HomeMy WebLinkAboutPermit Plumbing 1999-12-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
SPRINGFIELD
LOCATION OF PROPOSED WORK: <.:?'/O
ASSESSORS MAP: ~~~ 7"3
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LOT:
BLOCK:
JOB NUMBER 99/~6
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: ~ ~
SUBDIVISION:
PHONE:
OWNER: At F,<"'-~Y2
ADDRESS: y/ r?
CITY: c...-~IZ- illlc-..... 1-,: 1/
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STATE:
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DESCRIBE WORK: c:< ,~-(
ZIP:
779'77
NEW
REMODEL
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ADDITION
DEMOLISH
OTHER
CONTRACTOR'S NAME
GENERAL: tfi.~)......~l..,L
CON ST.
ADDRESS CONTRACTOR It
CO <-t) Ui{C/'-... 2 7 ~ ? zP )~/~;- // ~S '---
EXPIRES PHONE
'7~4/.t.. t. i;l- - lOt:> I
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PLUMBING:
MECHANICAL:
ELECTRICAL:
QUAD AREA:
It OF BLDGS:
OCCY GROUP:
1/ OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE:
It OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE: __
FLOOD PLAIN:
ZOr:JING CODE:
It 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, Inspections requested after 7;00 a.m. will be made the following work day,
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D
Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
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 - Prior
to filling trench.
D
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D
Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
IV1 Sanitary Sewer - Prior to filling
L,4..J trench.
D Storm Sewer - Prior to filling
trench,
D Water Line - Prior to filling
trench.
o
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS'
o Rough Mechanical - Prior to .
cove~ ,
o Rough Electrical - 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 Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - A(ter Installation.
o Insert - After fireplace approval
and instal/atlon of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
o Sidewalk & Driveway - After
excavation Is complete, (arms
and sutJ-base material in place,
0,
Fence - WIlen completed.
o
~"reet Trees - When all required
trees are planted.
0' Final'Plumbing - When aI/
plumbing worl< Is complete.
o Final Electrical - When aI/
electrical worl< is complete.
o Final Mechanical - When all
mechanical worl< 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
blockin~J 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 tl1e home is connected to
the service panel.
o
Final - Alter all required
inspections are approved and
porches, sl<irtlng, decks, and
venting have been installed,
Lot faces
Lot sq.)tg.,~ '
.- ~'b..'~\\ ~~,,:'
Lot coverage
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'~ ., '...
Topography
Total height
C ',"H::, . : ,"."
BUILDING 'PERMIT
ITEM
SQ, FT.
Main
Garage
Carport
1r;' ...,~..,. - .
," "'-,.
'::--;1 ....J:~, '. . '~: .-
.. ,,:.-t;'t~1 Value
Buildi'ng Permit Fee
State S'urcharge
Total Fee
Lot Type
Interior
Corner
Panhandle
Cul.de.sac '
X $/SQ, FT.
'>,'), '_....,.. .
,"'<' 1.
(A)
I Pl.
IN
Is
W, '
E
V A LU E
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO '
FT. ~.ttJ
FT.
FT.
;~
(C)
Dryer Vent
Wood Stove/Insert/Fireplace Unit
NO,
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
'State Issuance
State Surcharge
Sidewalk
It
Curbcut
(t
Demolition
.. S'lat?, Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, 0, and E Combined)
FEE
.. ,.,
~..
,.e;-'
t,I~ '
. :Z~
/ ''2?'
q'?/ ~~
,
Setbacks
HSE GAR ACC
IS T.HE PROPOSED,WORK iN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORIcAL REGISTER?
If yes, this application must be signed
31)d approved by" the Historical
Coordinator prior to permit issuance,
"APPROYED; ;'
'l~" ...._' -:\ :_, . '.", ,_ "".,.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on'the expr,ess conditiqn that'the said
construction shall, in all respects, conform to the Ordinance
adopted by, the C;ity of, Spring.field, including the"
Development Code, regulatiJ;lg the construction and use of
buildings; and may be suspended or'revoked at any time
upon violation of any provisions of said ord!nances.
Plan Check Fee:
.. r
Date Paid:
RE)ceipt Number'
Received By;
._--, ------
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
,~, DDITIONAL COMM:.~T~~,_ _ '..
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BY,slgnature,1 state and agree, that I have carefully examined
the corppleted application and do hereby cedify that all
Information hereon is true and correct, and I further certify,
that any and all work performed shall be done in accordance
with,theOrdinances of the City of Springfield, and the Laws
of 'the Sta'te 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 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,
r~quested at the proper time, that each address Is readable
from the street, that th rmitcard Is located at the front
of the property, an e approved set of plans will remain
on the site a~1 'mes urlng construction.
Signature
D~te fl,i. - (~-19'
.
'\
VALIDATION:
RECEIPT NUMBER '?~7"'//
DATE PAID /Z~,~
AMOUNT REC~IVED .--. 'fl/.. ~' , '.
REC"EIVED BY -h~~~~~
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