HomeMy WebLinkAboutPermit Plumbing 1995-7-31
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
LOT:
BLOCK:
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'"..
JOB NUMBER
q ~\1-~t&
225 FUtt1 Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
ns'ACO
OWNER: ~ \._~\'~9-l " PHONE: \c\\O' \~l\
;~~RE~\D~~~~ ~~\:: Afrt\lff\-- zip C\ l4r II
DESCRIB~WOR~\~J,~{) (1(ID '~~~ili1?~ ~~')lQc.o
NEW F1EMODEL __ A~DI~ON DEMOliSH OTHER J
1/
CONST.
CONTRACTOR II
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J,J! . t' - \ \V" ~ UlUl
CONTRACTOR'S NAME
ELECTRICAL:
ADDRESS
EXPiRES
PHONE
~ .-~q[)l
QUAD AREA:
h
11 OF BLDGS:
OCCY GROUP:
11 OF STORIES: ____'
WATER HEATER: _..
- OFFICE USE -
LAND USE:
II OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
FLOOD PLAIN:
ZONING CODE:
/I OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: ___
To request an Inspection, you must call 726,3769. Tt11s Is a 24 hour recording. All Inspections requested before 7:00 a,m. will be
made the same working dny, Inspections requested after 7:00 a.m. will be made the following worl< day.
o Tempornry Electric
o
Site Inspection - To be made
after excavation, but prior to
setting (orms,
o
Underslab Plumbing I 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 PllJmbing - Prior
to filllnQ trench.
o
Underlloor Plumblngl Mechanical
- Prior to Insulation or decl<lng.
D
Post and Bea~ - Prior to floor
insulation or decl\lng,
o Floor Insulation - Prior to
decking,
o Sanitary Sewer - Prior to filling
trench.
o
Storm Sew~r - Prior to filling
trench,
o
Water Line - Prior to filling
trench,
"
d Rough Plumbing - Prior. to
cover.
REQUIRED INSPECTIONS
/
~ Rough Mechanical - Prior to
cover.
.0 Rough Electrical - Prior to
cover. ,
o
Electrlcal ServIce - Must be
approved to obtain permanent
electrical, power.
o
Fireplace - Prior to facing
materials and framing Insp.
o Framln.g - Prior to cover.
o Wail/Ceiling Insulation ,- Prior to
cove~ ,
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit. ..
o
Curbcut & Approach - After
(orms are erected bllt prior to
placemont of concretG.
o Sidewalk & Drlvewa.v - After
excavation Is complete, forms
and sub-base material in place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. '
o Final Plumbing - When all
plumbing w()rl< Is complete.
o Final Electrical - When all
el~ctrlcal work Is complete.
~al Mechanical - When all
mechanical work is complete,
o Final Building - When all
required Inspections have been
approved and building Is
completed.
tiOth" ~(li) StfDl~
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 Final - After all required '
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
I
Lot sq. ftg.
Lot Type
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
\".'
Setbacks
I P.L. 'HSE I GAR' ACC
IN
Is
lw'
IE
VA LU E
"
SYSTEMS .DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
~~~l~ ft~~
Mechanlqal Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E ComblMd)
FEE
15.CU
j.lO
]lo- ~O
~.(X)
r 0.00
(.~O
0~(O'~O
....
,~2i)
'.-- IS THE PROPOSED WORI< IN THE
.. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
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 ltlal the said
construction shall, in all respects, conform to tllO Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the COr)..truction and use of
buildings, and may bG suspended or revoked at any time
upon Violation of allY provisions of said ordinances,
Plan Check Fee:
Date Paid:
...~-'.., -- '-'-~~'--" "~._-_._.---:.__...-.
Recel pt N umber:____. _______..___'~_
Received By:
-" "-_............._------~----_..._..~
-~~-~. --'~..._-_._----
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within tho City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have ciHefully examlhed
the completed application and do hereby certify that all
Information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of tho City of Sprlngfieid, and the.Laws
of the State of Oregon pertaining to the wor/< described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division,
I further certify that only contractors and employees who
are In compliance with ORS 701,055 will be used on this
prolect.
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 tho approved set of plans will remain
on the Sl~l all times during cons~>>on,
Slgn~ 4I~~
Date
VALIDATION: \d
RECEIPT NUMBE;~ ~ S D
DATE PAID _L"\1" .~
AMOUNT RECE~V.(:D __~l.. _
RECEIVED BY - 1)~
"---__ _____~ h__ _ _ _ ____ _~___
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