HomeMy WebLinkAboutPermit Plumbing 1994-7-19
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK' \ q 4f)
ASSESSORS MAP' \'l()~?ldV~ -
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LOT'
OWNER:
DESCRIBE WORK
NEW
REMODEL
ADDITION
CONTR~CT 'S NAME ~
GENER L: L~ {'\~ 'J..1
PLUMBINd., m" 1\tlA)
MECHANICAl'
ELECTRICA' .
QUAD AREA:6)~SlJ
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:
BLOCK'
STATE: .
.
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: n~~( Y)
SUBDIVISION:
PHONE: ~Y~Hn . ~\, \
ZIP: L\(\4'l~.J
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D Rough Mechan1cal ~ Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrlcal ServIce - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior, to cover.
D Wall/C'elllng 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.
I
D Sidewalk & Driveway - After
excavation Is complete, forms
and'sub-base materlal In place.
D Fen~e - When ~ompleted.
D ,Street Trees - When all required
trees are planted..
CON ST.
CONTRACTOR .
cn<;4\
frn4. \
EX~p Pl:lflNE
\\. ~.lr.Lft 12)0 11"1(11
1\ }h.q4 ~
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 war/king day, Inspections requested after 7:00 a.m. '"."'11/ be made the following work day.
REQUIRED INSPECTIONS
DEMOLISH
OTHER
D Temporary Electric
D Slto Inspection - To be made
after excavation, but prior to
settlng forms.
D Underslab Plumbing I Electrlcal/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated:
D Masonry - Steef 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. 1\ I\D
-- ~ary SewW~rlor to filling
~:~~~.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to I1IIIng
trench.
D Rough Plumbing - Prior to
cover.
ADDRESS'
- OFFICE USE -
LAND US".
. OF UNIT'"
CONSTR. TYPE:
HEAT SOURCE:
RANG'"
D FInal Plumbing - When all
plumbing W9rk Is complet.e.
o Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanIcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
D Blocking and Set-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
lnspectlons 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
L~t~ype.
Lot sq. fig.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de-sac
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.~STHEPROPOSED WORK IN THE,
"'HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
. ~ .." Setbacks .
I: P.L. HSE GAR ACC'
IN
Is
Iw
IE
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. - VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
San I t ary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
AS
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
Sidewalk
fI
fI
Curbcut
Demolition
State)ijWrlarge
JJ/n
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B. C. D. and E Combined)
FEE
\"5.OJ
-r :1~
({n .70
J'KW
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.S4.
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APPROVEP'
BUILDING VALUE, 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 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 Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
~~~~.~~,~~
the completed application and do :~e~~e~ertlfY 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.
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 h site a~lmes during construction. I .
Ignat r-J;r~,*~~~)
VALIDATION: