HomeMy WebLinkAboutPermit Plumbing 1996-5-14
OWNER' ~?, ~X
ADDRESS: '-b5~ ./ ~TiC~.h'/~,
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DESCRIB~WORK: _1?~p~~ /9-~~' ~~/~~~ C::;:;r=)[;/~'~- ~ ~
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NEW REM66E:{' ADDITION' DEt<JtO ISH OTHER ~ 'iY~'
RESIDENTIAL
'pERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP:
LOT:
CITY:
CONTRACTOR'S NAME
GENERAL'
PLUMBING:~~~~~ .
MECHANICAL:
ELECTRICAL:
,l
SPRINGFIELD
. ~!. .
JOB NUMBER
9~CO
BLOCK:
STATE:
~~.
r
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: /~~
SUBDIVISION:
PHONi='
ZIP:
q-;; 7/) ::::>
ADDRESS'
CON ST.
CONTRACTOR /I
PHONE
EXPIRES
- OFFICE USE -
QUAD AREA: LAND USF' FLOOD PLAIN:
/I OF BLDGS: /I. OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR, TYPE: /I' OF BDRMS:
/I OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. l:hls 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., ~III ~e made the following work day..
REQUIRED INSPECTIONS.
D Temporary Electric
D Site Inspection"':" To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/ Electrical!
Mechanical - Prlor'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 Undergroun'd Plumbing - Prior
to filling trench. .'
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking,
o Floor Insulation - Prior to . -
decking. .. '. .
rn
Sanitary Sewer - Pri.or to filling
trench,
D Storm Sewer - Prior to filling
, trench, .
o Water Line"':" Prior to filling
trench, '
o Rough Plumbing ~ Prior to
cover:
o Rough Mechanical,"';' Prior to
cover. '...
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 In~p,
o ,Framing - Prior to 'cover.
, j
o !waIIlC'elllng Insulation - Prior to'
.cover.
o Drywall - Prior to taping.
, ,
o Wood Stovo - After Installation,
o Insert - After fireplace approval
and Installation of unit.
,
,
o Cufl:?cut & Approac~ - After
. forms are erected buf prior 'to
placement of concrete,
f\7l Sidewalk & Driveway -'- After
L4-I excavation Is compiete: forms
and sub.base material in place.
o Fence. - When completed,
o Street Trees - When all r~qulred
trees are planted. "
D
Final Plumblng.- When all
plumbing w()rl~ Is complete.
D Final Electrical - When all
electrical work Is complete,
D 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
D Blocking and Set.Up - When all
blocking Is complete,
o PlumblngConne.c:~ions - When
home has been cO'flnected 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
Lot, sq,. ft~.
1-
LQt coverage
. j.
. " Top?graphy
Total height
Lot T\
Interior
Corner
Panhandle
Cul'de.sac
\
-:0:_=.-----::-.
;.. ;...,
Setbacks
HSE GAR ACC)
I
I P.L.
IN'
Is
Iw
'.1
' '." L:.E'
. ,
BUILDING PERMIT
ITEM . SQ, FT. X $/SQ, FT.
'Main
Garage
Carpor.t
To'ta('val ue'
Building Permit Fee
State Surcharge
Total Fee.
(A)
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC) .
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
FT, /~ ,
Sanitary Sewer .
Water FT,
Storm Sewer FT,
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
'State Surcharge
~ 1-::2!
Sidewalk "~ ft /'
Curbcut
ft
Demolition
State Surcharge
.
Total Miscellaneous Permits (E)
(C)
(D)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined) .
FEE
'2~. ~o,
....2~---
/;2. 0' ~~
r? _~
"::2 /. ~ v
-L/.1S
~>S . ~t;;"
IS THE PROPOSED WORK iN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II 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 that the said
construction shall, in all respects, conform to the Ordinance
ad~pted by the City of Springfield, including the
DevelopmenfCode, regulating the construction and use of
buildings, and may'be suspended or revoked at any time
u,pon violation of any proYisions of said ordinances,
Plan Check Fee:
- Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undevelo'ped
properties within the City limits which are being improved,
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed appncatlon and do hereby certlly 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 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 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 ~equlred 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, SI;\/n~uring~nS;ruijlon.
Slgna~U~~ TV~
Da,t;X/ S;//Y /96
VALIDATION:
. RECEIPT NUMBER 121. CJo/C(5
5-1L/.- ct?'
AMOUNT RECEIVED 3>?': 9 ~
~
DATE PAID
RECEIVED BY