HomeMy WebLinkAboutPermit Plumbing 1992-7-7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
LOCArION OF PROPOSED WORK:
ASSESSORS MAP:
/7/J}
LOT:
,I=L--A/
OWNER: ---T+-J2- c:-
ADDRESS: --:2.C.~ /"J/
CITY: -~r)
.
SPRINGFIELD
~2.?
'(.<;' 47_
~I
430-0
sT
BLOCK'
t1IeL5~ J
T .--r /
STATE: --L)A'
---,
'13 NUMB~I\ _92D'Z2..:=z..
225 Fifth Street
Springfield, Oregoll 97477
TAX LOT'
SUBDIVISION:
PHON'"
ZIP:_~.7~2?
DESCRIBE WORK: ~ :5oer/C0 .: ='4J~
NEW REMODEL ----- ADDITION DEMOLISH OTHER
CONTRACTO'TS NAME
GENERAL: _
ADDRESS
CONST,
CONTRACTOR'
PHONE
EXPIRES
PLUMBING _+-1 ~J~V".':I' J,---",_g.Lu_.~Q.:......E~~..I.''(a...._/Y)<=' 77
6u<;
/~2" '7'fb-/",-z.L.___
M~CHAN'CA' .
ELECTR'CAL:
OUAD AREA:
. OF BLDGS:
OCCY GROUP:
"OF STORIE~;:
WATER HEATER:
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR, TYPE:
HEAT SOURCE:
RANGF'
FLOOD PLAIN'
ZONING CODE:
, OF BDRMS:
SECONDARY HEAT:_
SQUARE FOOTAGE:
To request an in~pection, you must call 726.3769. This Is a 24 hour recording. All inspections requested before 7:00 a.m. will I)c
maclc the sallle working day. inspections requested after 7:00 a.m. will be made the following work day.
D
Temporary Electric
CI
Site Inspection - To be made
alter excavation, hut prior to
settinlJ forms.
D
Underslab Plumbing/Electricall
Mechanical - Prior to cover.
D
Footing - After trenches are
excava 10Cl.
D
Masonry - Steel location, bond
beams, ~Jroulin9.
D
Foundntion - Aller forms are
erected but prior 10 concrete
placement.
o
Underoround Plumbing - Prior
to fillino trench.
D
Underlloor Plumbing/Mechanical
_ PriO/ 10 insulation or decking.
D
Post and Oeam - PrIor to floor
insulalil,ln or dt..:cldng.
D
Floor Insulation - Prior to
cjeckino.
o
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - Pdor 10 filling
trench.
jy(Watcr Line
~ trench.
Prior to filling
D
Prior to
Rough Plumbing
caver.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prlor'ta
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior ta facing
materials and framing Insp.
D Framing - Priar la cover.
D
Wall/Ceiling Insulation
cover.
Prior ta
D
Drywall - Pdor to taping.
D Wood Stove - After instal/alion.
[~ Insert - Afler fireplace approval
and installation of unit.
D
Curbcut & Approach - After
forms are ercctecl bul prior to
placement of cancrete.
~Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
o
Fence - When completed.
D
Street Trees - Wilen all required
trees are planted.
D
Final Plumbing - Wilen all
plumbing worl{ is complete.
D
Final Electrical - When all
electrical worl{ is complete.
D
Final Mechanical - Wilen all
mecllanical work Is complete.
D
Final Building - WIlen all
required inspections Il,we been
approved and building is
completed.
o
Other
MOBILE HOME INSPECTIONS
o
Blocking and Set-Up - When all
blocking is complete.
o
Plumbing Connections - Wilen
home tH.\S been cannected to
water and sewer.
D
Electrical Connection - Wlwn
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
BUILDING PERMIT
ITEM
sa, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surchar.ge
Total Fee
Lot TYP'-
InterIor
Corner
Panhandle
Cul.de-sac
X $/SO. FT.
(A)
I PL. '
IN
Is
Iw
IE
VALUE
- '<, .
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s) NO
Sanitary Sewer
Water
Storm Sower
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
FT.
FT. L 50
FT.
(C)
Dryer Vent
Wood Stove/lnsertlFlreplace Unit
N'
Mechanical Permit
Issuance
Stale Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
?
.;.
fl
Curbcut
fl
Demolition
Stato SurchorgQ
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrlcal)
(A, B, C, D, and E Combined)
FEE
2. .;;- ~
/,2"
2?,zr
J/),~S
k70
Setbacks
HSE GAR'ACCI
I
I
I
I
.S THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON .
THE HISTORICAL REG'STER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to pcrmil issuance.
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition thaI the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and LIse of
buildings, and may be suspended or revoked a1 any lime
upon violation of any provisions of said or~inances.
"
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 examined
the completed application and do hereby certi fy that all
Information hereon is true and correcl, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of ttlC City of Springrlelcl, and the Law:.;
of the State of Oregon pertainIng 10 the worl< described
herein, and that NO OCCUPANCY will be made of any
structure wltllOut permission of the Building Safety Divir.ion.
I further certify thai only contractors and crllployees wtlO
are In compliance with ORS 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 the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
~lgnatura-1/1A..k!- f ,~,' .
Datp 7- 7 - q 2
VALIDATION:
RECEIPT NUMBER -S.pC'0S-
DATE PAir' r~92...
AMOUNT RECEIVED ~ -?, ,70
-~
RECEIVED BY