HomeMy WebLinkAboutPermit Mechanical 1999-10-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK: 62,4
17 () 3 2. 3 ~y
ASSESSORS MAP:
LOT:
OWNER: liN; t/-I4-
ADDRESS:' I.: 2-1../
CITY: C:;.av
-)
BLOCK:
~<;; 0 II'""~ I / I
. '
~ L~u_,",~"'-e
STATF'
rYL
JOB NUMBER
i'j If.{ P- L
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
/ I S"o 0
PHONE:_7'1b-Q-, ~
. ,
ZIP:
DESCRIBEWORK:/;;'S~ "'\~ IL~ .t...J~r'hec..~"- c,~J .c../ve.()/~/NSe/7~
....J ___ ,
NEW
REMODEL
CONTRACTOR~S NAME
GENERAl'
,PLUMBINr..
ADDITION
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR #
EXPIRES ':~ PHONE
MECHANICAL:
ELECTRICAL:
~~
~ue
(../
p~Z('2IV~7Vc;2.. 7111./0 r
~Yr-70?
, - OFFICE USE -
11-7t;
QUAD ARE~OTICt:: . LAl"m'-USE: - ATTENTION:oregoi1laW~~@rl3s~.~~
# OF BLDG!r: ~SttALLEYPtREtF"f.tiC~: - u rtrl€-e.dot)tedby~~(Jt!>I:J~:lty
TH1SPERMlI urrl~"'nT TOlIUW '" Th 5e rules are set forth
OCCY GROll!;':. -- JUN,OE.!i+HtSPERlllQJNerl'r.-'fYPE: I\Intifir.a.tionCenter. 0 Ii OF.sgRMSf"\ 001-
, AUH1UMILt: . , QNs::nMR inOAR952-001-0010thro~gn~ O;;J..,...
# OF STORliiiSMD'ENC~OR'SABANO "M'E~"'~OURCE: ':"0 v., ~btain CO~t1.dU.I<Jtb"~ijUW@~Y
\iV!Vlllll .. UU~ ',' UU I.."", ~ . h telephone
WATER HE~1800AVPER'OD. RANGE: r.allil'1Q the center. (NO~e6.LlRE<-Ir:(()k);[fl6W:
' nllmhArforthe Oregon Utlll.Y,IWlIfluCl;
, ~entArl's 1-8UU-,j,j~-~~).
To request an Inspection, you must call 726-3769. This Is a24 hour recordrrtg. Ai nspeclions requested before 7;00 a.m. will be
made the same 'working day,lnspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
D Temporary Electric
D Site Inspection - To be made
after excavation, but pr;[.or to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
,excavated. ' '
o Masonry ~ Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior, to concrete
placement.
o Underground Plumbing - Prior
to filling trench."
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking. '
o Floor Insulation - Prior to
decking. . ,
o Sanitary Sewer - Prior to filling
trench. '
o Storm Sewer.:... Prior to filling
trench.
o Water Line - Prior to filling
'trench.'.
O Rough Plumbing.,.... Prior to
cove~ ' , "
! '
o Rough Mechanical - Prior to
cover.
o Rough',EII:lctrical -.,. Prior to
, cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Final Plumbing - When all
plumbing w9rl< Is complete.
o Final Electrical - When all
electrical work is complete.
(~MeCh.niC" - When .11
mec anlcal work is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
o Framing - Prior to cover. ~~' /' "
" 0 Ot er ~A 5
D Wall/Gelling Insulation - Prior to ' &."" y
cover.'
D Drywall- Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
D Curbcllt & Approach - After
. forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
, excavation is complete, forms
and 'sub-base' material In place.
D Fence -:- When cOinpleted.
o ,Street Trees - When all required
trees are planted. '
f2+
~vv.d
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
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 have been Installed.
(~
"
Lot faces
Lot Typb,/'
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
.,
Panhandle'
Cul-de'sac
BUILDING PER~Il~ 'ii,
....'
d
'({.
ITEM
SO. FT.
X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
'v~:.
'. '.:, .;~
"
, i; ~~~~?l~Y:;
IS THE.PROPO$ED'-'YORK iN THE .
"HIST08ICAL DISTRICT, OR ON
'THE HISTORICA~ REGISTER?
If yes, this application must be signed
and approved, by the Historical
Coordinator prior to permit Issuance.
Setbacks
I: P.L. HSE I GAR ACe' I
I.
N
S
w
E
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
Wood Stove/~e~rePlace Unit
'-'--
t:;;;.an~/-6<- / {1irP
Mechanical Permit'
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
/ S- . 0 ()
/b.Oo
,.5'0
I,
U,5o
" APPROVED:,
BUILDI.NG V AfaE, PlAN CHECK
AND BUILDING PERMiT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the constru,ction 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
\ '.,
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 ali 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 agree to ensure that all required Inspections are
requested at the proper,trme, 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 aJ~i/s during co::-tlon.
Signature --.1/ d.
Data --t!;~-J 1(9
VALIDATION:
RECEIPT NUMBER 03,60DD
Ie// 2~ /f7
I ., ru
AMOUNT RECEIVED 2..5 /1
d 1AJw-/
DATE PAID
RECEIVED BY