HomeMy WebLinkAboutPermit Mechanical 1999-11-8
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: _/30
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ASSESSORS MAP:
LOT'
.
SPRINGFIELD
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2--2-
- ,
BLOCK:
OWNER:_'T:b."J~ UI'lIM(-S
ADDR~"'" ,3D P..... \ +~ \ I Co.
CITY:~\-I\fJ+'~UO
DESCRIBE WORK: ~~~ n-C.
NEW REMODEL ____ ADDITION ____
CONTRACTOR'S NAME
GENERA' -
STATE:
~
.
JOB NUMBER ~ 9/ 5 3,~.
225 Fi Ith Street
Springfield, Oregon 97477
TAX Lor:
t!:) 2-7t7V
SUBDIVISION'
PHONE:_]fl-'3S6~
l4-~+ fv..M.p
DEMOLISH _______ OTHER ________
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ZIP: tar'] llJ__
Wc:..~-c.. ..-
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES _~ PHONE
PLUMBING'
MECHANICAL: A6"""'G'\d~ JJ.eo..~~~~)..
ELECTRICA' .
QUAD AREA-
. OF BLDGS: ____
OCCY GROUP:
. OF STORIES:
WATER HEATER:
- OFFICE USE -
.'
LAND USE:
. OF UNITS: _
CONSTR. TYPE: ____
c;.~_-cLaw,
....
-'8'3~~
HEAT SOURCE:
RANGE: ___._
FLOOD PLAIN'
ZONING CODE: _____
II OF oonMS:
SECONOARY HEAT:
SQUARE FOOTAGE:
To request an Inspectlqn, 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 mado
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prlor'to concrete
placemont.
o
Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
.Insulatlon or decking..
D Flo~r Ins~latlon - Prior to
decking.
D Sanitary Sewer - Prior to fllllng
trench.
o Storm Sewor - Prior to filling
trench. . .
D Water Line - Prior to filling
trench.
, .
D
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough MechanIcal - Prior to
cover.
D Rough Electrlcal - Prior to
cover.
D Electrical Servlco - Must be
approved to obtain permanent
olectrlcal power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to c~ver.
D Wail/Ceiling Insulation - Prior to
cove~ _
D Drywall - Prior to taping.,
D Wood Stovo - After Installation.
D Insert - After fireplace approvesl
and Installation 01 unit.
, .0 Curbcut & Approach - After
..I' ". forms arc erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Fence - When completed.
D Street Trees - When all required
troos are planted. '
D Final Plumbing - When all
plumbing worl< Is complete.
- .
F;:2f Final Electrical - When all
~electrlcal work Is complete.
~ Final Mechonlcal - When all
4=J mochanlcal work Is complete.
D Final BUilding - When all
required Inspections have been
approved and buildIng is
completed.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Sel-Up - Wilen 011
blocking Is complete.
D Plumbing Connccllons - When
home 11a5 been connecled 10
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
venting havo boon Installod.
I"
lot faces
Lot TYP.
Interior
Lot sq. ftg.
Lot coverage
Corner
Topography
I'anhandlo
Total height
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT. X $/50. Fl
Main
'-l':"
'.
Garage
Carport
.-
Tolal Value
Building Permit Fee
Slate Surcharge
Tolal Fcc
(A)
Setbacks
P.L. I HSE ' GAR' ACC I
~__.. I
~~
. ':l
.!-,
~-i-,.
~_L
VALUE
"
. ".':: .:'~'
;1 .
a THE PROPO~ED WORK iN THE.
'''HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
II yes, lhls application must be signed
allll upprovell by the Hlstorlcul
CoordlniJtor prior to permit Issuance,
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This porndlls granted on tho ox pross condition tIuH tho 8ald
constructlon Shal.l,'ln,alt respects, cqnform tq, the Ordinance
adopted by the City' of Springfield. including the
Dcvelopment.Coae,-regulating the construction and use of
oulldlngs, and may be suspended or revoked at any time
upon violaOon of any provisions 'of ,said 'ord~narices,
Plan Check Fee'
'.
..
. ,
Dale Paid:
Receipt Number'
Received By:
Plans Reviewed By
Dale
l?YS:rEMS .DEVI;U?PMENT CHARGE (S.oq
. ..... , ~~ .' .", .-.. . ! j j, '0", ": .':! ''o...... '.:
,. . . (B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Pormlt
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace /fr!:?'Ir ~~
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
lor -r .~ r
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C. 0, and E Combined)
FEE
~/"J,
) t.; d-(J
/(')&0
/ :>'0
2&, SV
Zf>.t>v
Syst.ems .o.~'velopmcnt Char,ge Is du!} 9n all undeveloped
pr6'pe"it~e~ within 'the City limits ~tiicti a're being improved.
ADDITIONAL COMMENTS
__.)~AA'~~ r..l~1"
/f~~R''9I
By signature, I state and agree, that I have carefully examined
the compleled 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.
I further agreo to ensuro 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 pro~:tt~d the approved set of plans wtll remain
~ >< on the Sit")' _times dM COt ,stf'(Ctio: p
Slgnatura - /}.v ) ~~~
Daa- 015 -qq -
I
VALIDATION:
RECEIPT NUMBER 1'" I 2..3
DATE PAID J / / ~/'l5
AMOUNT RECEIVED (~7 .~
RECEIVED BY __._ ~~
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