HomeMy WebLinkAboutPermit Plumbing 1993-7-6
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
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LOT'
OWNER'
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ADDRESS:
CITY:
DESCRfBE WORK:
.
SPRINGFIELD
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NEW
REMODEL
ADDITION
DEMOLISH
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OTHER
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JOB NUMBER
1?0"707
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
6SbO
PHONE:
7f-/6 -~yC/ ~~~,;)("
ZIP'
977"77
GENERAl'
PLUMBtNG'
G-AA-y
CONST,
ADDRESS CONTRACTOR'
!.5l/te,u;;: r r dZA,,<l.T#flPV~AJA-- e,41
EXPIRES
11/2?-/~]
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PHONE
CONTRACTOR'S NAME
MECHANICA"
ELECTRICAL:
- 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. Alllnspectlons requested before 7:00 8.m. will be
made the same working day. Inspections requested after 7:00 a.m. will be made the followlng work day,
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior 10
set,ling forms.
D
Underslab Plumbing/Electricall
Mechanical - Prior to cover.
D
Footing - After trenches are
excavated. ,
D
Masonry - Sleer location, bond
beams, grouting,
D
Foundation - After forms are
erected but prior to concrete
placement.
D Un~e~ground Plumbing - Prior
to fltllng trench, .
D
Underfloor Plumbingl Mechanical
_ Prior to insulation or decking.
D
Post and Beam - Prior to floor
insulation or decking.
D Floor Insulation - Prior to
I decki ng, '.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench, .,
D Rough Plumbing - Pr16r to
cover,
REQUIRED INSPECTIONS
D Rough Mechanical .- Prior to
cover,
o Rough Electrical - Prior to
cover.
D Elec'trical Service ~ Must be
approved to obtain permanent
electrical power.
D Fireplace - PrIor to facIng
materlals an~ framing Insp.
D Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - PrIor to taping.
o Wood Stove - After installation.
D Insert - After fireplace approval
and Installation of unlt.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
D
Sidewalk & Driveway - After
excavatlon Is complete, forms
and sub-base material In place.
o Fence - When completed.
D Street Trees - When al] required
trees are planted.
D Final Plumbing - When all
plumbIng work is complete.
D Final Electrical - When all
electrical work is complete,
D Final Mechanical - When all
mechanical work is complete.
f':7( Final Building - When all
~ requlred Inspections have been
approved and building is
completed,
~ Other .:5"fF.bh~ ~
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set-up, and plumblng
inspections have been approved
and the home is connected to
the service panel.
D Final - After all requlred
inspections are approved and
porches, skirtlng, decks, and
venting have been Installed,
Lot faces
.
Lot Type
Lot sq, ltg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
I PL,
IN
S '
W
IE
BUILDING PERMIT
ITEM SQ, FT, X $/ SQ, FT, VALUE
Main
Garage
Carport
~
-_.~~-_._,.
Total Value
Building Permit Fee
State Surcharge
Total Fee (A)
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
----
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT
Water
FT,
Storm Sewer
FT.
Mobile Home
~~~
f'./h?
,
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood St9vellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
lt
Curbcul
lt
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
/~,()O
.7S"
/5, ?J
/Ch d~
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J~,'i'O
,~~ ~s-
Setbacks
I I I I
HSE GAR ACC
I
~S THE PROPOSED WORK IN THE
. HISTORICAL DISTRICT, OR ON ; J -h
THE HISTORICAL REGISTER? /V L/
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
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, re{Julating 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
By signature, I state and agree, that I have carefully examlned
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
her'ein, and that NO OCCUPANCY will be made of any
structure without permissi.on of the Building Safety Division.
I further certify that only corrtractors .and employees who
are in compliance with ORS 701,055 will be used on this
project.
I furUlcr agree to ensure that all required inspectio.ns are,
requested at the proper time, that each address is readable
from the street, that tile permit card is located at the front
of the property, and-the approved set of plans will remain
on the site aHll timeS_d~~ing construction.
/ )\,ig~aIUre ~!vr ~
Date I} ~/ S7 3
1 .
VALIDATION: n (11...'2...
RECEIPT NUMBER '-I3r,1--)
DATE PAin f) ,\ 0' . ct~
AMOUNT RECEIVE~.~ - :?A~ . ( O~
RECEIVED BY (_\\,.~