HomeMy WebLinkAboutPermit Mechanical 1999-2-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP:
17tJ'"
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LOT
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BLOCK:
OWNER: .AnTJL21t /YJ~~
ADDRESS:' '2/'t!i5 I<OSL B/OSs,(h-Y'I
CITY' .<; IJ Il /1...., a..J d
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STATF'
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JOB NUMBER
225 Fifth Streel
Springfield, Oregon 97477
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TAX LOT'
SUBDIVISION'
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PHONE:
7'-11
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ZIP:
97'177
DESCRIBE WORK: Z/1sf.c. (( N/.J..Ivrr:.) 6-11. '> LI1s.e Jl'f IY\ (> X ISh~ Mo..V/tl"''1 {;l'upfOrL
NEW
REMODEL
t
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAl'
ELECTRICAL'
~'ll<""
QUAD AREA'
. OF BLOGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER:
ADDITION
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR'
EXPIRES '"' PHONE
FLOOD PLAIN:
l:,~. ZONING CODE:
\\10 I Iv==:. 11L.&'~~B~t!fs!HE WO\"l~
TI1I::> t'th,v\\T SHA n "'UI~ P RMIT I::> NU I
"--"':OED UN('secoNI)A~Y HE!).T:
Au I hV' ,,~ DONED \'UH
,_. ",,"I('E.O ORs~O~~~ FOOTAGE:
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REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facIng
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
D Wood Slovo - After Installation.
~nsert - After fireplace approve!
~ and InstallatIon of unit.
o Curbcut & Approach - After
forms are cmcted but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
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To request an Inspection, you must call 726.3769. This Is a 24 hour ~ecordlng. All Inspections requested before 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.
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( 0'W'TtU"' ')
,
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electricall
Mechanical - Prior to cover.
D Fooling - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench,
D Underlloor Plumbing/MechanIcal
- Prior to Insulation or decking.
o Post and 8eam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Waler Line - Prior to filling
trench. ."
o Rough Plumbing - Prior to
cover.
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:_
o Final Plumbing - When all
plumbing w9rl< Is complet.e.
D Final Electrical - When all
electrical work.ls complete.
D Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
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MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blockIng Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o 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 ~ype.
Lot sq. fig.
Interior
Lot coverage
Corne r
Panhandle .,.
Topography
Total height
CuI-de-sac
BUILDING PERIVIIT1j
i, 't
ITEM
sa. FT.
X $/50. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
I PL.
N
---.,.
S
_V'!.__
E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal 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/Insert/Fireplace Unit
Dryer Vent
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Mechanical Permit /??/J()
Issuance
State Surcharge
/7 r-f ,-II
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
State Surcharge
FEE
/...,~o
J r;-O'D
J 0 .OD
J 2-0
~ ,2AJ
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) '7 {5.,,2-o
(A, B, C. 0, and E Combined)
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~S THE PROPOSED WORK tN THE,
. "'HISTORICAL DISTRICT, OR ON
THE HtSTORICAL REGISTER?
II yes. Ihls application must be signed
and approved by the Historical
Coordinator prior to permit Issuance,
Setbacks
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HSE GAR ACC
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I
I
I
APPROVED:
BUILDING "ALUE, 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 Ihe City of Springfield, Including the
Dovelopment 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
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By signature. I state and agree. that I have carefUlly examined
the completed appllcallon and do hereby cerllfy that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done in accordance
wllh the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and Ihat NO OCCUPANCY will be made of any
structure without permission of th~ BuildIng Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
prolect,
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 dU~lng constructlo
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Signav-, ~--;
Date 2//7/)"
VALIDATION:
RECEIPT NUMBER
DATE PAIr>
AMOUNT RECEIVEr>
RECEIVED BY _
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I '7~? 20
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