HomeMy WebLinkAboutPermit Plumbing 1995-5-2
OWNER' ~~z:>y ('EWCLC~ , PHONE: 7~-<::::5/$<"V
ADDRESS:' ~?-=i- '3' >' ~~~ ~~ _~ .4 '
::?~^--p STATE: ~ ZIP: :;;;':>7:?~
DESCRIBE WORK: /~~C~~ /9~'?JS- f.~ ~ ?c'""'Rv.::;.)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
ASSESSORS MAP'
LOT'
CITY:
NEW
REMODEL
CONTRACTOR'S NAME
'.
BLOCK:
ADDITION
DEMOLISH
-~
JOB NUMBER
~?~
225 Fifth Street
Springfield, Oregon 97477
SUBDIVISION:
OTHER
, ADDRESS
CONST.
CONTRACTOR It
PHONE
GENERA~ ' , ~ "_
1- h ::?~~:;;-?;r~>~L
PLUMBING:r;~ ~~ ?~~A.r9~r
MECHANICAL:
ELECTRICAL:
EXPIRES
/::;>~ y/_ ? / . -95: 7'7'"/"'26 SI /
r /
- OFFICE USE -
QUAD AREA: LAND USE' , FLOOD PLAIN:
It OF BLDGS: It OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: It OF BDRMS:
It OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: 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 same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to ,
seltlng forms.
o Underslab Plumblng/Electricaf/
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.
D Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
-, Prior to. Insulation or decking.
'\. '
D Post and Beam - Prior to floor'
Insulation or decking. ' ,
o Floor Insulation...... Prior to
decking. _.. .
r171 Sanitary SewE;r - Prior to fllilng
!,A-J trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to IlIling
trench. . '
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical .-:. PrIor to
cover.
o Rough Electrlcal- Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall I Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
, forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, 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 work Is complete.
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - 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 PJumblng Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and tile home Is connected to
the service panel.
o Final - After all required
Ins'pections are approved and
porches, skirting, decks, and
venting have been installed.
Lot faces
Lot TY_
_ Interior
Lot sq. ftg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
....:.
I P.L.
IN'
Is
Iw
IE
VALUE
I~
.Total F:.e ~ ~ . , ,. . (~) '."
. -..... ...... .
SYSTEMS DEVELOPMENT C'HARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT. 7>
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
, Total Charge
;~
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELL.~NEOUS PERMITS
Mobile ,Home
State Issuance
State Surcharge,
Sidewalk fl
Curbcut
ft
Demolition
State Su rcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
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.S THE PROPOSED WORK tN 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.
Setbacks
HSE GAR ACC
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the expr~s con91tlon that the said
construction shall, In all respects, conform to the Ordinance
adopte,d 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:
t;U:'"
~ ~",..' ~
',"-:" '
'. '~'Plan~Revlew~d By
";'~:~.: 1 '.. .'
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 ~nd do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done'ln accordance
with the Ordinancus 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 permission of the Building Safety Division.
I further certify that onIY,c,9htractors and employees who
;' "'."'\"
are In compliance ",:,Ith 'OR5 701.0~5 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.
Slgnature//} ,-
Date~ - ~--
VALIDATION:
RECEIPT NUMBER /.~/':S-'
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DATE PAID
".
AMOUNT RECEIVED
RECEIVED BY