HomeMy WebLinkAboutPermit Mechanical 1999-2-22
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
LOCATION OF PROPOSED WORK' 'If' :3
/763 J'i/'f
ASSESSORS MAP'
LOr-
OWNER: clCvJcJl1 ~""'(Ccfl
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CITY:
BLOCK:
STATF'
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'19 () 2 'l'f'
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
tJ?ZoD
PHON~' 7'(7- 7R23
ZIP'
97/f '7 7
DESCRIBE WORK: d.o,"i.(f (:~:J,') D; I +~""",",-,.e ~ "- "\<<.r .(!.n-J {'~f/"t\~, {~'f;pr; vtr~f ~r.
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NEW REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME
GENERAl.
PLUMBING'
MECHANICA" Beyl'V'qr f{r<< I.''J
ELECTRICAl' R ,'~...< t=(r~j,..:<
QUAD AREA'
. OF BLDGS'
ADORESS
CONST.
CONTRACTOR'
EXPIRES -:c> PHONE
'300 (::<-f1r eJ(tv '<?~ I
O't'fR '?
11- (S-99
6~'i3~o'f
, -
- OFFICE USE -
LAND USE: _
# OF UNITS'
FLOOD PLAIN'
ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
NOTICE: 'Ia"" ."nulrss vou to
# OF STORIES: _ __,_ H.Et.T SOURCE: .,.....-ec.'TI()N.oregon "Ec;ONUAR'UtlMT:
THIS PERMIT SHALL EXPIRE IF I HE WUHK tll~W rules adopted by the oregon ',,,,..,
WATER HEATER: _ BA~.GE'.,..."- 0 Thosel!l.!;!6BBrrootA"'~:'
AUTHORlltU UNUtH THIS PtHMl1 I", I~VI Notification velll"r, -'1 ,,,'_,- "'^Q Q<;?.Q01-
"""'''''''w''''r;) "D 'co '\l~""""r:G C:!'\r:l ;0 ~R9)>f-UVI-vu 'v' ..-~~ """'rI,Joo hv
To requesl an Inspectlon/,you must-call 'p26-~76~ 'fhfs'IS a 24 ho r c~g\\'\ln.N'6MlllWtlO{lS':te(jUeSleo-lle10)'e 7:00 a.m. will be
made the same ~-?rkI2? MY: IpE.!'Ir5\'pns requested after 7:00 afIR c~II,\ri'8tf\'t\'i'M\Wr,f~~ti10~~y?ne
REQUIRED INSR~lilddGNS3 Oregon Utility Notification
, U r. "ter is H}QQ;332-2344).
D Rough Mechanical - PrJotE?to L.J Final Plumbing - When all
cover. plumbing w9rk Is complet.e.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab PlumbIng/Electrical/
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.
o Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
deckl "g.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
D Rough Electrical - Prior to
cover.
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 Wail/Ceiling Insula\lon - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvel
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.
D Fence - '-"fhen cOinpleted.
o Streel Trees - When all required
trees are planted.
~. Final Electrical - When all
electrical work.ls complete.
o Flna' Mechanical - When all
mechanical work 15 complete.
D Final BUilding - When all
required Inspections have been
approved and building Is
completed.
~ Other e::.Ifr /./..v~
PL 4/1:5 ~~
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 connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot ~yp.
Interior
Lot sq. ltg,
Lot coverage
Corner
Topography
Total height
"
Panhandle'
Cul.de-sac
BUILDING PERMIT!'
"
i.
't
ITEM
SO. FT.
X $/SO. FT. -
MaIn
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fec
(A)
I PL. '
IN
Is
W
----
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
(e)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
~ n--'
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Mlscellaneou6 Permits (E)
TOTAL AMOUNT D~E (excluding electrical)
(A, B, C, 0, and E qDmblned)
FEE
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I IS THE PROPOSED WORK tN THE,
""HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
.",:;.,,11'::.
Selbacks '
HSE GAR Accl
I
I
I
I
BUILDING VALOE, PLAN CHECK
AND BUILDING PERMIT
If yes, this application must be sIgned
and approved by the Historical
Coordinator prior to permit Issuance,
APPROVEP'
This permit is granted on the express condition that the saId
construction shall, In all respects, conform to the Ordinance
adopled 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:
Oate 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
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tEl tx.7.<-r.J7
/JIM. A-. r-
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By sIgnature, I state and agree, that I have ca.refully examined
the completed application and do hereby certify that all
Information hereon Is true and correct. and I further certify
thaI any and all work performed shall be done In accordance
with the Ordlnanc~s of the City of Springfield, and the Laws
of the Slate of Oregon pertaining to the work described
herein, and thaI 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 all times during construction.
Signature ~ /f .6
r
Datf> 2-2-2..-/.9
VALIDATION:
RECEIPT NUMBER ,,-; ~13 7,
DATE PAIr> ;J. / 2.:J-/f'i
AMOUNT RECEIVEd Zt. ~r1
RECEIVED BY tJ~
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