HomeMy WebLinkAboutPermit Mechanical 1998-10-7
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,37S9
LOCATION OF PROPOSED WORK:
/76 ~L&}y
ASSESSORS MAP'
LOT-
.
SPRINGFIELD
1.1,,,
V-i..LL 0 .
BLOCK:
OWNER'
ADDRESS'
CITY:
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STATE:
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JOB NUMBER 1? I 26 b
225 Fifth Street
Springfield, Oregon 97477
~ P RIY1<?,P'e l,.j () l<- q 74.12
TAX LOT- tiLl '5 z...)..
SUBDIVISION:
PHONE:S4/.'7 .J. b- a(,,() I
ZIP:
97-<;7'7
DESCRIBE WORK: ..::tr\:'-\f\U(d...(~,...0..~ f\ Nou) 8.'(.l.. Hrn'lr\lpA <i 1-\!1Qr
NEW REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL: R<.,<.,n.c.ill \.~
Pu.m",
,-
ADDRESS
CONST.
CONTRACTOR .
EXPIRES ':':' PHONE
1--\Qr.lh(\~" RI(\,
'l-',c1, t30x '11.2. "
1'.uQ<1..l1L..Q~9"l<l<lO if 101,.1,<:; 1)'3h;l.OO()
I ~. ..:,v 1I0N'O
. Ol/ow,,,,^_ ' re90n 10....
.'101IfiCRti,.....-;, QuOPtSd h.'i"L 'o"lU1res "",.,
- OFFI~~1Ml1? 962_;Oc;:~eOr. Those~~/~regon Uti/it~
~O~ YoU 1 0 th~ s are set ~
QUAD ARE.e,: .' LAND USE: I'~II:,. may Obtain 0'#l.'o6fllll'gelN.onh
NnYIt.;\:' nu '..II'Beente eOP/esOft~ ~'vVJ.
. O,,""SUlGS: ' Oel,OF UNITS' mberfOrtlle 0/ (Note:;ml)lIN eC!#"li:h..
THIS PERMIT SHALL t:}\t'1111: Ir I HE W nl\~ C egon U ft,epho w-y--
OCCY GROUP.jr-rrrr' " II'il" ""'''''''IT IS N~f>NSTR. TYPE: enter is 1->80 tiUIf'>N<$f1ICM.Q~
AUTHORI""LI ul~lJl:n v,'l:nIYI 0..332'2344 ''''!.of!
. OCOm\Vb:uO~D FOR HEAT SOURCE: SECO~DARY HEAT:
WAT~tf.lT6J\1i'-P-ERl88., RANGF' SQUARE FOOTAGE:
ELECTRICAl'
5tJl./"b.
.:1.590
To feQUt;t~t an inspttctlon, you lIlusi <.:aii 726.3709. This is a 24 hour recording. Ail 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 mado
atter excavatlon, but prior to
setting forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footing - After 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
te 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
decKI ng.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to IIIl1ng
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 - Prior to cover.
D Wail/Ceiling InsulatIon - Prior to
cover.
o Drywall - Prior to ,taping,
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Drivew,ay - After
excavation Is complete, forms
and sub.base material In place,
D Fence - VVhen completed.
D Street Trees - Wh~n all required
trees are planted. .
D Final Plumbing - When all
plumbing w9rl< Is complet.c.
D Final Electrical - When all
electrical work Is complete.
B Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocKing Is complete,
D Plumbing Connoctlons - When
home has been connected to
water .3.nd sewer.
D Electrical Connection - When
blocking, set-up, and plumbing
Inspecllons 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 focco
~Ol IQ, fig,
Lot coverage
Topography
Total height
BUILDING PERMIT' ;.
ITEM
SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Lot ~pe.
Interior
Corner
Panhandle'
Cui-dc-sac
x $/SQ, FT.
(A)
.,' t~~ \<\~;
~s THE PROPOSED W~RK I~ THE! .
'--HISTORICA~ DISTRICT, OR ON
THE HISlORICA~ REGISTER?
If yes, fhls application must be signed
and approved by the Historical
Coordinator prior to permIt issuance.
Sotbaoks
..B.b... .t!Qa. _\i8fi, ACC I
N
Is
w
----
,E
.~
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanllary S~Yler
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
N'
FT.
FT,
FT,
(C)
Wood Stove/Insert/Fireplace Unit
N'
Drr;;;:} (JP,rr?
,
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
:
State Sur~harge
Total Miscellaneous Permits (E)
FEE
(<); 00
(O,dO
'K / 7r
l\, .;;l. (.".;LO
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
I
_J
'~, "
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
APPROVED:
This permit is granted on the express condition that the said
construction' shall, In all respects, conform to the OrdInance
adopted by trye 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 COMMENTS
lUt ~ ~ ~
~
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 perlalnlng 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 lurther 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 during construction.
Signature ~O m C:\--\O m lob
Date
lo-e:-.,-qx-
VALIDATION:
RECEIPT NUMBER
DATE PAIr>
AMOUNT RECEIVED
RECEIVED BY
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