HomeMy WebLinkAboutPermit Mechanical 1999-6-4
RESIDENTIAL
PERMIT APPLICATION
Ins pee lions: 726.3769
Office: 726.3759
LOCATION OF PROPOS!~C)..RJf. J 9~4f
ASSESSORS MAP: rD'(ltrJ..J
LOT'
OWNER'
ADORES""
CITY'
.?I m:1,,-- hi.; ......0
9t..1! ~,;'bDLV
Spr"rc -h-W.
~
e
SPRINGFIELD
\
;(,; I /7a,u)
...2),..11'''-< J
BLOCK:
:Dr, I/<..J
STAT'"
r::>~
DESCRIBE WORK'
Z-h~~11 >>~
:?:-...... ,;?
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERA' .
PLUMBING'
MECHANICA' ./h--""1' 4""#'),,,:;<
ELECTRICA' .
DEMOLISH
OTHER
..
1967? C(
JOB NUMBER
225 Filth Street
Springfield, Oregon 97477
_ TAX LOT:
12() c)
SUBDIVISION'
PHON'"
7;z& - ;L"NLf
ZIP' "T?v77
ADDRESS
CONST,
CONTRACTOR'
EXPIRES .,-:,< PHONE
7 t1C t?!;c....-
'fjClI~';
&/1'
?'I~-/fJf
. - OFFICE USE -
'. eqlllres YOI)\v
QUAD AREA' \ . LAND USE: _~~()N:orE:900 lawnr "'''''OD,I1)bWI~V
TICi<:. '" 1_, dbyt 6=-~ rtr
. OF BLDGS: NO r;;. oAFLJ"""1I!'lpll 10110'11 !lIles. ad??:eTnose rilS'~I~a_~~~o;:..-
THISPERMIl ::it1Au.EXPIRE:"lrtrl<'V"'" Notilicatlonv""'-" 1I nOAI-'I\:l"Z:-V-
OCCY GROUP: .. JI'eERTHIS~\irFlSN@I:me.\:lc"::".n01-00'Otnro '~~Clli !3I!lRMS5 by
AUt HUt1ILI:U , \ . - may obtalO COpl 'I p\1one
. OF STORIES: '-11 """-Il'EDORISABAND~CE: jl090. 'lOll -t~r. {NotesE>S6<NWA8Yti!:l,EAT:
"'V" .11:1"'1 calliog "'''' v_".- Utility NO'll""" '
WATER HEATER:M1Y 1!lO D/lV PI=RIQD. RANGE: _ ._........Inr tM Oregooo 3""OITAR-El.FOOTAGE: _.
, ..J.;~~n'eriS '-80 . 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 forms.
D Underslab Plumblng/Eleclrlcall
MechanIcal - Prior to cover.
D Fooling - Aller trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior 10 concrete
placemont.
D Underground Plumbing - Prior
10 filling trench.
D Underlloor PlumblnglMechanlcal
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Pflo~ to filling
trench. .
D Water Line - Prior to filling
trench.
-
D Rough Plumbing - Prlo.r to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - PrIor to D FInal Plumbing - When nil
cover. ~mblng wc;>rl( Is complet.c.
D Rough Electrical - Prior to D nol Electrical - When all
cover. loctrlcal work.ls complete.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp. ,
D Framing - Prior to cover: .
D Wall/C'alllng Insulation - Prior to
cover.
'-.
o Drywall - Prior to taping.
D Wood Stove - After Installntlon.
o Insert - After fireplace approv~1
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sldewall< & Driveway - After
excavation is complete. (OllllS
and sub.base ma!erlal In place.
., D Fence - \Vhen completed.
D Strool Trees - When all required
trees are planted.
D Final Mechanical - When all
~Chanlcal work Is complete.
FI al BUilding - When all
o r. qulred InspectIons h.ave bocn
approved and building Is
completed. '.' . .
DO'her
MOBILE HOME INSPECTIONS
o Blocking and Sel-lIp - When all
blocking Is complete.
o PlumbIng Connecllons - When
home has been connected to
water and sewer.
o Eleclrlcol Connecllon - When
blocking, set.up, and plumbing
inspcclions have been approved
and the home Is connected to
the service panel.
D Flnnl - After all required
inspections are approved and
porches, skirting, decks, and
venting have been Installed,
Lot faces Lot TYP:Jt Setbacks ~ THE PROPOSED WORK IN THE _
Lot sq. flg. _lnt r I PL. IHSEIGARIACCI tSTORICAL DISTRICT, OR ON
I I THE HISTORICAL REGISTER?
Lot coverage Corner N II yes, this application must be signed
.. S I and approved by the Historical
Topography Panhandle I --= =-j Coordinator prIor to permit Issuance.
Total height Cul-de.sac ~~L
APPROVED'
BUILDING PERMIT
ITEM sa. FT.
X t/sa. FT, - VALUE
Maln
Garage
"
Carport
Tolal Value
Building Permit Fee
Stale Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permll
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Slove/lnsert/Flreplace Unit
Dryer Vent
/kJ-fJwwtJ
,
Mechanical Permit
1-
It;. 0 0
10 -/N
4" 7 J
2? 20
Issuance
State Surcharge
Total Permll
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
fl
Curbcut
Demollllon
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (e~cludlng eleclrlcal)
(A, B, C, 0, and E Combined)
,.....~ "!,.,,,-, ,,-~....
. f. " ,/ '
BUILDING VALOE, PLAN CHECK
AND BUILDING PERMIT
ThIs permit is granted on the express condition that the said
constructlon shall, In all respects, conform to the Ordinance
adopted by the Cily of Sprlngfleld, 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:
Dale Paid:
Receipt Number'
Received By:
Plans Reviewed By
Dale
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
/1
at:n~
~"(~
I
L
I
By signature, I stato and agree, that I have carefully examined
the completed application and do hereby certHy that all
InformatIon hereon Is true and correct, and I further cerllty
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield. and the Laws
of the Slate of Oregon perlalnlng to tho work described
herein, and thai NO OCCUPANCY wllf be made of any
structure wllhout permission of the Building Safely Division.
I further certify that only contractors and employees who
arc In compliance wllh ORS 701.055 will be used on this
prolect.
I furlher agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from tho street, that the permit card Is located at the front
of the property, and the approved s~t of plans will reinaln
on the site at all 11m _ rnmuctlon~
Signature d; / z. ~.)
Dale ~'b U
VALIDATION:
RECEIPT NUMBER () '3 If 31 r
DATE PAID ~/" 77
AMOUNT RECEI;ED ,I . ~
RECEIVED BY ~ II tJ #
". ".... ,'" - .... . .....,... -.._--.....,-.,.._...........-~,- .~...~_.......~ _.~# ~.#..-..... ............