HomeMy WebLinkAboutPermit Mechanical 1997-5-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Oltice: 726.3759
.
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SPRINCr:IELD
LOCATION OF PROPOSED WORI<: 1060
/ 70-'3:J;;' L(j
EVA B SE.RY
jo5b ~ UlNA. Li
S P R.. / r-.l {;;r:=- / G f.-I/J
ASSESSORS MAP'
LOT:
OWNER'
ADDRESS'
CITY:
DESCRIBE WORI<' / NS fA LL
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICA' .
ELECTRICAl'
(!.om -P-o t' +- t='"1o UJ
QUAD AREA-
. OF BLDGS:
OCCY GROUP'
. OF STORIES: ____
WATER HEATER:
BLOCK:
STATE:
DR
JOB NLJMOER
9 7tJ(// 7 /
I-f-E:I+ f
PumP
225 Fiflh Street
Sprlngllelcl, O"'gon 97477
TAX LOT:_{)O::5V
SUBDIVISION'
PHONE: _ '74'7- /Jc.2.3
ZIP:
Cf1(/ '17
ADDITION
DEMOLISH
OTHEIl
SYSTEIYl
ADDRESS
CON ST.
CONTRACTOR'
PHONE
D Rough ElcClricnl - Prior to
cover.
D Electrical ServIce - MuSI be
approved 10 oblnl" permanent
cleclrlco.l power.
D Fireplace - PrIor 10 tilclng
materials and ffilming Insp.
D
D
FramIng - PrIor to cover.
Wail/Ceiling InsulillJon - PrIor to
cover.
{Cj5/ J)DIIf S+.
EXPIIlES
Sk-b
S,*'d 911(77
OOl/&O
~1Jq'l 1 ~(rO/{)O
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF.: ___
FLOOD PLAIN:
ZONING CODE:__
" OF 8DRMS:
SECONDARY HEAT:_,
SQUARl, FOOTACE: .__._.
To request an Inspccllon. you must call 726.3769. Tills Is i1 24 hour recording. All Inspections requested berore 7:00 a.m. will be
made Ihe some working dny, Inspecllons requcstcd oftcr 7:00 a.m. will be mn(Je the following worl~ d.1Y,
D Tempornry Electric \ ~U~I~:~~':~C~IP~~:~~l~S D Final Plumbing _ Wl'en 011
~~cr. plumbing worl, is cOmplel,c..
D Site Inspection - To be made
after excavatIon, but prIor to
selling forllls.
D Underslnb Plumbing/Electricnl/
Mcchnnlcnl - Prior 10 cover.
D Footing - After trenches are
excavated.
D Masonry - Steel locntlon, bond
beams, groutlng.
D Foundnllon - After forms me
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
10 rllIlng (rench.
D
Undorfloor Plumblng/Mechnnical
- Prior to InsulatIon or decl~lng.
D
D
Post and Boam - Prior 10 floor
Insulation or decl<lng.
Floor Insulation - Prior to
decking.
O Sanitary Sewer - !"'rlor to filling
trench.
D Slorm Sowcr - Prior to tilling
trench.
D Water Line - Prior 10 filling
trench.
D Rough Plull1blno - Prior to
cover.
D Drywnll - Prior to t.1plng.
D Wood Stove - Afler Install.1l1on.
o Insert - After fireplace approval
and Installallon of unit.
D
Curbclll & Appro.lch - After
forms arc erocted but prior 10
plncement of concrete.
D Sidewalk & OriVCW:I,\' - Aflcr
excnvntion Is complete, fOlms
anel sub.bnSI] In.1!C,:r1.11 In place.
D
Fence - \-VIlen completed.
D
~Hroot Trco~ - When nil required
trees arc plan led.
D Finnl Eleclrlcnl - When all
~I ctricol worl~ Is complete.
, Fin.11 MeclulIlicnl - When nIl
. lTleCl1i.lnlcol worl~ 1:'1 cornplato,
D Finnl Ouilding - Whon all
required In~pcctlons havc been
approved and builcllng is
completed.
D Othor
MOBILE HOME INSPECTIONS
D Olockino nnd Set.Up - When all
blocl~ln~l Is complete.
o
Plumbing Connecllons - When
tlQlne hns been connected to
Wfllcr :1f1(1 sewer.
D Electrical COllnection - When
IJlocldllO. sel,un, nnd prllmblng
In~.;pcr.lion:; Il:lV(l been apprOVetl
fll1(J 1I1e hOll1o Is connocted 10
the service panel.
D
Fin..1 - Afler nil required
Inspections nre approved and
porches, sl(lrting, dccl(s, and
venting tHlve been Installed,
Lot facos
.
Lot Type
Lot sq. IIg.
Interior
Lot coverage
Corner
Topography
Tolal height
Panhandlo
Cul.de'$i\c
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT
Main
Garage
Carport
Tolal Value
Building Permi t Fcc
State Surcharge
Tolal Fcc
(A)
SctiJ;:!cl<:;
I P.L. I HSE I GAR ACC I
I
I
I
:~---I--J--'- ~
N
S
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
ResIdential BLlth($)
N'
Sanllnry S~wer
1"1:
Water
FT.
FT.
Storm Sewer
Mobile Horne
Plumbing Permll
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Slove/lnsert/Flrcpl3cc'Unil
Dryer Vent
__IA^~
Mechanical Perrnl t
Issuanco
Slalo SUrChargeT'b 70 A~l,,^,--
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stalo Surcharge
Sidewalk
II
Curbcut
II
Domolltlon
?tate Surcharge
Total Mlscollaneous Permits (E)
TDTAL AMOUNT DUE (excluding eleclrlcal)
(A, B, C, D, and E Combined)
FEE
l~L.a[L
~D~flD
,117
. '4';--
-2.1LW
il-JP-.4f)
.HE I'ROPOSED WORI< iN .ii-iE":----'
'..HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application musl be signed
;)nd approved by the Historical
Coordinator prior to permit issuance.
l
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conrorm to the OrdInance
adopled by Ihe Clly 01 Springlleld, including Ihe
Development Code, rcgula.ling the constructlon and use of
buildings, and may be suspended or revoked at any lime
upon violntion of any provisions or said ordinances.
Plan Check Fcc:
Dole Paid:
Receipt Number'
Received By:
--.. --.-----.--
Plans Reviewed By
Date
Systems Duvclopmenl Chmge Is due on all undovelop,?d
properties withIn the City limils whictl arc being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, tha.t I have cc:Hcfully examined
tho comploted applIcation and do hereby eartHy that all
In(ormallon hereor, 13 true ancl correct, and I further eertHy
that any and all work performed shall be done in accordance
Wlttl the Ordinances or the City of Springfield, and the Laws
of the Stille of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made or any
structure without permission of the Building Safety Division.
I further certify thai only contractors and employees' who
a.re In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure ttlal all required Inspections are
requested at the proper time, lhat each address Is readable
(rom the street, that the permit card Is located at the lronl
of the property. and the approved set of plans wlll remain
on Iho slto at all times during construction.
Signature 717 (l ~CJW
Dale ',5: d -q;
VALIDATION:
RECEIPT NUMBER tl..5S71
DATE PAID 5'~ 1. -1'7
AMOUNT RECEIVED .:1.& 2fT)
~-
.'
RECEIVED BY