HomeMy WebLinkAboutPermit Plumbing 1997-6-3
RESIDENTIAL
PERMIT APPLICATION
Inspections: '126.3769
Office: 726.3759
LOCATioN .OF PROPOSED WORK:
ASSESSORS MAP:
LOT:..
/7t5:s
,.,.~
SPRINGFIELD
/
/19
, , .
7.-7
BLOCK:
OWNER:~xk fA) I ~4:--er
ADDRESS:' 1~9 . (AJ'L' ~~ (\.../''-_~e^--1.. c.... \
CITY: ~':)I rr-1~f'..("'"lr:>1~1("\Q , .'., STA.:TE:'
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DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR~S NAME
GENERAL:
,r:?l'IJ
P:LUMBING:1-V~)~{') t'\~\..'''I\~ {"
, ,
MECHANICAl'
ELECTRICAL:
CUAD AREA:
1/ OF BLDGS:
OCCY GROUP:
I/'OF STORIES:
WATER HEATER:
or,
JOB NUMBER
CJ70/77
..
TAX LOT:
SUBDIVISION:
C)~ 9 CTe::;;
PHON f=.
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_ ZIP:
7-7-<177
( ,
r; ") · .
-I-'( 15? pG I. r
OTHER
ADDITION
DEMOLISH
ADDRESS
CONST,
CONTRACTOR 1/
':::'>
D Rough Mechanical "':'Prlor t.o
cover,
, ,
o RoughEh~ctrical -.,. Prior to
cover.
D Electrical Service - Must be
. approved to obtain permanent
electrical power.'
D Fireplace - Prior to facing
materials and framing Insp,
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover. '
o Drywall - Prior to taping,
o Wood Stove - After Installation,
0' Insert - After fireplace approval
and Installation of unit.
DCurbcut & Approach - After
. forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway "'7" After
excavation is complete, forms
and'sub,base material In place,
o Fence' - When comPleted::
o ,Street Trees - When allrequlred
trees are planted. ' '
EXPIRES
PHONE
-.Jt!f 5-- f( l tI 'c- c AJ
- OFFICE USE -
LAND USE:
# OF UNITS:
CONSTR. TYPE:
I:iEAT SOURCE:
RANGE'
'7~;2
1;07
,/ ,'~
~-/7//
FLOOD PLAIN:
ZONING CODE:
1/ OF BDRMS:
SECONDARY HEAT:
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,lnspections requested after 7:00 a,m. will be made the following work day,
REQUfRED INSPECTIONS
[J Temporary Electric
o Site Inspection ~. To be made
.. after excavation, but prior to
setting forms.
o Underslab Pfumblng/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
,.. exca~ated. ,
o Masonry -Steel location, bond
, beams, grouting.
o Foundation - After forms are
, erected but prior to concrete
placement. 'I
D Underground Plumbing - Prior
, to filling trench. ,
o UnderfloorPlumblngl Mechanical
-Prior to Insulation or decking,
D Post and Beam - Prior to floor ,
, Insl!latlon or decking, , ,,'
o Floor Insulation - Prior to,'-
decking. ,
f'5<( Sanitary Sewer "-- Prior to, filling, '
~rench.
o Storm Sewer -' Prior to filling
trench. .
o VfaterLlne -'-:- prior to filling
trench. , , "
, '
D. Rough Plu!11bing_~ Prior to
cover. " "
o Final Plumbing - When all
. plumbing wqrl< Is complete,
o Final Electrical - When all
. electrical work is complete.
o Final Mechanlcal'- When all
mechanical work is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
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
a(ld the home Is connected to
the service panel.
o Final - After all required
Inspections are appro'ved and
porches, skirting, decks, and
~entlng have been Installed,
Lot faces
Lot Type
Lot sq. ftg.
Interior,
Lot coveragej
Corner
Panhandle '!:
Topography
Total height
Cul-de.sac
;
BUILDING PERMIT
ITEM SQ, FT.
:ri ,'i;c~
X $/ SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
:~, , 7
p.L.
N
S
W
E
VALUE
"
SYSTEMS ,DEVELOPMENT GHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S!3wer
Water
FT, ~~
Storm,Sewer
: Mobile Home
FT.
FT,
Plumbing Permit
State Surcharge
z.~ +1:2 (;)
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent'
Mechanical Permit
Issuance
State Surcharge
Total 'Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
49t>O
.7~
.~3;~
~'-:...c'
41., . UJ
"
,:",".
I, "
\:~.
Setbacks '
THE PROPOSEDWORK.lNTHE.
, ,"STOF.lICAL DISTRICT, OR ON
THE HISTORICAL 8EGISTER?
HSE GAR ACe' I
I
I
I
I
BUILDlNbV~Ltl'E,'PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condit[on that the said
construction shal',in all respects, conform'to,the Ordinance
adopted by' the Cityo{ Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provision's.of said ordinances.
If yes, ,this application must be signed
and approved by the Historical
Coordinator prior to permit Issu,ance.
. '
f.>,PPROVED:
Plan Check Fee:
Date Paid:
Receipt Number:
Received By:
Plans Reyiewed By
Date
Systems Developme,,'t Char-ge Is due 6n all undeveloped
properties within the City limits which are being improved.
AD D ITIO N ALCO M M E NTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further ~ertify
that any and ali 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 ('Iny
structure without permission of the Building Safety Division,
I further certify that only contractors and employees who,
are In compliance with GRS 701:055 w'lIl be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper time, that each address is read~ble
from the street, that the permit card Is loeatee! at the front
of the prc;>perty, and the approved set of plans will remain
- -'Ofl-t~e at all times durIng con ruetin., .
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VALIDATION:
RECEIPT NUMBER
2h2.'32'
02~)
~~,
'....,. ,
L
DATE PAID
AMOUNT RECEIVED
,
RECEIVED BY