HomeMy WebLinkAboutPermit Plumbing 1994-9-1
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK: . (~5L.(
ASSESSORS MAP: I / o?:J7 _(hL(~
LOT:
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BLOCK:
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OWNER:
ADDRESS'
CITY'
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STATF'
OIL
"
JOB NUMBER
q t{ l367
225 Fifth Street
Sprl ngfleld,Oregon97 47
Blvd
TAX LOT:
I () C; DC)
SUBDIVISION:
PHONF'
7Q7-"L7fo3
ZIP:
97477
DESCRIBE WORK:
7L, -k- s.e,L0-04 l~ 'I{ z r LLc €'IM..Q--u::+-
SuJ(0{ Li~
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL'
PLUMBING;-Y~ frW,\f) ')my] ~
MECHANICAL:'
ELECTRICAL'
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
. WATER HEATER:
ADDITION
DEMOLISH
OTHER
ADDRESS'
CON ST.
CONTRACTOR #
PHONE
D Rough Mechanical -.:. Prior to
cover.
D Roug'hElectrlcal - Prior to
cover,
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
i
D Framing - Prior: to cover.
D Wall/ C'elllng Insulation - Prlor'to
cover. '
D Drywall ..,.. Prior to taping,
D Wood Stove - After Installation.
D Insert - After fireplace approval
. and Installation of unit.
D Curbcut & Approach - After
, 'forl1)S are erected but prior to
placement of concrete,
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted,
EXPIRES
10 ro ~~/
F) -I Cj~'1 b '11 b-1 224
?O .~()/ (0, ~ ~-rJ. ,q 7Lf77
- OFFICE USE -
LAND USE:
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANG~'
FLOOD PLAIN:
ZONING CODE:
# 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,
REQUIRED INSPECTIONS
D Temporary Electric'
D Site Inspection - To be made
. after excavation, but prior to
setting forms,
D Underslab Plumbing/ Electrical!
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry .:- Steellbcatlon, bond
beams, grouting. .
D Foundation - After forms are
' erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
.,
D Underfloor Plumbing/Mechanical
, - Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking, .
o Fltiorl~SlJ/atlon - Prior to ' ,
decking. ' . . '
r;/l Sanitary Sewer - Prior to filling
L,A..J trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench. "
D Rough Plumbing - Prior to
cover.
"
o Final Plumbing - When all
plumbing work Is complete,
o Flnal:'Electrical - Wnen 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 - Whep all
blocking is complete. "
o Plumbing Connections - When
home has been connected to .
water and sewer,
D Electrical Connection - When
blocking, set-up, and plulT,jbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
inspections are appro'ved and
porches, skirting, decks, and
venting have been Installed,
;'
Lot faces
Lot Type
Lot sq, ftg.
Interior
Lot coverage
Corner
. i
Topography
Total ijeigl'1t.
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM
X $1 SQ. FT.
SQ, FT,
Main
Gaj;(lge
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
: 'i
}.";;:,',:.
:,: .( ,;
Setbacks
I ~P,L. HSE GAR Accl
IN
Is
lw
IE
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fix\ures
Residential Bath(s) NO
2.0
"
Sanitary Sewer FT,
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State S~rfharge
3ifo" MM.tv\. ~~
T04~1 Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State:Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demoll tion
o 'State Surcharge
Total Miscellaneous Permits (E)
FEE
26,DO
26. DC)
1.25
l:J..::;;i
-z.? ~o
TOTAL AMOUNT DUE (excluding electrical) -;2...7. (1.8>
(A, B, C, D, and E Combined)
,S THEPROPOSED 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,
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
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 within the City limits which are being improved.
ADDITIONAL COMMENTS
By slgnat.ure, I state and agree, that I have carefully examIned
the completed application and do herebycertlfy 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 required inspections are
requested at the proper t1.me, 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 ~'~ during construction.
Stgnature:d:./";~ ~.~./ JJ
,,. . /
Date
9-,/- .~4
VALIDATION:
RECEIPT NUMBER
DATE PAID
'/7/ 5' .:>~
9--/~ ~V'
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AMOUNT RECEIVED
RECEIVED BY