HomeMy WebLinkAboutPermit Plumbing 1994-9-28
RESIDENTIAL
PERMIT APPLICATION
Inspections: 7263769
Office' 726.3759
LOCATION OF PROPOSED WORK
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ASSESSORS MAP
LOT
/100:;0 r~~c....Ub.
1 (')2 I 2..
BLOCK
JOB NUMBER
93/20'1
225 Filth Street
Springfield, Oregon 97477
TAX LOT
'3 Co ()-f)
SUBDIVISION
PHONE
~I.f?~S(5 [)
OWNER A--0!c\-0NY V DSed
ADDRESS {OOD CBJT1<AL ~LvO
CITY <;p~mG-P(B."D
STATE
OR.
07'i 717
ZIP~.. .._
REMODEL
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ADDITION )(
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DESCRIBE WORK
NEW
DEMOLISH
OTHER
P/~R<-~J
/ '
CONTRACTOR'S NAME
GENERAL
PLUMBING
MECHANICAL
ELECTRICAl
ADDRESS
CONST
CONTRACTOR'
EXPIRES
PHONE
o r<.SW
QUAD AREA
· OF BLDGS
OCCY GROUP
· OF STORIES
WATER HEATER
(2.3
f
- OFFICE USE _
({ ! I
I
VN
613
LAND USE
· OF UNITS
CONSTR TYPE
HEAT SOURCE
RANGE
FLOOD PLAIN
ZONING CODE
LD!2,
. OF BDRMS
SECONDARY HEAT
SQUARE FOOTAGE
Lfo-o
To request an Inspection, you must cafl 7263769 This Is a 24 hour recording Alllnspecflons reQuesled before 700 a m will be
made the same working day, InspectIons requested after 700 a m will be made the (ollowlng work day
o Temporary ElectrIc
o Site Inspection - To be made
after excavation, but prior to
setting forms
o Underslab Plumblng/Electrlcall
Mechanlca' - PrIor to cover
o Footing - After trenches are
excavated ~
o Mesonry - Steel location, bond
beams. grouting
o Foundstion - After forms are
erected but prior to Concrete
placement
o Underground PlumbIng - Prior
to f11f1ng trench
O Underfloor PlumbIng/Mechanical
- Prior to Insulation or decking
o Post and Beam - Prior to floor
Insulation or decking
o Floor Insulation - Prior to
decking
o Sanitary Sewer - Prior to fllflng
trench
o Storm Sewer - PrIor to filling
trench
o Water LIne - Prior to filling
trench
rx1 Rough Plumbing - Prior to
('-cover
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover
o Rough Electrical - PrIor to
cover
o ElectrIcal ServIce - Must be
approved to obtain permanf'nt
electrical power
o FIreplace - Prior to facing
materials and framIng Insp
o FramIng - Prior to COver
I
o Wail/Ceiling InsJlation - Prior to
cover
o Drywall - Prior to taping
o Wood Stove - After Installation
o Insert - After fireplace approval
and Installation of unit
\
o Curbcu! & Approach - After
forms are erected but prior to
placemont of concrete
o Sidewalk & DrIveway - After
excavation Is completo, forms
and sub base material In place
o Fence - When completed
o Street Trees - When all required
trees are planted
IYl Final Plumbing - When all
~Iumblng work Is complete
o Final Electrical - When all
electrIcal work Is complete t
o Final Mechanical - When all
mechanicar work [s complete
o Final Building - When all
requIred Inspections have been
approved and building Is
completed
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set Up - Whep all
blockln.g Is complete
o Plumbing Connections - When
home has been connected to
water and sewer
o
Electrical Connection - When
blocking, set up, and plun)blng
Inspections have been approved
and the home Is connerted to
the servIce panel
o Final - After all required
Inspections are approved and
porches, sklrttng, decks, and
venting have been Installed
Lot faces Lot Typ I
Lot sq ftg Interior ! PL
IN
Lot coverage Corner
Is
Topography Panhandle
Total ~elght Cui de sac W
E
BUILDING PERMIT
ITEM SO FT X $/so FT VALUE
Main
Galage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures 2
,
Residential Bath(s) N'
Sanitary Sewer FT
Water FT
Storm Sewer FT
Mobile Home
Plumbing Permit
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Fu mace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Perml t
Issuahce
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
fI
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrlcal)
(A, B, C, D, and E Combined)
\1\
Setbacks
HSE GAR ACC
FEE
? 1:) 'f'O
/"D
.1':0
2-I.~O
?/~
3 THE PROPOSED WORK IN 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
APPROVED
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
constructlon shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Development Code, regulating the construction and use of
oulldlngs, and may oe 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 undevefoped
properties within the City limits wl)lch 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 oe made of any
structure without permission of the Building Safety Division
I further certify that only contractors and employees who
are In compliance With QRS 701055 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 during construction
Xture n. Ii U~
\~~ l
Date 9-2-f!5 ~ crCyL
"-'
VALIDATION
RECEIPT NUMBER
J4-Cf:J~ Z5
9;/2. :s ~'7 f
_ '?-/ 6. <J
~~
DATE PAI['
AMOUNT RECEIVED
RECEIVED BY