HomeMy WebLinkAboutPermit Mechanical 2001-8-14 (2)
OWNER' ~j?.Y"\ ~o.L'J
ADDR""'O'" €39-9 lli.utrltY
CITY: ~~O ol \J
DESCrK' 1~..a:buL ~
NEW REMODEL ADDITION
RESIDENTIAL
PERMIT APPLICATION
Inspecllons: 726.3769
Office: 726.3759
LOT'
.
SPRINGFIELD
.1,....,
BLOCK:
STATE:~
('-'"n-"\cl~
DEMOLISH
OTHER
.
0/-00"67'-{-<J(
JOB NUMBER
225 Filth Street
Springfield, Oregon 97477
(JOliN
SUBDIVISION'
PHONE: _
YJU-( J--f:::L+
ZIP' q "=1.~..rA
ADDRESS'
CON ST.
CONTRACTOR'
EXPIRES ',""' PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING: 1/l17lv>A Ln L ,. ,
MECHANIC~ur- -q1,Q)U~-1qCS / /)m #J)
ELECTRICA' .
%rJ
6J~
7 26~oloo
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS: . OF UNIT~' ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE:_ SQUARE' FOOTAGE:
To request an Inspection, you must catl 726.3769, This Is a 24 hour recording. Alllnspecllons requested be foro 7:00 a,m, will bo
made the same working day. Inspectlons requested after 7:00 a.m. ,,:,",111 be made the following work day.
D Temporary Electric
D Site Inspection - To be made
"atter excavation, but prior to
setting forms.
D Underslab Plumblng/Elactrlcall
Mechanical - Prior to cover.
o Footing - Alter trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting. .
D 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.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
o Waler Line - Prior 10 filling
trench.
o Rough Plumbing - Prior to
cover.
,
ough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
D Wall/C.elllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After It~sta"atlon.
o Insert - After fireplace approvel
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prIor to
placement of eoncrt!le.
D Sidewalk & Driveway - After
exe'avetlon Is complete, forms
and sub.base material In place.
o Fence - \Nhen cCiY'Ipleted.
D Street Trees - Wh~n all required
trees are planted.
D
Final Plumbing - When all
plumbing w~>rl( Is complet.c.
D Final Electrical - When all
electrical work Is complete.
~ Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is r
completed.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Sel.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, sklrllng, decks, and
venting havo been Installed.
,
Lot faces
Lot ~yp.
Lot sq, fig,
Interior
Lot coverage
Corner
Topography
Panhandle'
Total height
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT,
'(
"
X $/SO, FT. a
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
c~.
f'-f-! ';;';\
P.L. HSE
N
---..
S
w
, '
"'.IF .:~~.~'~f~'~i' -
.." ".(~, ~
.~ .~
.
IS THE PROPOSED WORK IN THE _
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
t . -.....
Setbacks
GAR Accl
-1
II yes, this application must be signed
and approved by the Historical
, Coordinator prior to permit Issuance.
~_..!.---..J-L___-:
APPROVED'
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
Tolal Charge
(C)
MECHANICAL PERMIT
Ie.
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
-,
State Surcharge
Total Permll
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
II
Curbcut
II
Demolition
Slate Surcharge
FEE
u~
( .1"-: A>
IV')
'/DV?
, 1-1~
(0\ '
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) iJ(=+Y
(A, B, C, 0, and E Combined) C
I '
7.
"
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
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 Developmenl Charge Is due on all undeveloped
properties within tho City limits which are being Improved,
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby carlHy 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 tho City or Sprlngflold, and the Laws
of the State of Oregon perlalnlng to tho work described
herein, and that NO OCCUPANCY will be made or 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 lo ensure that all required .Inspectlons are
requested at the proper time, that each address Is readable
from the street, that the pormlt card Is located at the front
of the prop y. and tho approved set or plans will remain
on the site a all times ring construction.
\
Signature "
Date
VALIDATION:
RECEIPT NUMBER bC(( ~
DATE PAI~ /t(j:) /
AMOUNT RE;Elvff,/7)
RECEIVED BY ,~
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