HomeMy WebLinkAboutPermit Plumbing 1997-9-8
RESIDENTIAL
PERMIT APPLICATION
.
SPRlNGFlELO
Jai: t@
LOCATION OF PROPOSED WORK' 9 33 A st.
ASSESSORS MAP' /?~ 3A3'.oO-Y'2
Inspeellons: 726.3769
Olliee: 726.3759
LOT'
OWNER: DAI<UJ ;,.., 1./) + ~
ADDRESS'-...:5"h Uo.- / () Jr 51-.
CITY: :5j.dfl d
BLOCK:
E'"' ijCYC;A' u:_oL L
STATE:~
.
JOB NUMBER
9?/3/8-
225 Fiflh Slreel
Sprlnglleld. Oregon 97477
TAX LOT- c:;I ~-;;.::s.:::>
SUBDIVISION:
PHONE:
7~ - /::lJt.
ZIP: 9?U n -?
. , . 1 ,
DESCRIBE WORK:~ ~ .-u....&.::. ," ;T ~- ~~_. ~ ~ . ~
I -,--l -' I"", ~c:.<.,.>~
NEW REMODEL ADDITION DEMOLISH K ~OTHER ::. -~. . _, _ ,," ___~
, ~ --'-~':I'l""......t'.1 \.,l'! '1(-'. "J
CONST. I '
CONTRACTO~S NAME, /", /- A~~~~~t'"""J-C?;';:~CTOR' EXPIRES -, PHONE
OENERAL:"7"'~~~/~) . ~ ~.. - ~~.-'{ ~~. ~~
PLUMBING'
MECHANICAl'
ELECTRICAl'
1
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN:
. OF BLDGS' . OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR, TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' SOUARE FOOTAGE:
TO reQuest an lnspcctlon, you.!!,~~caIl726.3769. This Is a_2~thouLmcorrllnc. .A.1I1nspectlcr':!:-;,oque5:od before: 7:00-a.rTl. will be
made 'the same working day. Inspeclions requested afler 7:00 a.m, wlll be made the folloWing work day,
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
seltlng (orms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o MO$onry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrele
placement.
D Underground Plumbing - Prior
to filling trench, ,
o Underlloor PlumbIng/Mechanical
_ Prior to Insulation or decking.
D Post and Boom - Prior to floor
Insulation or decking.
O Floor Insulation - PrIor to
decking,
[K] Sanitary Sewcr - Prior to filling
~r~""C/~$
D Storm Sewor - Prior 10 filling
trench.
U Waler Line - Prior to filling
trench.
D Rough Plumbing - Prior 10
eOl/er.
D Rough Mechanlcat - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical ServIce - Must "be
approved to obtain permanent
electrical power.
D FIreplace - Prior to facing
matcr'lals and framing Insp.
o Fr'amlng - Prior' to cover.
D Wall/C'clllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - Atter installation.
o Insert - After fireplace approvzal
and Installation of unit.
o
Curbcut & Approach - After
(orms are erected but prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation is complolc, forms
and sub~base material In place.
o Fence - When completed.
D Street Treos - When all required
trees are planted. '
D Final Plumbing - When all
plumbing w9rl< Is complet,e.
o Final Elec'rical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical worl< Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
GrI Olhor~~ ~IEAY.. 4L..
:P~"!? ~
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Conncctlo~s - When
home has been connected to
waler and sewer.
o
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
Inspectlons are approved and
porches, skirting, decks, and
venting have been Installed.
.
Lot faces
Lot Type
Lot sq. ftg.
InterIor
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de-sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Moin
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fcc'
(A)
f.':
.
I ( IS THE PROPOSED WORK IN THE.
'"."HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance:
Setbacks
I PL. HSE GAR ACC.
IN
Is
Iw
IE
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary sewe~ FT,
Water
FT,
Storm Sewer
FT,
Mobile Home
FEE
Plumbing Permit
State Surcharge
Total Charge
/5' ....,
~ ~~.i
-Lb ' 2.'::::>
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stoveflnsert/Flroplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
../$. .-
~S' . ,.'"
T3 .<<:-~
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
/9. sty
~~r
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condlllon that the said
constructIon shall, in. all respects, conform to the Ordinance
adopted by Ihe 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 tho City limits which are being Improved.
ADDITIONAL COMMENTS
By sIgnature, I gtatc and agree, that I have carofully examined
the completed application and do hereby certify that all
InformatIon horeon Is true anct correct, and l,further certify
that any and all work performed shall be done In accordance
with the Ordinances or Iho City of Springfield, and the Laws
of the St<lto of Oregon p.erlalnlng to tho work described
herein, and that NO OCCUPANCY wilt be made of any
structure without permission or the Building Safety Division.
I further certify that only contractors and employees who
arc In compliance with ORS 701.055 will be used on this
project.
I furthor agrce 10 ensure thai all required Inspoctlons 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 tho approved set of plans will remain
on the site all Imes during construction.
Signature
,
DateJ"'~ - '1:...,7
VALIDATION:
RECEIPT NUMBER ;?') -=3-::?~
~~"':>
AMOUNT RECEIVED ""3 $. ~ ~/
RECEIVED BY r;:;:/"'~-
/"'/ -
'"
DATE PAtD