HomeMy WebLinkAboutPermit Plumbing 1994-8-17
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
~SESSORS MAP: /"'7 /7 ~
LOT:
OWNER: ~\Ct\~~ ~~
ADDRESS~' Ccclj~ ~h
CITY: ~ \C~()I'-l{)
~, \J \....ACf..
DESCRIBE WORK'
NEW
REMODEL
t..,
SPRINGFIELD
i cl.:59 Ce..w TE.A\ I\J \A ~ ,
-:2../n 44.
BLOCK:
,~
JOB NUMBER
qcj/203>
225 Fifth Street
Springfield, Oregon 97477
~~NGf\GlJJ C)~ C,1'-f7rf
TAX LOT: /52c?O
SUBDIVISION'
fl., r'~l 1'\.... \ A\ .(jOffif\-t\>0 Ie::!.. '\
L1\Nt0--;-\,-)t""'- ""t)..,JOKJ\J PHONE: lJIO)
~C., '.ttvL "
REQUIRED INSPECTIONS
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 Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After I~stallatlon.
D Insert - After fireplace approval
and Installation of unit.
DCurbcut & Approach - After
forms are erected but prior to
placement of concrete.
o 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. . ,~.
\
5::2.,- t=);L1 '(
. ZIP:
, q ~f6~'
I ,
STATF'
M-
Pc-v mB f Nt\'
OTHER ~i\i ~
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR /I EXPIRES PHONE
GENERAL: (')n.\ ~p~ ~..\Cl1~ Ci\N~-~<S~
1. PLUMBING:
MECHANICAL'
ELECTRICAL:
- OFFICE USE -
QUAD AREA: 2,J:? }J\A; LAND USE: )/11 FLOOD PLAIN:
/I OF BLDGS: # OF UNITS: ZONING CODE: Lj/(
OCCY GROUP: CONSTR. TYPE: /I OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE, FOOTAGE:
\,J CN_ \oJ
\ '\f\. <::. -r r- t:! I ~_...... i.-
' 'LJ ~ l (::- '1 \'k.,. ~- 1--
ADDITION
DEMOLISH
To request an Inspection, you must call 726-3.769. 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.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting. .
o Foundation - After forms are
erected'but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking. '_
\
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. '
D Water Line - Prior to filling
trench.
1Vf'ROU9h Plumbing - Prior to
r-.. cover.
""
~ ,
1.><1 Final Plumbing - When all
/' ,;Iumblng work Is complete.
D Final Electrical - \lV.hen 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.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Whe[1 all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plurTJbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
,j; \" .:~
" " "
,;
Lot faces Lot Type'
Lot sq. Itg. Interior i'F~ L.
: ~I N'
Lot coverage Corner Is
Topography Panhandle
Iw
Total I1,elght Cul-de-sac IE
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Flx\ures
Residential Bath(s) NO
Sanitary Sewer FT.
, Water FT.
Storm Sewer FT.
/--'
r
Mobile Home
Plumbing Permit
Stat~. Surcharge
Total Charge
'3 f?/J ~/??/AJ/
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
, NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State'Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
~)-p-O'
'6,Cl-O
J~
II
/,,'d~{)
-\..U I
~1'~~
.',';'i"
i >'.; ~"::~~i\ii&',:~\'/
4'
Setbacks '
IS TH E PROPOSED v.vORK 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.
HSE GAR ACe' I
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 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.
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 d",'ng con,structl~~
^,gnat",e r~d.., ~
I ' ( B//~1/ /0 '
Date . ~~~ J'~ /
VALIDATION:
RECEIPT NUMBER
14355-
e/>'7/Fc/
( ~cr< $0
~~~
DATE PAID
AMOUNT RECEIVED
RECEIVED BY