HomeMy WebLinkAboutPermit Mechanical 1999-9-13
RESIDENTIAL "!J
PERMIT APPLICATIOJf""
~tij
LOCATION OF PROPOSED WORK' 8-5 b {l--o QJ:.'\", f\J-- Qd
ASSESSORS MAP: /Y"'>(j ~,,/IT;' ~
'Inspectlons: 726-3769
Office: 726-3759
LOT'
BLOCK:
OWNER' ('{ 1P () a <\J B c..~.R L. Lb .
ADDRE;~" :.:(S 11 ~ t. ,;::) \ ~ p\ v e...:(\ ve-
CITY' \JO( ;-\Ovnd
DESCRIBE WORK'
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' .
PLUMBING:
MECHANICAL' W"':VP,,-\ ii, S", r'\
ELECTRICA' .
QUAD AREA'
, OF BLDGS'
OCCY GROUP:
, OF STORIES'
WATER HEATEf"
JOB ","<e""i'iiR q9~~
225 Fifth Street
Springfield, Oregon 97477
~(\~~&\ C1l'ill,
TAX LOT' ;:;j2Y~
SUBDIVISION:
PHONF' \~S03 -?-3 ~ - 3"1'1 :l
r.o bD'i... ~d \<(; LP '
o {' .e !?P (') ZIP: q'l ';l ~ d-
STATF'
ADDITION
DEMOLISH
OTHER
EXPIRES ,-:'> PHONE
('fJ5 s-c.; 'K' rl-
FLOOD PLAIN:
ZONING CODE: _
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspectlon"you.must-call 726-3769. This Is a 24 hour recording, All Inspections requesled before 7:00 a,m, will be
made the same working day, Inspections requested alter 7:00 a,m, will be made Ihe following work day.
o Tempo,ary electric
o Site Inspection - To be mado
alter excavation, but prior to
setting forms.
o UnderaJab Plumblng/ElectrlclllI,
Mechanical - Prior to cover':
o Footing - Alter trenches are"
excavated. ,
o Masonry - Steel location, bond
beams, grouting. '
o FoundatIon - After forms are
erected but prior to concrete i'
placemel)L, " . , ','
o Underground Ptumblng - Prior
to filling trench.
- }O(";.$.,.t";J t~~; 1 0".
o Underlloor, Plumblng/Me~!ii>anlcel
- Prior tg 1?"Ulatlon or:decklng,
, I'
D Post and 'Beam - Prl~r'to floor'
insulation or decking.
D Floor Insu.!a!!on - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer,- Prior to filling
trench.
D Water Line - Prior to filling
trench. ,.
D Rough Plumbing - Prior to
cover. . .
ADDRESS
CONST,
CONTRACTOR,'
L\\{)~) \lrl~ (\ ~-\-ye;c..\-
1:
- OFFICE USE -
LAND US!"
, OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
REQUIRED INSPECTIONS
~ Rough Mechanical - Prior to
6~,1~
CQver.
,~v":';
0: Electrical Service - Must be
approved to obtain permanent
1 electrical power,
,
0' Flreplsce - Prior to facing
I materials and framing Insp.
D Framing - Prior to cover.
\
O'Wall/Celllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
i .. ~ :
o Wood slavD - After Installallon,
o Insert - Alter fireplace approvel
and Installation 01 unit,
O'Curbcut & Approach - After
forms are erected but prior to
I placemont of concrete.
o Sidewalk & Driveway - After
lexcavatlon Is compietc, forms
and sub.base material in place,
o Fence...,. When completed,
o 'Street Trees - When all required
trees are planted. .
D FInal Plumbing - When all
plumbing w9rk Is complel,e,
o Final Electrical - When all
electrical work,ls complete.
rvl Final Mechanical - When all
Y'-' meChanical work Is complete.
..
o Final BuildIng - When alf
required Inspections have been
approved and buHdlng is
completed.
~ Othe;i#L _~_
-~~~
MOBIL~ HOrylE INSPECTIO.NS
o Blocking and Sel.Up - When all
blocking Is complete.
D PlumbIng Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
snd the home Is connected to
the service panel.
o Final - Aller alf required
Inspections are approved and
porchos,' sklrtlng, decks, and
vent,lng hav,e been Installed.
'~
Lot faces
Lot sq. ltg.
Lot coverage
Corner
Panhandle \
Topography
Total height
Cul-de-sac
BUILDING PERMIT'~ ,fr "
ITEM Sa. FT. X S/SQ, FT. D
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
I P.L.
IN
Is
_V"!.__
E
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
~bM /.r;-:~
r'7' Go",... ~
7?~+O'
't-~~I .~
(0)' 2:;:' . ~~
PLUMBING PERMIT-
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S!'lwer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood StovellnsertlFlreplace Unit
Dryer Vent ~
~r/~~
/,1.. V" "J..~7~
Mechanical Permit
Issuance
State Surcharge
Total Permll,~;
.
,.
....
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
Slate SurCha'ge
Tolal Mlscellaneoua Permila , (E)
TOTAL AMOUNT DUE (excludIng electrical)
lA, B, Co 0, andE qomblnelll
FEE
\;','
i:
Setbacks
HSEIGAR ACC
I
IS THf"'" ;..,OSED WORK IN THE.
HISTO ,DISTRICT, OR ON
THE HIS RICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
_J APPROVEO:
BUILDING "ALOE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the salll
constru'ction shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Oevelopment 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 Roviewed By
Date
Systems Oevelopment Charge Is due on all undeveloped
properties within U10 City limits which are being Improved.
ADDITIONAL COMMENTS
By algnature, I stale and,agree, that I have carefully examined
the completed application and do hereby certify that all
InformaJlon 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 01 Springfield, and Ihe Laws
of the State 01 Oregon perlalnlng to tho work described
herein, and thai 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 agree to ensure that all required Inspections are
requested at the proper tlme,that each address Is readable
from the street, that the permlt'card Is located at the front
of the property, and the approved set of plans will remain
:~g:~~:7~
Date q, {3 - <1 q
VALIDATION:
RECEIPT NUMBER ? """"'7.:)"'-
DATE PAID ~ ~/ ;?, '7 ;
AMOUNT RECEI~' ~
RECEIVED BY, ". ;,. 5"'~
//1.-
-;