HomeMy WebLinkAboutPermit Mechanical 1999-4-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT'
.
SPRINGFIELD
.,.", ,
.
97d S7 d
/
BLOCK'
JOB NUMBER
225 FilII' Slrcel
Spllnglleld, OlCgon 97477
..
TAX LOT:
SUBOIVISION'
/ Yc'ol
OWNER' \'n \l\ci ' \=ffi f\~ \ i fI.:. ~ ....l PHONE:
ADOR~:~? ():2.,-~O-.\p:\a'r\\(J('l)u_
CITy:~pi~btlt'i ~ . J STATE: Ur-f'Orn
OESCRIBE WORK: l.n4n.li . ~n10.oi:. \Y'1e~(l6l..- I ,
NEW REMOOEL AOOITION DEMOLISH - OTH~R
i14L1 ,IQ LO
ZIP: al~ll
r\ir.
CONST,
CONTRACTOR'~ NAME I \J \ . ADi;>"l!i~S CONTRACTOR' EXPIRES~,
GENERAL: C \Cl.mP,~ 1({/(}t,(\~~7t'J\sloIJYI"VV'~ 4,3Ql.p 3/f?(02'
PLUMBING' ---J
MECHANICA' '
ELECTRICAl'
OUAO AREA'
. OF BLOGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
PHONE
41Ql2ID1
- OFFICE USE -
Al TEN nON:ulegon law reqUlfes you 10
LAND USE: f;:Jl!ow rllle&aOOpted by ttr~fflI~.Ililitl'
. OF UNITS: Notification Cente!. Those z'CJ~l\MeM~lP.nh
in OAR 952-001-0010 through' OAf! g5'~UU1-
CONSTR. TYPE: -ee9&.-Y"" ';"'y alltain copitlSloffililil!1MlS~ ~'
HEAT SOURCE: cal!inQ the cent~r. (Note~\M-\~6Rl\~~EAT:
numOer for the Oregon UtllTtY-Notlflcatlon
RANGE: -G"i",t:r:,,1-800-3~~.FOOTAGE:
.
To roquesl ar" Inspecllon, you must call 726.3769. This Is a 24 hour recording. All Inspections reauested before 7:00 a.m. will bo
made the same working day. Inspections requested after 7:00 a.m. will be made tho followIng work day.
D Temporary Electric
D Site Inspecllon - To be mado
after excavation, but prior to
seltlng forms.
D Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
D Footing - Arter trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
10 filling trench,
D Underfloor Plumbing/MechanIcal
- Prior to Insulallon or decking.
D Post and Beam - Prior to floor
Insula lion or decking.
D Floor Insulation - Prior to
decking.
D Sanllary Sewer - Prior to filling
Irench,
D Storm Sewer - Prior to (lllIng
trench.
D Waler Line - Prior 10 filling
trench.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - 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 - P~lor to cover.
D Wail/Ceiling Insulallon - Prior to
cover.
D Orywall - Prior 10 laplng,
D Wood Stovo - After Installation.
D Insert - After flreplace approval
and Installation 01 unit.
D Curbcut & Approach - After
forms are erected bul prior to
placement of concrete.
D Sidewalk & Orlvew31' - Arter
excavation Is complete, forms
and sub-base material In place.
D Fence - When completed.
D Streut Troos - Whun all required
trees are planted.
D Final Plumbing - When all
plumbing wc;)(I< Is complet,e.
D Final Electrical - WIlen 01/
~etec.1rlcal worl( Is complete.
)
n ~Jnal Mechanical - When all
- ",cchanlcal work Is complete.
D Final Building - Whcn all
required Inspections have boen
approved and building Is
completed.
DOlhor
..
.
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.
"
o Electrlca' Connection - When
blocking, set.up, and plumbing
Inspections have been npproved .
and the home Is connected to .
the service panel.
D Final - Aller all requilcd
Inspections arc apPl'Oved and
porches, skirting, decks, and
venting have been Installed.
lot (aces
.
Lol Type
...
.r.... :': .
Setbacks
~IGA;IACcl
Ji.____
S
~-~=iJ
Lot sQ. rtg,
Inlerlor
..
lot coverage
Corne r
Topography
Total height
Panhandle
Cui-do-sac
BUILDING PERMIT
ITEM 'SO. FT. X $/SO. FT. ~ VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fcc
Slate SUrcharge,
lOlal Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
~ ITEM
Fixtures
Resldenllal Bath(s) N'
Sanitary S~wer FT.
Water FT.
Storm Sewer FT.
MObile Home
Plumbing Permit
Stato Surcharge
Total Charge (C)
FEE
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
I OVnt
...... - f~-
~ Mechanical Permit
/ :J:cJo
/O,tJ~
lfrP/__
2%. z.c_
Issuance
Slato Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home ii-
State Issuance I
State Surcharge
Sidewalk II
Curbcul II
.. Demollllon
" Slale Surcharge
Tolal Miscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
IS THE PROPOS EO WORK iN THE.
. HISTORICAL OISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Ihls application must be signed
and approved by Ihe Historical
Coordlnalor prior 10 perrnll Issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perm/lis granted on Ihe express condillon Ihallho said
conslruction shall. In all respects, conform (0 Ole Ordinance
adopted by the City 01 Springfield, including the
Dovolopment Code, rogulallng the construcl/on and USe of
buildings, and may bo suspended or revokod at any time
upon viola lion 0' any provisions 0' said ordinances.
Plan Check Fee:
Oale Paid:
Receip( Number'
Received By:
Plans AcvlcwCClOy-'-------
Oalo
Systems Developmenf Charge Is duo on all undeveloped
properties within the City limits which are bQlng Improved.
ADDITIONAL COMMENTS
By signature, I olalo and agroo, thai I have carofully oxamlned
Ihe compleled Bppllcallon and do horeby cerllfy thai all
Information horeon 15 true and correct, and I further carlHy
that any and all work performed shall bo dona In accordance
with tho Ordlnancll9 of tho City of Sprlngflold, erld the Laws
of tho Stoto of Oregon pertaining to tho worl~ descrlbod
herein, and that NO OCCUPANCY will bo mado of any
structure wllhout permission 0' Ihe Building SafOly Division,
I further cerllfy thai only contractors and omployeos who
arc In compliance wllh OAS 701.055 will be used on this
project.
I further agreo 10 ensuro thai all required Inspections ara
reqUesled at the propor limo, that oach oddresB Is readable
'rom Iho streot, that tho parmll card Is locBtoct ,allha (ront
of tho property, and tho approved set of plans will remain
on the slte;%m , u g C::I:~.:lon.
Signature l/. -,Iff ---
Oato 1-/9 r
VALIDATION: )' 3
RECEIPT NUMBER I It? '5/ l
DATE PAID 1/1; q" Z-u /}
AMOUNT RECEIVED Y~J
RECEIVEO BY