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HomeMy WebLinkAboutPermit Plumbing 1991-3-22 RESIDENTIAL PERMIT APPLICATION ::::!n"spections: ?'26-3~ ()ttlce: fLb-jf:J\:1 y SPRINGFIELD LOCATION OF PROPOSED WORK: r:?$ '3 AS,SESS()R? M~P: 1?-~5?-"2.5''''~ 3. ~~~ 1~~/ -/'if. 5~F -.' " '. , 5~~2::> ~ ' ~. " LOT: OWNER: ADDRESS: CITY: /~~/~Ar./~ - - 'BLOCK: . ?TATE: ~ ' ,~ '''JOB NUMBEH9/0:2~ 7 225 Fifth Street Springfield, Oregon 97477 !.'\X.LOT: SUBDIVISION: /~b PHON E: "?~:>- ~~ ~ ZIP: DESCRIBE WORK.i'1f..;--/~&:~~ NEW REMODEL ADDITION ~r~ _~/f'WC~ ~~/-,. CONTRACTOR'S NAME GENERAl . Ct~~. pLUMBING.: MECHANICAL: ELECTRICAl' DEMOLISH OTHER ADDRESS CONST. CONTRACTOR # PHONE REQUIRED INSPECTIONS D Rough Mechanical - Prior to cove~ . D Rough Electrical - Prior to cover. D Electrical Service - Must be approved to obtain permanent electrical. power. D Fireplace - Prior to facing materials and framing Insp. EXPIRES - 'OFFICE USE - QUAD AREA: LAND USF' FLOOD PLAIN: # OF BLDGS' # OF UNITS: ZONING CODE: OCCYGROUP: CONSTR. TYPE: # OF BDRMS: # OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RANGI=' 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 o Si.telnspection -: To be made . after excavation, but prior to setting forms. D Underslab Plumbing/ Electricall 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. r17l Underground Plumbing - Prior 1A.J to filling trench. D' Underfloor Plumbing/Mechanical ....., Prior to insulation or decking. D Post and Beam - Prior to floo~ insulation o'r decking. . D Floor Insulation - Prior to decki ng. D Sanitary Sewer - Prior to filling trench. D Storm Sewer - Prior to filling trench. D Water Line - Prior to filling trench. D Rough Plumbing - Prior .to cover. D Framing - Prior to cover. D Wall/Ceiling Insulation - Prior 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 forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation is complete, forms , and sul?-base material in place. D Fence..;... When completed. o Street:rrees -'When alr'required trees are planted. ., D Final Plumbing - When all plumbing work is complete. D 'Final Electrical - When all electrical work is complete. D Final Mechanical - When all mechanical work is complete. D Final Building - When all required inspections have been approved and building is completed. D Other MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking is complete. D Plumbing Connections - When home has been connected to water and sewer. D Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service paneL '. D Final - After all required. . inspections are'.approved and " p'orches, 'skirting, 'decks, an'd venting have been installed. .' Lot coverage Lot Type , Setbacks THE PROPOSED WORK IN THE Interior I P.L. HSEGAR Accl HISTORICAL DISTRiCt; OR ON IN I THE HISTORICAL REGISTER? Corner If yes, this application must be signed Panhandle I~ I' and approved by the Historical Iw I Coordinator prior to permit issuance. Cul-de-sac IE I APPROVED: Lot faces Lot sq. ftg. Topography Total height ITEM SO. FT. X $/SO. FT. VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT BUILDING PERMIT Main 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 th.e 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. Garage Carport Plan Check Fee: Date Paid: Total Val ue Receipt Number. Building Permit Fee Received By: State Surcharge Total Fee (A) Plans Reviewed By Date SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures Residential Bath(s) NO Sanitary Sewer FT. FT. ~ S'CJ / 3S:~ Water Storm Sewer FT. Mobile Home Total Charge (C) "2 s-: ~ /- ~S- r ~."2S Plumbing Permit State Su rcharge MECHANICAL PERMIT Furnace Vent Fan NO By signature, I state and agree, that I have carefully 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 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. Exhaust Hood Wood Stove/Insert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Su rcharge Total Permit (D) 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. Signaturp;B.L(;- ~ ~a~e3- ;t 3- ~ /CJCJ I MISCELLANEOUS PERMITS Mobile Home' State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Su rcharge o VALIDATION: Total Miscellaneous Permits (E) RECEIPT NUMBER 1~,5. ~~~ ... '5r-- g-<~-<;7/ TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) , DATE PAID AMOUNT RECEIVED.........?~ 2S n.. . RECEIVED. BY <<~~~ ~