HomeMy WebLinkAboutPermit Plumbing 1993-7-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: _/7 /)~
LOT'
OWNER: J<!..o 680..e.,t>
ADDRESS" ~.. 11,'0,. J]?>/C
51''€(~h'';'L.LJ
.
SPRINGFIELD
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CITY'
DESCRIBE WORK'
NEW
REMODEL
. ADDITION
STATF'
(C)~
.
JOB NUMBER
q ??Cl"J11
DEMOLISH y:
OTHER
225 Fifth Street
Springfield. Oregon 97477
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'7 LJ2:J-o
TAX LOT'
SUBDIVISION'
PHONE:
71/6 -~c,.t// ff,~~,t:I~'X)
ZtP:
971"7 ?
CONTRACTOR'S NAME
GENERAL: __~
CONST.
ADDRESS CONTRACTOR'
8~.e,...,d-.rr iiAJe.T/Y/o/Dt-'/P?- 9.4r
EXPIRES
)~/2/~/9 ~
PHONE
PLUMBING'
MECHANICAL:
ELECTRICAl'
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER'
- OFFICE USE -
LAND USF'
. OF UNITS:
CONSTR. TYP'"
HEAT SOURCE:
RANG'"
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspection, you musf 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 foilawlng work day.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D
Underslab Plumbing/Electricall
Mechanical - Prior to cover.
D Footing - After trenches are
excavated. .
o
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
D
Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
D
Post and Beam - Prior to floor
insulation or decking. .
D Floor Insulation - Prior to
decking. .
o
Sanitary Sewer - Prior to filling
trench.
D
Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
. trench.
D Rough Plumbing - Prior to
cover. "
REQUIRED INSPECTIONS
D Rough Mechanical - 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
materials and framing Insp.
o
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 unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavntiOI"l Is complete, forms
ar.d sub-base materia! in place.
D Fence - When completed.
D Street Trees - V'..'hen at! required
tmes are planted.
D
Final Plumbing - When all
plumbing work is complet.e.
o Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work Is complete.
~ Final Building - When all
~ required inspections have been
approved and building is
completed.
g] Other ~..!~ ~
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 plumbing
inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces
.
Lot Type
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT.
Main
Garage
Carport
"
, ,-
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
en./ /z,. c::Ay.?
>
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
__J
I
~S THE PROPOSED WORK IN THE
. Hlc;TORICAL DISTRICT, OR ON t<J 0
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
I PL.
Setbacks
HSE GAR Accl
N
S
w
E
VALUE
:~,
FEE
/6"tP.o
,7.)
)C;: 7 S-
/9"tlo
,90
/ f.J .1'0
? A 05:
-vT'
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
"
This permit is granted on the express condition that the said
construction shall, in air respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, wD;;laling 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 uncJeveloped
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
lnformatlon 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 permissjo~ of the Building Safely 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 inspeclio,ns are
requested at the proper time, that each address is readable
from the 'street, that the permit card is 1Q(:ated at the front
of the property, and tile approved set of plans will remain
on the site a/lall time~ d~ng 0structi~/ /J _
)Csignaturl' ~ ('t~
Date 11~/9?
VALIDATION: t:).. .r7
RECEiPT NUMBER q "00 ~
DATE PAID 'I.. \c' , q~. -
AMOUNO RECE~EJl < ~ . ~S
RECEiVED SY ~\ \)W
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