HomeMy WebLinkAboutPermit Plumbing 1992-11-10
RESIDENTIAL
PERMIT APPLICATION
Inspections:, 726-3769
Office: 726,3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
LOT'
qo!
BLOCK'
OWNER'
ADDRESS:
CITY:
/(,n ~ p, 0 /l.o ^'t<' /'1 13 ""'-
/',0,/010 2-D
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OESCRIBE WORK:
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NEW
REMODEL
ADDITION
.
SPRINGFIELD
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STAT'"
oIL
,')Qtl~('~ ~. A?EC
DEMOLISH ~ OTHER
.'
JOB NUMBER
92/%2
\ .
"
,225 Filth Street
Springfield, Oregon 97477
~,.. S~/Lf~6-N,e~/7
(12/ (f()
TAX LOT:
-,
:~._~ ' .
SUBDiVISION-
", ~
PHON""
"1 "I' b - $] yO',
ZIP'
9'77'7 7
'I~. ..
CONST,
~OR#
CONTRACT~'S NAME 0,. n ~-::+-I-ADDRESS
GENERAL: l:\ f\)\ \k~'wu.~ }
PLUMBING: -_.__.tr-_.~.
MECHANICA' '
ELECTRICA' '
EXPIRES
\ \ llki-qo
PHONE
f:,
- 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' RANG'" 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.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior 10
settIng lorms.
o
Underslab Plumbing} Electrlcall
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
Underfloor Plumbing/Mechanical
_ Prior to Insulation or decking,
o
Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decktng, .
1=:1
Sanitary Sewer - Prior to fllllng
trench.
o
Storm Sewer - Prior to filling
trench.
\ ~
o Water. L1ne..- Prior to filling
, trench. -' ~ '."\ .
, ':
O Rough Plumbing - Prior to
cover, " . .
D Rough Mochanlcal - PrIor to
cover.
CI nough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framIng Insp.
o Framing - Prior to cover.
o Wall/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - After i~stallat'io~'. .,
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'
oxcavatlon Is complete, forms
and sub.base material In place.
o
Fence":" -When completed.
o FInal Plumbing - When all
plumbing work Is complet,e.
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When alt
mechanical work Is complete.
"J>5--'lat./n c7N
l8'Flnal BuildIng - When all
required Inspections have been
approved and building Is
completed.
~Other-..:J;:;..v~ CA;O
MOBILE HOME INSPECTIONS
.".....
....L. . h.
tJ BI~cklng:andSel'Up - When all
blockIng Is complete. .
. .
. .
'D..piumbl~g Connections - When
. home has' been connected to
, water and' sewer. ,
.. ' -, .;',
D ElectrIcal ccii1"nectlon - Wh'en
, "blocklng,'set:up,tarid plUmbing"
Inspectlons'tlave"been approved
..and,the.home'ls'connected to
, tlie service 'pa~el. . .
ej'''' '.~. ,-' ,
" ',' . .' ",' '.Flnal.'.- iittir,a,I,1 ~e<lulred ' -',
. ,. ..' " ::' '. . '" , ;~ . ...:~S:", . ,I,nJl'pec.t~oDs ,ar,!~apwoved ,and :' ':,1..,
o St~eet Trees - When all required ~..~.~-r,,,~:..:s'i'porches:skl~tlng. decks, and" "- '-
- trees are planted, . 'f:' i.,.,,' .:ven~~~g.~ha~e been Installed. ,;-.
_~' ~'r _,_. .....
LO! t.a9~e5'1 "t' ~l' ~,- ,L:.C?t Type.
'.fi~', ,t;.,. j ; 'i: ;'1'- t c" ~J '. '.
Lot\J~ti:'~ig/:'-, ~~;"';,:~h',!r-:"7i~ :~).'Ir1t~:r'i9?:,tr:~
~ ...~.;.,f :---' , ',., 'f . ;'.. .' I, ,-:...~->"*:."'~' ,.-
Lot ~'overage. _ ~ 4C~r;"er' ,
"/-~~~;'.~.' ~. :>.,.....,~;;!ifi..t::^,.'~.,.~,J ~:L '"~.~ .~,.;:);:
,T?pograpt'y. ',,/-'---",.;;.. '-,-- panhandle'
. .' . l~' .
,Total' height '::c:...........,
::':1 .>::-' ";<Cl,~.I:~:i:~ .h~tI.,,: <_~
Cul-de.sac'
,.
.',,' ,'.
....
'.;
':~', ..\'. _::"'" ,. -: .....'_-....~' .... ,,\.,<<"'''''' '4
BUILDING;J!ERMIT ' ,
, ,~. ._ , '._ r,' __ .' . , ,
-ITEM" '. SO;.FTi',:.x $/~Q, FT,
",'': '.'1 ",_.,_,"
Main
. '
......i
Garage
"IF_'
Carpo~t
',1~
~.. . ~
.... ,.;,
',~
Total Value:'
Bull9ing Permit Fee
State Surcharge
Total Fee
(A) ,
. 'l.. ~ . ..
.,,' S.',
Iw
L___
:B'UILDING VALUE;:'PlAN CHECK
AND, BUILDING PERMIT
" .-' '.
ThIs permit Is granted"on the express condition lhat the said
constructlon shall, In all respects, conform to the Ordinance
adopted by the City or Sprlngfteld, Including the
Development Code, regulatIng the constructlon'and use of
buildings, and may be 'suspended or revoked at any time
upon. violation of any provisions of saId orc.tinances.
;,~ I. '
.,', . . p.L.
,~ 1'1',.,.
.,\; "N"
VALUE
'"
/kD
~
~
~-
~.
SY~TEMS:P~YELOPMENT,,:9HARGE (SDC)
. . 1 .,' , J ~ ,~ '. .. _.- :.:~, .
(8)
PLUMBIN'G PERMIT
ITEM
Fixtures
Residential Balh(s) NO
Sanitary Sewer FT.
Water ' FT
Storm Sewer FT,
Mobile .Home
:y::;,,,~ ~-
PlumbIng Permit
State Surcharge
Total Charge:
(C)
MECHANICAL PERMIT!
Furnace
Exhaust Hood'
Vent Fan
N'
Wood StovellnsertlFI..replace Unit
Dryer Vent
Mechanical Permit
Issuance
State, Surcharge
Total Permit
. (D)
MISCELLANEOUS PERMITS,
~ ..- j' "_ ~ ..I, j . ; '. ., , . !. ..
Mobile Home~~",J _ 1; " ",' . .,!t" ",
'::;1;;' ' .
State, Issuance
State Surcharge
, "
Sidewalk
It
Curbcut
It
Demolltton
State Surcharge
Total Miscellaneous' Permits. .
t';
'(Eh..:'
. ." ..
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, D, and E Combined) ,
',<l
FEE
/ z:; 6-0
.7.r
/,<:::. 7.1""
/~"t)
.9Z)
-3,4.C 5'
Sotbacks
.HSE !GA.R'[ Acc'l
" .. I
. ,
I'
. THE PROPOSED WORK IN1'HE
HISTORICAL DISTRICT, OR ON
THE t-ibTORICAL REGISTER?
l"t' . :'
If yos,',thls 'application must be slgnod
.1 '
and approved by the. Historical
Coordl~n'ator prior to permit Issuance.
APPROYED'
Plan Check Fee:
Date Paid:
Receipt Number
Recelved By:
Plans Revlewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I st..lle and agree, that I have carefully examined
the completed application and do hereby certify tha1 all
Information llereon is truo and correct, and 1 further certify
that any and all work performed shall be done In accordance
with the Ordinances of tile Clly of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thai NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I furtller certify tllat only contractors and employees who
are In compliance with ORS 701.055 will be used on 1hls
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 the site r\ all times during constru~tl/ A \
X;gnaturn V~~ U, ~
I Date~/t)/r~
,jDOw..QQ. tx.1- LOn 1'11c;C~ ) ~
VALIDATION: (J (o-~ )
RECEIPT NUMBI,n I 10 o:::r-
'-Ll~l-q-:y~
AMOUNT RECEIVED ,_ ,.3 ~ t;.r. .
RECEIVED E~.JZiliil2f~/IIH
,
DATE PAID