HomeMy WebLinkAboutPermit Plumbing 1991-6-18
RESIDENTIAL
PERMIT APPLICATION
Inspections 7263769
Office 726 3759
LOT
SPRINGFIELD
BLOCK
,
JOB NUMBER
C\\()8~ )
225 Fifth Street
Springfield, Oregon 97477
TAX LOT
(y)P(j4
SUBDIVISION
OWNER ?- \ ,""-UL ~J...> '0;\C"\.t'\ ~>U PHONE 14 \- ~
ADDRF"'''' rJ(n~?J ~\ \~'f\.\'\,\('Q('S) ~~..:x?~
CITY ~~~~ ~TATE (() JG
DESCRIBE WORK \( \-\ J... J... .\\"\. D\-[\C"\ ~~_tVTY\..l~
NEW REMODEL ADDITION DloMOLlSH OTHER
CONTRACTOR'S NAME
GENERAL
PLUMBING
MECHANICAL
CO 1 ,) \'\-.Q.,;V
ELECTRICAL
QUAD AREA
. OF BLDGS
OCCY GROUP
# OF STORIES
WATER HEATER
ZIP
G\' \-<\ II
ADDRESS
CONST
CONTRACTOR #
PHONE
REQUIRED INSPECTIONS
o Rough Mechamcal - Prior to
cover
D Rough Electncal - Prior to
cover
D Electncal Service - Must be
approved to obtain permanent
electrical power
o
Fireplace - Prior to facing
materials and framing lnsp
- OFFICE USE -
LAND USE
# OF UNITS
CONSTR TYPE
HEAT SOURCE
RANGE
EXPIRES
FLOOD PLAIN
ZONING CODE
# OF BDRMS
SECONDARY HEAT
SQUARE FOOTAGE
To request an Inspection, you must call 7263769 ThiS IS a 24 hour recording All Inspections requested before 700 am w!ll be
made the same workIng day, inspectIOns requested after 700 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 Plumblng/Electncal/
Mechanical - Prior to cover
D 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
o
Underfloor Plumbing/ Mechanical
- Prior to InsulatIon or decking
o
Post and Beam - Prior to floor
Insulation or decking
D Floor Insulation - Prior to
decking
D Sanitary Sewer - Prior to filling
trench
D Storm Sewer - Prior to fllllng
trench
D Water Line - Prior to filling
trench
~U9h Plumbmg - Prior to
~over
o Framing - Prior to cover
o Wail/Ceiling Insulation - Prior to
cover
D Drywall - Prior to taping
o Wood Stove - After Installation
D Insert - After fireplace approval
and installation of unit
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete
o Sidewalk & Dnveway - After
excavation IS complete, forms
and sub base material In place
D Fence - 'When completed
D Street Trees - When all req~ulred
trees are planted
o
Final Plumbmg - When all
plumbIng work IS complete
D Fmal Electncal - When all
electrical work IS complete
o
Fmal Mechanical - When all
mechanical work IS complete
o Fmal Building - When all
required Inspections have been
approved and bUilding 15
completed
OOthe,
MOBILE HOME INSPECTIONS
o Blockmg and Set Up - When all
blocking IS complete
D Plumbing Connections - When
home has been connected to
water and sewer
o Electncal 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. Setbacks THE PROPOSED WORK IN THE
Lot SQ ftg Interror PL HSE GAR ACC I HISTORICAL DISTRICT, OR ON
I THE HISTORICAL REGISTER?
Lot coverage Corner N If yes, this application must be signed
Is I and approved by the HistOrical
Topography Panhandle Iw I Coordinator prior to permit Issuance
Total height CuI de sac IE I
APPROVED
BUILDING PERMIT
ITEM SO FT X $/SO FT
VALU E
BUILDING VALUE, PLAN CHECK
AND 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 Spnngfleld, 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
Garage
Carport
pran Check Fee
Date Paid
Total Value
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
Water FT
Storm Sewer FT
Mobile Home
Total Charge
(C)
J S.U-)
,'is
F51'3
Plumbing Permit
State Surcharge
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 Sprrngfleld, and the Laws
of the State of Oregon pertaining to the work descrrbed
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 GRS 701055 Will be used on thIS
project
Exhaust Hood
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
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 WI!I remain
on the te at all times, dn construction ,
Slgnatur ~,~) LI/kfl /.6; dLd.//lT./->
&-/!7-91 (j
MISCELLANEOUS PERMITS
MobIle Home
State Issuance
State Surcharge
Sidewalk
ft
Date
Curbcut
It
Demolition
TOTAL AMOUNT DUE (excluding electncal)
(A, B, C, D, and E Combined)
J es '7-5
VALIDATION f\ A /' "'..)
RECEIPT NUMBER] rOrrn) (\
DATE PAIL> 0 ' {X . q (
AMOUNT RECEIVEr> ./3 1:'..
CCf>~
RECEIVED BY
j
State Surcharge
Total MIscellaneous Permits (E)