HomeMy WebLinkAboutPermit Mechanical 1999-10-14
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
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LOCATION OF PROPOSED WORK: /I'-/.s-
ASSESSORS MAP' / 1 0 3 J. 7 .5 5
LOT:
OWNER:
ADDRESS:
CITY'
VI r<. ~ll- f) (/N/ C-I~
/&200 N. /2t.p
, 'Pt-c'4zr.J~
DESCRIBE WORK: ~
//v<'~
NEW REMODEL
ADDITION
BLOCK:
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STATi='
~~ PVfV1p '1-
. './" DEMOLISH
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JOB NUMBER
"
/'jt~ 4}}.
225 Fi fth Street'
Springfield, Or~gon 97477
TAX LOT:
SUBDIVISION'
///00
PHONE'
991- 3~4~
ZIP: -.!Ll~ 3'1
OTHER
C6MPk~ D</C-r
~y t;./ ~ 1-1
, - OFFICE USE -
, ,
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 - Prior to cover.,
D Wall/C'elllng Insulatlon~,:~rlor to
cove~ '
D Drywall - Prior to t~Pln.~:
D Wood Stovo - After Installation.
D Insert - After fireplace approvlll
and Installation of unit.
. 'h
D Curbcut & Approach - After
" ' forms are erected but prior to
" placement of concrete.
CONTRACTOR'S NAME
GENERAL: ~1/yVIe-5
CONST.
ADDRESS CONTRACTOR #
l-k-:----fI77f'1/h J I > ~~ >:.f.
.~
PLUMBINf::'
MECHANICAL:
ELECTRICAL:
EXPIRES
PHONE
QUAD AR~'^TI~C~' " ' ": " " . LA~D U~E' ArTi.::1\J j I( "':', lrc.........n!aw r;ffih.00D PLAIN'
,,,~..o " . ~ v .1. ~""""'~lv,"",Y'ViJJ..v
# OF BLD~!C O&::CI\1I1T ~~AI L EXPIRE 'iFtafbWg~~s: 4 .f~!~?w rules adopted by ther6~iWe \:!&BE:
-. -. 0" I\hlT I~ NOT I;JUlIl!l;tHlfJH vemer. I hose rules are setforth
OCCY GRQ\(f;THOBlZED UNDER THIS PER."COI-TSTR. TYPI1f:l OAR qi:;~-nn1-0011) throug!1 @j-!\F~J}l~.:.l}:'I~0;-
# OF STOROOfV1MENCEDORISABANDONE8~PfsOURCE9og0:..vou may obtain copiefs'EBSRi6A!FW ~EAT:
6NV 180 DAY PERIOD. l,;i::U111 19 me cemer. (Note: the telephone
WATER HEATER: ' RANGE: __ n1lmtlArfnrth", n~Q"10q Ut'II'SnWh.'RIbJ;;If:){)TAGE:
-4',' I ..y'1loi\:hlll\.lc:tI.iUT' '
~t:!H:.yL'3~' ir- -; or~n I"')l"'\r: "'_r"\,/ ~\
. ~.... -.....". "J ,_
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting form~.
D Underslab Plumbing/ Electricall
Mechanical - Prior to cover.
D Footing - After 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 - Prlor,to floor
Insulation o~ decking. ,
D Floor Insulation - Prior 'to
decking.
o Sanitary Sewer -Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. ,
,. ;.~,
o Water Line - P~lor to filling
trench. '" ' "
D Rough Plumblng- ~Prlor to
cover. '
D Sldewall< & 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. .
o Final Plumbing - When all
. plumbing w9rl< Is complete.
Inal Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
, '
o Other
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.
D Final - After all required'
Inspections are approved and
porches, skirting, decks, and
venttng' have been Installed.
(
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle "
Cul-de'sac
BUILDING PERr9J1T 'j,
!! .
t
ITEM
SO. FT.
X $/so. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
';;0: ~;":!;it;\>
r'
I P.L.
IN
Is
Setbacks '
I I I I
HSE GAR ACC
I
w
E
VALUE
'.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(sr N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan'
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
JU
~IA A-. I?
I
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk It
Curbcut It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
jf",oo
/ 6- () Q
J. )1)
2.'- Sb
\, IS THE PROPOSED WORK iN THE,
"HISTORICAL DISTRICT, OR ON
, THE HISTORICAL REGISTER?
If yes, this applioatlon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED:
",':' '-' ....1-.
BUILDING VALtlE, 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: '
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMIYIENTS I
f E:l,. t:?. .., If; (J (/P",......
IZ~" I~, '
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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 all 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.
~.
VALIDATION:
RECEIPT NUMBER
(); ~~91
I~ /If.( 11'r
4-' S"'6/1
dtJJ
DATE PAID
AMOUNT RECEIVED
RECEIVED BY