HomeMy WebLinkAboutPermit Plumbing 1999-11-1
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WO~K3
ASSESSORS MAP: I 1 OJ-
LOT:
OWNER'
R (c1I\ r,rrd
CITY:
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl.
PLUMBING:
1Z<>~
~'-k;1L
MECHANICAL:
ELECTRICAL'
QUAD AREA"
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER'
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SPRINGFIELD
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BLOCK:
STATE:
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JOB NUMBER
q1/5/4
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT:
LILlO\[
SUBDIVISION:
PHONE:
74fo -'-fLiC
ZIP: '1"lL(7f(
ADDITION
DEMOLISH
OTHER ~W~ ~--fT ,Xii~
ADDRESS
CONST.
CONTRACTOR #
EXPIRES .,~ PHONE
~l
R l'y-c.;v- ~
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01/07-
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- OFFICE USE -
LAND USE: _
# OF UNITS:
CONSTR. TYPE:
..~ "
FLOOD PLAIN:
ZONING CODE:
~..# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
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 Plumbing/ Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated. .
D Masonry - Steel location, bond
beams, grouting.' '
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground pi4mblng - Prior
, to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam -. Prior to tlgor
Insulation or deoklng. '
.' ,
./
HEAT SOURCE:
RANGE:
REQUIRED INSPECTIONS
D Rough Mechanical ..:.. Prior to
cover. ." .
-. . ".'
D RoughEleclrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stovo - After Installation.
D Insert - After fireplace approv41
and Installation or unit.
o Floor Insulation - Prior to ..
decking. .' ~', . -~ \ 0 'Curbcut & Approach - Atter
forms are (lrtlcted but prior to
)?!sanitary Sewer..... Prior t; filling placement of concrete.
trench.
o Sidewall< & Driveway - After
D Storm Sewer"- Prior to mllng excavation Is' compiete, forms
trench. . '. and sub-base material In place.
C, '\ .,:~:' .~~~~: ~~
o Water L1n(e ~ ~rl~~ ~o filling
trench. .,', '", '. ' ';
d." ..'
o ~~~:~ piu~.~ln~: ,.~"~ Prior to
\ "' :...\
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D Fence - When completed.
D Street Trees - When. all required
trees are planted. " ",'
"
, .
,
'O'Final Plumbing - When all
plumbing W9rl< Is complete,
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work :s complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
D Other
MOBILE HOME INSPECfIONS
o Blocking and Set,Up - When all
blocking Is cOmJ)/ele.
o Plumbing Connections - When
home has been connected to
water ancJ 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
porchos, skirting, decks, and
venting have been Installed,
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
panhandle ~.
Cul-de'S~G . \
BUILDING PERMIT .t
t
ITEM
SO. FT.
X $/SO. FT.
Main
Garage
Carport
.' Total;Val,ue
.J. .'
l~ :--
I'~., - .
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT'CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
FT. ~
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
";2. ~tD -r / :2- D
(C)
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan .
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
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)
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I P.L.
IN
S
W'
E
VALUE
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FEE
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Setba'cks
HSE GAR ACC'
IS THE PROPOSED WORK i'NTHE .
"HIST08ICAL DISTRICT, OR ON
, THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING V)\U3E,PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express cO,ndition that the said
construction shall. In all respects; c.onform to the Ordinance
adopted' ,by the City of Spr!ngfl~,ld, Including the
Development Code, regulating the construction and use of
oulldlngs, and may be suspt:!nded or reyoked 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 ari work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon perlalnlng 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 time, that each address Is readable
from the street, that the permit card Is located at the front
of the property, and the approved s 0 plans will remain
on the site >fil'\:mes du'y-,con tm lion.
Signature ~L I'C __
Date 1/- (J -?CJ
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
)u,X; 7
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RECEIVED BY