HomeMy WebLinkAboutPermit Mechanical 1999-6-10
.
.
SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
.1.,.. ,
qq&>~/
JOB NUMBER
Inspections: 726.3769
Office: 726.3759
225 Fifth Street
Sprlnglleld, Oregon 97477
~oJ\\~r~nrl
TAX LOT:
() R q.J.:j n
.e::J~,":~
ASSESSORS MAP:
LOT'
BLOCK:
SUBDIVISION'
OWNER' Cj.LlrI U A K~ AS
, I~ .\)~~
ADDRESS: .I.! J..4 . "IJ)O^, ,
CITY: "'-.Jpfl'l'l1bll'grf
f);),,<O-I.;{,~J.,
PHON'"
()p...
9'747)
STAT'"
ZIP:
/-lIp <I AJJ..I
I r .
DESCRIBE WORK: .::r:n,,,>T'{-l I j l'rhGn r. j
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
CONST,
CONTRACTOR'
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL: A:Dor I Atfrt Hon nno.. A \~
,
ADDRESS
EXPIRES
PHONE
<"'
f'.o , P.xJx '1/;),
Fur Oil- 91<L<J 0
~ \\J~.;z.75 8.31..:touO
(5'1 J) 10 ,n - ..2";'i.Q
ELECTRICAl'
- OFFICE USE -
QUAD ARE'" LAND USE: _,_ FLOOD PLAIN'
. OF BLDGS' . OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: _ SQUARE FOOTAGE:
TO' requtlst an ln~p(:ctlon. YOu must call 726-3769. This Ie n 24 hour rccord!ng. AI! Ins:Ject!ons,reql'est~d b~fnre 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
D Temporary Electric
D Rough Mechanical - Prior to
cover.
o FInal Plumbing - When all
plumbing w9rl< Is camplet.e.
D Site Inspoctlon - To be mado
after excavation, but prior to
setting forms.
o Rough Electrical - Prior to
cover.
o Final Electrical - When all
electrical work Is complete.
D
Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
0' Final MechanIcal - When all
mechanical work Is complete,
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Footing - After trenches are
excavated.
D Final Building - When all
required Inspections have been
approved and building is
completed.
o Fireplace - Prior to facing
materials and framing Insp.
D
Masonry - Steel location, bond
beams, grouting,
D Framing - Prior to cover.
OOthsr
o Foundation - After forms are
erected but prior to concrete
placement.
D Wail/Ceiling Insulation - 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.
o Wood Stovo - After Installation.
D Blocking and Set.Up - When all
blocking is complete.
D Post and Beam - Prior to tloor
Insulation or decking.
o Insert - After fireplace approval
and Installation of unit.
D Floor Insulation - Prior to
decking,
D Plumbing Connections - When
home has been connected to
water and sewer.
D Curbcut & Approach - After
forms are emcted but prior to
placement of concrete.
D Sanitary Sewer - Prior to flJllng
trench.
D Electrical Connection - When
blocking, set.up. and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Sidewalk &: Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Storm Sewer - Prior to filling
trench.
D Fence - vVhen completed.
D Water Line - Prior to filling
trench. .
D Final - After all required
InspectIons are approved and
porches, skirting, decks, and
venting have been Installed.
D Rough Plumbing - Prior to
cover.
o Street Trees - When all required
trees are planted.
Lot faces
L~t ~yp.
Lot sq. ltg,
Lot coverage
Topography
Total height
Interior
Corner
Panhandle'
Cul-de-sac
BUILDING PERMIT';
"
"
'{
ITEM
SQ, FT,
X $/SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fcc
(A)
:.: . };, L.~ ~'.~ ~
. /,.1 "
., THE PROPOSED WORK iN THE,
HISTOI;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance,
Setbacks
I 1 I I .1
P.L. HSE GAR ACC
1!.._ _..
S
IN
----
E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT,
FT,
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
~
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (eXCluding electrical)
(A. B, C, D, and E Combined)
FEE
/~..,
. ..-
/Io'?
:Z'~
. V'
,;l.l. ,.l.O
, APPROVE['\'
, ", " '!. .
BUILDING VALOE, PLAN CHECK
AND BUILDING PERMIT
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
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordInances.
Plan Check Fee:
Date Paid:
Recel pt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within tile City Ii mils 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 he approved set of plans will remain
on the site at a I .es dUrlngl\s]1rn~
Signature ,-...6' ~ 1_ ) /~ ~
Date ;;:C-/()~qq
VALIDATION:
RECEIPT NUMBER ~~3~/
..c -/LJ 4.-,
AMOUNT RECEIVED ""2.f=C 2&:>
RECEIVED BY / ~~ ~
. i' <'
DATE PAID