HomeMy WebLinkAboutPermit Plumbing 1993-7-6 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK'
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ASSESSORS MAP'
LOT:
OWNER' Jeo680;e..D
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SPRINGFIELD
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CITY:
DESCRfBE WORi<'
NEW
REMODEL
. ADDITION
STATE: 101.
DEMOLISH y:
OTHER
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JOB NUMBER
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225 Fifth Street
Springfield, Oregon 97477
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TAX LOT:
SUBDIVIStON'
PHONE:
7 t/ h - ~ c,.' // /" ~t:,t:/...~)
ZIP: 9' 71"7 ?
GENERAL'
PLUMBING:
0- Afir
CONST,
ADDRESS CONTRACTOR'
Be~p.Lrr tiA/2~~~?'/.P~ 9.41
EXPIRES
){/..Y'/9~
PHONE
CONTRACTOR'S NAME
MECHANICA"
ELECTRICA! '
,
- 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: 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 foilowing work day.
o Temporary Electric
o
Site Inspection - To be made
after excavation, but prlar to
setting forms.
o Underslab Plumbing/Electricall
Mechanical - Prior to cover.
o Footing" - After trenches are
excavated, '
o
Masonry - Steel location, bond
beams, grouting.
o
Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench. .
o Underlloor Plumbing/Mechanical
_ Prior to insulation or decking.
o
Post and Beam - Prior to floor
insulation or decking. .
o
Floor Insulation - Prior to
decking. '
o Sanitary Sewer - Pri'or to filling
trench. ,
o Storm Sewer - Prior to filling
trench. '
O Water Line':"" Prior to filling
, trench,
o Rough Plumbing - Prior to
cover. "
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover,
o
Rough Electrical - Prlor to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prlor'to facing
materials and framIng Insp.
o
Framing - Prior to cover.
o WallfCeiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o
Insert - After fireplace approval
and installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
o Sidewalk & Driveway - After
excavntlo" Is complete, forms
ar:d sub-base materl.J.! in place.
o Fence - Wh~n completed.
o Streel Trees - V-':hen all required
tmes are p:anted. ,
o
Final Plumbing - When all
plumbing work Is complet.e.
o Final Electrical - When all
electrical work is complete,
o Final Mechanical - When all
mechanical work is complete.
~ Final Building - When all
~ required Inspecttons have been
approved and building is
completed.
.KlOther~;~ ~
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blockIng is complete.
o
Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o FinaJ - After all required
inspections are approved and
porches, skIrting, decks, and
venting have been Installed.
Lot faces
Lot sq, ltg,
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
SQ. FT
Main
Garage
Carport
"
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
.
Lot Type
Interior
Corner
Panhandle
Cui-dc-sac
X $/SQ, FT
(A)
,
i
i
~S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON ~ 0
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to pennit issuance.
Setbacks
'HSE GAR'ACCI
I PL,
IN
Is
W
E
VALUE
.:\i-.
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
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Plumbing Permit
State Surcharge
Total C~arge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
N'
FT,
FT,
FT
(C)
Dryer Vent
Wood Stove/Insert/Fireplace Unit
N'
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
lt
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
/G""'''
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;c;: 7 J
/9, //0
,90
I 7b :'0
~10~
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
l'
This permit is granted on ttle express condition that the said
construction stlall, ill all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, re~];...llaling 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:
Recelpt Number.
Received By:
Plans Revlewed By
Date
Systems Development Charge is due. on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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By signature, I state and agree, that I have carefully examined
the,completed application and do hereby certify that all
~nformation 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 permissioQ of the Buildlng Safety Division.
I further certify that only cornractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that ~Il required inspcclio,ns 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 a~proved set of plans will remain
on the site <t'tl tlmc~ d?)ng 0structi~/ /J _
)(signature ~ I' ~
Dale l/iRl'? y
VALIDATION: t:).., .,--,
RECE'PT NUMBER L1QV::;;
DATE PAin '\, ~ ' q ~,
AMOUNT RECE!Vsfl'-- 24 . ~S
RECEIVED SY ~\[)W
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