HomeMy WebLinkAboutPermit Mechanical 1999-1-25
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
~.
LOCATION OF PROPOSED WORK: :)~;:)
17~~ 2-J }-]
ASSESSORS MAP:
LOT'
~""1" ,". ~.'.:~.
BLOCK:
---~-
JOB NUMBER!l_90j 1) 7
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
tJ 37/16
OWNER~Q.L~k' ~( ~)hv\-O DO-
ADDRESS~ l & ~ -::J UJ 2 1 J\
CITY: Sn, j\ t' n, ',~ -l~, ill d
'-----'~...L ",)1 \
DESCRIBE WORK, Cc,. Cw . J-t M ;t I ~/ (] iA. CfIDd; r! ,m.; n ~
NEW '>( REMODEL ' ADDITION 'DEMOLISH OTHER I
CONTRACTOR'S NAME
I'/(;f- ,1/, A)
]
/
/
/
GENERAl.
PLUMBING:
MECHANICAL:
ELECTRICAL:
QUAD AREA:
II OF BLDGS:
OCCY GROUP:
II OF STORIES:
WATER HEATER:
CONSr:, uireS you. '.'"'
, O{\l'ore~'NM,.f~ffi~gon Utlht)EXPIRES
A11EN I \ adopted by the les are set forth
to\lU~J ~.~IQ~ nter. ,\ I~~ rl' OAR ~62..0C~ -
l'1,:,titicatlo~ -u~, _ ~l)1 () thrOUg~ ~ \\='.'3 rilles bY
in OAR 950! ma\f obtain cOP'~the telepho~e
OO~v. :~')the center. \Net~ti\iW Not\ll~a\'on
r.alhng ...' a ()rAOOn -;:Wn
""nmberlOI lH ..:: 1_ROO-$~~-~ '
, I 'elll"" ,-
- OFFICE USE -
SJLQU '--'
ClUt, I
STATE' ' ~
ADDRESS
LAND USE:_
II OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
RANGE: __
/4 h ~;)S 7.:<'
ZIP: ~/lf 77
, JU A()( 0 fVV\
- 0 " . I
PHONE:
,~
PHONE
FLOOD PLAIN:
ZONING CODE:
II OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
lllf'l'''11'''^I''''.
i\1Vi IVIIom.
To request an Inspection, you must call 726-3769, This 1~i11i:-48~~U{lcgr9A~g, ~V~Mg~F.tlfr!f~ WeP~~ted before 7:00 a.m, will be
made the same working day, 'Inspections requested after tl:60 a.il1Y1WIII ip,e rha~ tlie following work day.
R'eiftl~sPEe1r.elNsllS PERMIT IS NOT
S ""m~M~!\Ir.FD n8 IS ABANDONr=n FOR
Ro h Mechanical ':- Prior to Final Plumbing - When all
o er. ANY?f1O [V\Y PERIOD. o plumbing w()rl< Is complete.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior. to
setting forms.
o Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated. ; "
o Masonry - Steel location, bond
beams, grouting.,
o Foundation' ~ After forms are
erected, but- prior to concrete
placement. '
o Underground Plumbing - Prior
to filling tre~~h. ,
o Underfloor Plumbing/Mechanical
-,Prior to insulation or decking.
o Rough Electrical ....,. Prior to
cover. '~, '.,
.... . -, ,.'
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Final Electrical....,. When all
electrical work is complete.
~I Fi-2 Mechanical - When all
~~~anical work Is complete,
o Final Building - When all
required Inspections have been
approved and building is
completed, .
o Framing - Prior to covE::!- CJ ~ . \ ')!.Lr' '~:';'~ ~ '.
. '" n 0 er &-;r J V..,LJV
, .f
o Wail/Ceiling Insulatlo'n' -::' Prior to
cover,
o Fireplace - Prior to facing
materials and framing Insp,
i'
. ~ *' 0, .t
D Drywall - Prior to t~rl.n~:;...;
o Wood Stovo - After I~stallatlon.
D Post and Beam - Prior to floor
Insulation or de'ckln'g. 0 l':'Isert - After fireplace approvlll
~ " ,,' i..\:: .' e " --I.' " ,I j. and Installation of unit.
O Floor'lnsulation - Prior to
decking. ,- " '. 0 Curbcut & Approach - After
;. ',.' forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench. '
D Storm Sewer - Prior to mllng
trench. ' " '.
I ~'
,,..;. "';'t"...... ...~
O Water Line - Prior to filling
trench. I, ", !
t ~
. "
O Rough Plumbl~p ~ 'Prior to
cover,' , :",
},
o Sidewalk & Driveway - After
excavation Is complete, foi'ms
and sub-base material In place.
o Fence - When cOi','pleted,
O ,Street Trees - When. '~I~'r~qulred
trees are planted. '....~, "
MOBILE HOME INSPECTIONS
o 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.
o Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been Installed.'
"
" '
Lot faces,
Lot Typ
Lot, sq, ftg.
'- . ;. ,
Interior
Lot coverage
Corner
Panhandle r
Topography
,
1:9.\;:l.1 height
Cul-de'sac
!:'
BUILDING' P~ER~IT
ITEM SO. FT.
.:t,: ':;!1' .:t
X $/SO, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A),
SYSTEMS DEVELOPMENT CHARGE (SDC) , '
Syste'1ls Development Charge is, due on all undeveloped
properties within the City limits which are being improved.
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
FT.
Water
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent J I
c,.,., f1v II c..
Mech~n';C~I\ pe/mi:t ,"
Issuance
State Surcharge
Total Permit,
(D)
MISCELLANEOUS PERMITS'
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Mlscella,neous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined) ,
;., ; ,Ii:' i,-", ,:, .,.'-,i ;:~;','\{~~?"
I P.L.
VALUE
"
FEE
~. () 0
/
I
;5;017
LD.Ov
'ft. 7;-
U.H)
,~'.I'
Setba'cks '
HSE GAR ACC'
~S THE PROPOS~D WORK iN THE.
-HISTO!=iICAL DiStRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
ane;! approved ,by the Historical
C.oord I nator prior: to permi t issuance.
N
S
w
E
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APPROVED:
_...,~ , . .r't-., . ;i~ .~.!'
BUILDING VALUE, 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:
Receipt Number:
Received By: '
i.,,- <
Plans Reviewed By
Date
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 ali 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 e'nsure 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
:~g::~"iI:\~}:~~
t~ ' U
Date { - &.'3 ..q 9
VALIDATION:
o 32 ~ 70
I / ~r I f'7
I .'
j/tJJ'
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY