HomeMy WebLinkAboutPermit Plumbing 1992-4-30
'1
RESIDENTIAL
PERMIT APPLICATION
Inspections:, 726-3769
OUice: 726.3759
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LOCATION OF PROPOSED WORK: ~/J1 t'
ASSESSORS MAP: /7tJ ~:2.0 '3 4
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f3RA;?,!) v..} A Y
LOT:
BLOCK:
", ~ .:. I . ,j j;;.~-.;
OWNER: _S'J1~~
ADDRESS: '5 't 3 ()
V/1rv eovCf2
~t2!:;/tIH!61 J) I /\/~
C t,,~ I JI?.
CITY:
DESCRIBE WORK:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL:
PLUMBING: M l. ~o ""..../L-r
JOB NUMBER
920(;;~7
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
04~C7D
SUBDIVISION:
PHONE:
~() b - 6 f(',. 37' ~~
STATE:
W I1SIII',JS ro /1J
ZIP'
7-R t' 6 (
DEMOLISH
OTHER
,
b).."1iA. ~
ADDRESS
CONST.
CONTRACTOR /I
EXPIRES
PHONE
cl5o/vs ~L~~L~' 7/C,J..(1:)
, 1>. t),~tJ><' Z ~ lJCx~ (})<, 97~ I
<1 'j ?-"Y ~ J-
MECHANICAL:
ELECTRICAL:
QUAD AREA:
/I OF SLOGS:
OCCY GROUP:
/I OF STORIES:
WATER HEATER:
-- OFFICE USE -
LAND USE:
/I OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
~ - It/...
'13
FLOOD PLAIN:
, '
ZONING CODE:
/I OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an insr>ection, you must call 726.3769, This Is a 24 hour recording. All inspections requested before 7:00,a,m, will be
made nlC salTle working day, inspections requested after 7:00 a,m. will be made the following work day,
r ' I Tcmporary Elcc tric '
o
Sitc Inspection - To be made
after excavation, but prior to
setting forms,
o
Underslab Plumbing / ElectricalJ
Mechanical - Prior, to cover,
o
Footing - After trenches are
excavated,
o
Masonry - Steel location, 'bond,
beams, grouting.
o
Fo'undation - After forms are
erected but prior to' concrete
placement. .
o
Underground Plumbing - Prior
to filling trench.
r~
Underlloor Plumbing/ Mecllanical
- Prior to insulation or decl~ing.
o
Post and Beam - Prior to 11001'
insulation,or decl~ing.
o
Floor Insulation - Prior to
decking,
o
Sanitary Sewer - Prior to filling
trencll.
o
Storm Sewer - Prior to filling
trench,
/'
1><.1 Water Line - Prior to filling.
/ trench. ~(,..::'
o Rough Plumbing - Prior to
cover. '
REQUIRED INSPECTIONS
O Rough Mechapical -- Pri~,r to
cover, I':'
-"."
"
D Rough Electrical
cover, ;
Prior to
o Electrical Service - Must' be
approved to obtain permanent
electrical pow,er.
o
Fireplace - Prior to facing
materials and framing Insp,
o
Framing - Prior to cover,
o Wall/Ceiling Ipsulation - Prior to
, cove~ ;
I
o Drywall - Pribr to taping,
I I Wood Stove --!- Alte,r installation,
o Insert - Afte~ flrep'lace approval
and installation of unit.
o
, I
I I,
Curbcut & Approach - After
forms are erected b.ut prior'to
placement of ~oncrete.
,
o Sidewalk & D~iveway -; Alter
excavation is complete, forms
and sub,base ;mater,ial in place:
, I
o
Fence - When completed.
I
I
i j ,
, i!"
D Street'Trees ...;- When all requi red
trees are planted. ,
o
Final Plumbing - When all
plumbing worl~ is complete,
o Final Electrical -'- Wilen all
electrical worl~ is complete,
o
Final Mechanical - When all,
mechanical work is complete,
D Final Building -When all
required inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
,D Blockhlg .and Set. Up - Wlwn all
blocl~"lg IS complete,
o Plumbing Connections - Wilen
home has been connected to
water and sewer,
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - After all required
inspections are approved and
porches, skirting, decks, ane!
venting have been installed,
Lo~l faces "
h
Lot Type
Lot sq, ltg,
Inlerior,
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de-sac
".
BUILDING PERMIT
ITEM
SO. FT.
X $/SO, FT.
Main
Garage
Carport
Total Value
Building Permil Fee
Slate Surcharge
Total Fee
(A)
~
_S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR,ON
THE'HISTORICAL REGISTER?
If yes, tllis application must be signed
and. approved by the Historical
Coordinator prior to permit issuance.
Setbacks
PL' ' HSE I GAR' Ace I
N
.;,.,
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
NO
Sanitary Sewer
FT.
Water
/....... I
, FT. U?,r'/
Storm Sewer
FT:
Mobile Home
Plumbing Permit
State Surcharge
Total ChargE;
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lns~rtlFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
ft
Demolition
Slate Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
4cJ073
2,OD
//,? ,00
,
, ~2,CJO
A~PROVED:
BUILDING VALUE,' PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thallllc said
construciiori shall: in all respects, conrorin'to the Ordinance
adopted by the City of Springfield, including the
Development 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 Clleck 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 examin'ed
the completed 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 Safely Division.
I further certi fy 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 time, th'at each address is readable
from the street, that the pe'rmit card is located ai the front
of the property, and the approved set of plans will remain
on the site at all times during construction,
, XSignature ./~-&~~ -;7~~
/" / ' / - ~ ~
-Y' ~ --:5 C' -- ./ ~
Date
VALIDATION:
RECEIPT NUMBER cJ.)- iJ S
~/3t!)/'7 2-
AMOUNT RECEIVE~ (42 ~
RECEIVED BY ~~
DATE PAID