HomeMy WebLinkAboutPermit Plumbing 1996-10-14
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ortice: 726.3759
ASSESSORS MAP:
LOT:
--
SPRINGFIELD
JOB NUMBER .~~:fl~
225 Fifth Street
Springfield, Oregon 97477
--........
TAX LOT: J 3~ )
SUBDIVISION:
OWNER: NQJ\ ~ ~^3tUQl ' L(~tl CL_
ADDRESS: -V 0 2nx 7 (0/ / 1.rtilt
CITY: .<;pP (c ~ ~ .. I STATE: II () lZ
DESCRIBE WORK: rtpbtt./ ~~f7l1)-y 60 I~..I/j/ //h{l
NEW REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME
BLOCK:
PHONE:
ZIP: 971.(77
ADDRESS
CONST.
CONTRACTOR #
EXPIRES .~ PHONE
GENERAL: '
PLUMBING: _f\hf~~;y'"' . rn....137;x I UhK-_
MECHANICAL:
ELECTRICAL:
/()1./333 JKd/L7
l(C5--L( 7~L-/
s
- OFFICE USE -
QUAD AREA: LAND USE: _,. FLOOD PLAIN:
# OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
,
To request an Inspection, you must call 72~:3769, This Is a 24 hour recording, All Inspections requested berore 7:00 a,m, will be
made the sarrle working day, Inspections requested arter 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 Pfumblngl Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
D
Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench. '
D
Underfloor Plumbing I Mechanical
- Prior to Insulation or decl<lng.
D
Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
~ sa, nltary Sewer - Prior to filling
r---'\rench.
o Storm Sewer - Prior to 1IIIIng
trench.
o Water -LIne - Prior to filling
trench.
o .Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical -:- Prior to
cover.
/
o
Rough Electrical - Prior to
cover.
D 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/C'elling Insulation - Prior to
cover.
o Drywall - Prior to ~aplng.
o Wood Stovo - After Install allan.
D Insert - Arter fireplace approval
,and Installation or unit.
o
Curbcut & Approach - After
forms are erected bul prior to
placement or concrete.
o Sidewalk & Drlvewav - Arter
excavation Is complete, forms
and sub.base material In place.
o Fence - Wtlen completed.
o Street Trees - When all required
trees are planted,
D
Final Plumbing - When' all
plumbing w\Jrl< is complete.
o
Final Electrical - When all
electrical ,worl< is complete.
D Final Mechanical - When all
mechanical worl< is complete.
o Final Building - When all
, required Inspections have been
approved and building Is
completed.
D Other
MOBilE- HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is comp,lete.
o Plumbing Connections":'" When
home has been connected to
water and sewer,
o
Electrical Connection - When
blocking, set.up, and plumbing
Inspeclions have been. approved
and the home is connected to
the service panel.
/
o
Final - After all required
Inspections are approved and
porches, skirting, decl<s, and
venting have been installed,
f '. '~':', '" ,i\~',:'_.
". .....t! ';:'
'. ~: I I;
Lot faces
Lot TYPL
Lot sq, f,ig.
Interior
Setbacks
PL.IHSE'GAR'ACC'
'IS THE PROPOSED WORK IN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Hls'torlcal
Coordinator prior to permit issuance.
Lot coverage
Corner
N
Topography
Total height
Panhandle'
S
Cul-de-sac
W
E
J
APPROVED:
ITEM
SQ. FT.
X $/SQ, FT.
VALUE
BUILDING VALUE, PLAN CHECK
,AND BUILDING PERMIT
BUILDING PERMIT
Garage
"
This, permit Is granted on the express conditldn thatlhe 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.
Main
Carport
Plan Check Fee:
Date Paid:
Total Value
Building Permit Fee
Receipt Number:
State Surcharge
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within tho Ci.'y limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s) NO
Sanitary S~wer FT. C; ()
Water FT.
Storm Sewer FT.
Mobile Home
!to. /J[)
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
NO
By signature, I stale and agree, that I have carofully 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 Ordinances of the City of Springfield, and the Laws
of the Slate 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.
Exhaust Hood
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree 10 ensure that all required Inspections are
requested at the proper time, lhat each address Is readable
from the street, ltlat the permit card Is located at the front
of the properly, and lhe approved set of plans will remain
on the slle at all times during construction.
"~
Signature ,Q14'LLtf t?, -
~
Date I (/ )("')- I t../ -9 {.
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
I
Demolition
Total Miscellaneous Permits (E)
VALIDATION:
RECEIPT NUMBER Ji;/-l11
10 -- J1j~ tf &
ff70
DATE PAID
State Surcharge
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, D, and E Combined)
AMOUNT RECEIVED
FIECEIVED 8Y __,~__