HomeMy WebLinkAboutPermit Plumbing 1998-11-5
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
SPRINGFIELD
LOCATION OF PROPOSED WORK: 2S J w .J' +
ASSESSORS MAP: _I 7 6 .3 L 1 If,Y
LOT:
OWNER: ~.......dy
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ADDRESS: ,~
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CITY:
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DESCRIBE WORK:
I?<Y?/e..e~...........,- I
NEW
REMODEL
CONTRACTOR'S NAME
GENERA! .
PLUMBING: If,,~} - J( QU /-c,....."
MECHANICAL:
ELECTRICAl.
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BLOCK:
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STATE:
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JOB NUMBER
tff 15 g G
61'
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225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
0116j
ADDITION
DEMOLISH ____ OTHER
SUBDIVISION:
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ZIP:
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ADDRESS
CONST,
CONTRACTOR #
EXPIRES ,,:,> PHONE
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{(f"'7- I) 7)
n law requires you to ..:. OFFICE USE NOTICE
ATTENTION:Orego . Oregon Utility :
QUAD AR~ l:Hinoted by the s are seHtm\l1lSE: - T}f/S PtFt lIT bH FLOO. D PLAIN:
,TO.. ter Those rUle 1 IV Q ALL CXP/~t: I '
# OF 1Mm. ijjg~tlon Cen - ~O tt-r.oogh OAR 95~9P.gNITS: AUIHORIZ12D UNO' .~ONIN'G~grrl:J.E..WoRK
. ,OAR 952-0U I-U. . of the rules uy '" '." ~H TH/~ Pt:b
OCCY 1~09t}!~. ~hta\n COPI~ telepf1&i1@TR,TYPE:COMMENCEDOPl/6#OFtrDr'{lVPMITISNOT
h enter (Note. 1I1e . . AN\q' . \01 ABANDON{:f"I t:f"\
# OF sTo~m\M:Ig tee ~1':tY.'l ,-,Wity Notif\G~~9rsoURCE: . d 1F.lD D.i1~' P&RIO,sECONl)AJ:i't"f!/~lt-:
number forme, ~ .2-2344). '/-J.
WATER HEATER:C,::,nt~rlS 1--800-33 RANGE: 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 sarne working day, Inspections requested after 7:00 a,m, will be made the following werk day,
D Temporary Electric
D Site Inspection - To be made
after excavatJon, but prior to
setting forms.
D Underslab Plumbing/ Electrical/
Mechanical - Prior to. cever,
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting,
D Foundation - After forms are
erected but prior, to concrete
placement.
D Underground Plumbing - Prier
, to filling trench. ,
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam - Prior to. fleor
Insulation er decking,
D Floor Insulation - Prior to
decking.
REQUIRED INSPECTIONS
D Rough Mechanical ~ Prier to.
cover,
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical pewer.
D Fireplace - Prior to facing
materials and framing Insp,
D Framing - Prior to cover,
D Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
D Wood Slove - After Installatien.
o Insert - After flreplace,apprevl'll
and installation 01 unit.
, 0 Curbcut & Approach - After
. , ,. forms are erected but prior to
D Sanitary Sewer - Prior to filling placement of concret(~,
trench.
o Storm Sewer - Prier to filling
trench. " ~ .,
\; \,
'.
D Water Line - Prier to. fillirg
trench. '
,
, .
D Rough Plumbang ~: Prier to.
cover,
" ....', j .....~....'
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place,
D Fence - Wtlen cOj"1pleted,
o Street Trees - When all required
trees are planted,
D Final Plumbing - When all
. plumbing worl< is complete,
, ,
D Final Electrical - When all
electrical work is complete,
D Final Mechanical - When all
mechaflical work Is complete,
D Final Building - When all
required Inspections have been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete,
o Plumbing Connections - When
tlOme has been connected to.
water and sewer,
o
Electrical Connection - When
blocking, sel-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 sq. ftg.
Lot coverage
Topography
Total height
BUILDING PERI\ihri
ITEM
SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Lot Typ,
Interior
Corner
Panhandle
Cul-de-sac
X $/SQ, FT.
(A)
;':.~ ~ ; ,. .,~
':
Setbacks
HSE GAR Accl
I
I
I P,L.
N
S
w
E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
N'
FT.
jJtJ
FT,
FT.
(C)
Dryer Vent
Wood Stove/Insert/Fireplace Unit
NO
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
t.;o tv
tf~ '0
l 2tJ 2.a
'-f J 2AJ
IS THE PROPOSED WORK iN THE _
HISTOI'lICAL 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 VALOE, 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, regulating 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 wllhln 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 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 Ordinanctls 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 wi thout 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
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.
Signature cO-_../ d ;;yL
Date II / J / 7 if
VALIDATION: A J q
RECEIPT NUMBER U / 7"
I( / f /7 f
AMOUNT RECEIVED t 'f{j 2 tJ /I
RECEIVED BY /A () Ww
DATE PAID