
RECEIPT NUM8EH rJ 3::2-7 ( 7
I - d-"6" - "l'"
<tr :::J- (p . ';1-0
~
DATE PAID
AMOUNT RECEIVr-.D
F1~CEIVED OY