HomeMy WebLinkAboutPermit Plumbing 1998-6-1
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
SPRINGFIELD
......1IIUlI
ASSESSORS MAP:
LOCATION OF PROPOSED WORK: ~35q
/76 3 2-5 3.}
LOT:
BLOCK:
JOB NUMBER Cfi 0' Li 9
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: /0700
. SUBDIVISION:
PHONF'
7{{7-28{o{p
()i(\c~lNne-
ADDRESS: " \ 3c;s~ r (J)[) ~ nVl (01 6lucf,
CITY: '~PO\ rt?\M e\d
DESCRIBE WORK: -~ r\.~\ \-O,Jf \'6 6e...lAfV'r l~Q_
REMODEL ADDITION
OWNER:
NEW
nR
~p('J ~
STATE:
DEMOLISH
ZIP:
47'-177
r
OTHER
CONTRACTOR'S NAME
GENERAL: (1OsdlVe-\ t CO~~
PLUMBING:
MECHANICAL:
ELECTRICAL:
QUAD AREA:
/I OF SLOGS:
OCCY GROUP:
/I OF STORIES:
WATER HEATER:
ADDRESS
/)1;377 {1r#O-f1KJ .
CONST.
CONTRACTOR /I
7~LY{ ri (l
EXPIRES ~. PHONE
q/g/qi~'7<<ffi
. 1 .
HEAT SOURCE:
RANGE:
FLOOD I"LAIN:
ZONING CODE:
. It OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: ___
NOTICE:
THJ~ r:n"lIT DI 1,\;.1 f:X;:inc i,. ~ 1'ffi=~~~~SE _
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS AB~~BoLf.{€o FOR
ANY 180 DAY PERIOD. II OF UNITS:
CONSTA. TYPE: ___
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. AII.jnspections requested before 7:00 a.m. will be
made the same "Yorklng day, Inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS'
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
selling forms.
D ,Underslab Plumbing I Electricall
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundalion - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decl<ing.
"
o Post and Beam"":' Prior to floor
Insulation or decking.
o Floor Insulation - Prior to,
decking. ,',
o Sanitary Sewer - Prior to filling
trench. ,
D Storm Sewer - Prior to filling
trench. ,
o Water Line - Prior to filling
, trench.
D Rough Plumbing - Prior to
cover.
'.
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 Waif/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
D Insert - After fireplace approvlll
and installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Drivew3\' - After
excavation is complete, forms
,and su~).base material in place,
o Fence - Wtlen completed.
D Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing w()(k is complete.
D 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.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blockin9 is complete.
o Plumbing Connections - When
tlOme has been COnnected 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 Type
Loi sq. ftg.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de.sac
BUILDING PERMIT
ITEM ' SO. FT.
X $/SO. FT.
Main
Garage
Carport
Total Value
Bu.ilding' Permit Fee
. Slate Surcharge
Total Fcc
(A)
I P.L.
IN
\S
VA LU E
"
W
E
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
Water
F1'.
FT.
Storm Sewer
FT.
Mobile Home
s.ew~ 'fRPo..V1 tor
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood'
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
. State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
Stat? Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
'fO~
t,(}o i.~v
Lf~~'UJ
. :-j
Setbacks
HSEGAR'Accl
IS THE PROPOSED WORK iN THE
HISTORICAL DISTRICT, OR ON
THE HI~TORICAL REGISTER?
if yes, this, application must be signed
and apP,J'oved by the Historical
Coordiri"at.or prior to permit issuance.
'-~
, .
APPR0Yro: "
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 aflY time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
____. _._n
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City lim~(~~~rTdF.':~}e being improved.
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By signature, I stale 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.
I further agree to ensure that all required inspections are
r~quested at the proper time, that each address Is read ble
from tile street, that the permit card is loca at front
of the property, and the apR ved se of ill remain
on the site at all times ding con r tio.
Signature
Date
C)( -:ti-ry
VALIDATION:
RECEIPT NUMBER fJ 3 () I 0 z.
Giller?
L{ 5.2 c) J
a/WM/
DATE PAID
AMOUNT RECEIVED
RECEIVED BY