HomeMy WebLinkAboutPermit Plumbing 1998-2-23
RESIDENTiAL
PERMIT APPLICATION
In~pecllons: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WO,ijt
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OWNER'
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ADORc~e:.
CITY:
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SPRINGFIELD
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JOB NUMBER
225 Fifth Street
Sprlnglleld, Oregon 97477
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DESCRIBE WORI<'
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NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING' Q,~~ Q......,,~
MECHANICAl'
ELECTRICA' .
ADDITION
DEMOLISH
OTHER
TAX LOT'
SUBDIVISION'
PHONE: _.:J.Q ~ - n l/3..!{
ZIP:
f'l,U'L01~
S~foll
f}enz-<~ ,.,,-E
ADDRESS
CONST.
CONTRACTOR #
EXPIRES '::'> PHONE
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
D' Framing - Prior to cover.
o WalllC'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - Atter Installation.
o Insert - After fireplace approv~1
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub-base mat~rla' In place.
o Fence - When cOi"'lpleted,
o Street Trees - When all required
trees are planted.
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- OFFICE USE -
QUAD AREA- LAN'~,.u~ FLOOD PLAIN'
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N OF BLDGS: # ~-#~" ~Ca' ZONING CODE:_
OCCY GROUP: CONS~T~~.s' q,-b-6'~ N OF BDRMS:
~&: ~ & r:?0'
N OF STORIES: HEAT SOUR !'(y.f: (y.$1a'7~0o. ....OSUI'1.. SECONDARY HEAT:
WATER HEATER: RANGE: '.$1)_ q,-I"l ~?I. v6'J'.... SQUARE FOOTAGE:
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To request an Inspection, you must call 726.3769. This Is a 24 hour rec~~3_. ~)n~ctlons requested before 7:00 8.m. wIll be
made the same working day, \nspectlons requested after 7:00 a.m. w~~(f~ following work day.
o Temporary ElectrIc ~:~~~::~h:~C:IPE~ ~I Plumbing - When all
cover. plumbing w9rK \5 complet.e.
D Site Inspection - To be made
after excavation, but prIor to
setting forms_
o Underslab PlumblnglElectrlcsl1
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting,
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
~nderl1Por Plumb~ Mechanical
~-pnOl to-InSU18llOn or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
dec g,
,--t-o
Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to tilling
trench.
o Water line - Prior to filling
trench.
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o Rough Plumbing ~ Prior to
cover.
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o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Flnsl Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete.
I
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspeclions have been approved
and the home is connected to
the servIce panel.
o Final - After all required
lnspe~tlons are approved and
porches, skirting, decks, and
venting have been Installed.
.......
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Lot faces
Lot SQ. ftg.
Lot coverage
Topography
Total height
, .'
BUILDING PERMIT!
ITEM SO. FT X
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fce
i~cil'-~YP.
..;.~:
Interior
I PL.'
Corner
N
Panhandle
S
~--,~
Cul-de-sac
'f
$/SO. FT
VALUE
'.
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
~dential Bath(S)
I Sanitary !i-~
--- ~.
N'
FT Get>
Water
FT,
Storm Sewer
FT
Mobile Home
Plumbing Permit
State Surcharge
Total Chargt?
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovel Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
FEE
..
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-- .~s THE" PRO?Of.ED ~OR\<. IN THE,'
, . HISTOI;lICAL DISTRICT, OR':ON- .
THE HISTORICAL REGISTER?
If yes, this application must be signed-.....
and approved by the HistorIcal
Coordinator prior to permit Issuance.
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HSE I GAi~
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APPROVED'
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BUILDING VAlIJE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thai the said
construction sha((,ln all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
ouildings, 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 undevelope~_ ~-
properties within tile City limits which are being improved.
ADDITIONAL COMMENTS
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(C)
MISCELLANEOUS PERMITS
(D)
Mobile Home
State Issuance
Stato Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
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Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
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By signature, I state and agree, that I have carefully eXamine?
the completed application and do hereby certify that all
Information hereon is true and correct, and I further c~'rti;y
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the La.ws
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 OAS 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 th>~ front
of the property, and the approved set of plaAs will remain
on. the site ~al~ times d~_nC'~~/~
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VALIDATION:
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DATE PAID ,;;(\5g<6D
AMOUNT RECEIVED --.it/i!. 2r; ~,
RECEIVED "BY . ;--~.-, .
---- . :,
RECEIPT NUMBER
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