HomeMy WebLinkAboutPermit Plumbing 1991-11-26
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ADDRESS: :2 (;0 SM...J'ii. 6/ s-T
CITY:~f/u7~~!J
30)
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
,ASSESSORS MAP:
LOT:
/702.
OWNE.R:
g/J
DESCRIBE WORK:
NEW X
REMODEL
CONTRACTOR'S NAME
GENERAL:
~a.Jd;;2.5r.?
---
-
" PLUMBING;
MECHANICAl'
ELECTRICAL:
"
SPRINGFIELD
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9//3 ~ 7
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LO'!:
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3~ 33
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SUBDIVISION:
PHONE:
ZIP:
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BLOCK:
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ADDRESS,
CONST.
CONTRACTOR #
PHONE
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover,
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D
Fireplace - Prior to facing
materials and framing Insp,
STATE:
ADDITION
DEMOLISH
OTHER
EXPIRES
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
# OF BLDGS' # OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR. TYPE: # OF BDRMS:
#OF STORIES' HEAT SOURCE: SECO'NDARY HEAT:
WATER HEATER: RANGE: 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. '
D Foundation - After forms are
, erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Underfloor Plumbing/ Mechanical
- Prior to insulation or decking.
D
Post and Beam - Prior to floor
insulation or decking.
D Floor Insulation - Prior to
decking. ,
. ~II Sanitary Sewer - Prior to filling
~ trench.
D Storm Sewer - Prior to filling
trench.
/ D Water Lin~ - Prior to filling
trench.
D Rough Plumbing - Prior to
cove~ .
D
Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After installation.
D Insert - After fireplace approval
and installation of unit.
D
Curbcut & 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 completed.
o Street Trees - When all required
trees are planted.
D
Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrical work is complete.
D
Final ~echanjcaJ - When all
mechanical work is complete.
D
Final Building - When all
required inspections have be,en
approved and building is
completed.
D
Other
MOBILE HOME INSPECTIONS
D 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, ski rti ng, decks, and
venting have been installed.
;~ :::
Lot faces Lot Type ~,:~ Setbacks ~ THE PROPOSED WORK IN THE
Lot sq. ftg. Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height _ Cul-de-sac IE I
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
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 construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Garage
Carport
Plan Check Fee:
Date Paid:
Total Value
Receipt Number'
Building Permit Fee
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) ~A
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fi xtu res
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
? ~, t'
FT. ;;::> (,./
zq<(JO
Mobile Home
Plumbing Permit
Total Charge
(C)
J:2-S
f
2~ < 2..5"
State Surcharge
MECHANICAL PERMIT
Furnace
Vent Fan
NO
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 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.
Exhaust Hood
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Su rcharge
Total Permit
(D)
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 set of plans will remain
on the site at all times during construction.
Signature ~~/I/ a~
, V
Date //- ~6 -- 7/
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
VALIDATION:
RECEIVED BY
3190
//-2& -if
2~/2...S"
~~
RECEIPT NUMBER
Total Miscellaneous Permits (E) .
DATE PAID
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
2 - 2A
_J/J .
AMOUNT RECEIVED