HomeMy WebLinkAboutPermit Plumbing 1991-5-31
.
.
SPRINGFIELD
.~
RESIDENTIAL
PERMIT APPLICATION
9/~~yr~
JOB NUMBER
Inspections: 726-3769
Office: 726-3759
*'
~Yt?,f LI1
~
225 Fifth Street
Springfield, Oregon 97477
S/!r,Jr J ,()p Ir( o-f'
TAX LOT: O? t-;I O'e:>
77"3
. /7-~ 3 .~ l-!- / t/
LOCATION OF PROPOSED WORK:
I
BLOCK:
SUBDIVISION:
OWNER-JtL,l~~ Ld/HAA..
ADDRESS: 2- ~ s;- ~)~ ,.vt BVV> II)~
CITY: E -' 0 PA/"<-. f!!! STATE:
~ /
. 3'12- ~o ~-s --3
PHONE:
A
~/
(J rf7,
97'/0.)
ZIP:
DESCRIBE WORK'
NEW REMODEL
A
~1:A:t fr-
o)
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR #
CONTRACTOR'S NAME
I'J t{) t1C V-
ADDRESS
EXPIRES
PHONE
GENERAL'
........
PLUMBING:
MECHANICAL:
ELECTRICAl.
- OFFICE USE -
LAND USF'
QUAD AREA:
FLOOD PLAIN:
ZONING CODE:
# OF BLDGS:
# OF UNITS:
OCCY GROUP:
# OF STORIES'
CONSTR. TYPE:
HEAT SOURO:'
RANGE:
# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
WATER HEATER:
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.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Temporary Electric
D Final Plumbing - When all
plumbing work is complete.
D Site Inspection - To be made
after excavation. but prior to
setting forms.
D Rough Electrical - Prior to
cover.
D Final Electrical - When all
electrical work is complete.
.
D Final Mechanical - When all
mechanical work is complete.
D
Underslab Plumbing/ Electrical/
Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtai n permanent
electrical power.
D' Footing - After trenches are
excavated.
D Final Building - When all
required inspections have been
approved and building is
completed.
D Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting.
D Framing - Prior to cover.
D Other
D Foundation - After forms are
erected but prior to concrete
placement.
D Wall/Ceiling Insulation - Prior to
cover.
[!] Underground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D
Underfloor Plumbing/ Mechanical
- Prior to insulation or decking.
D Wood Stove - After installation.
D Blocking and Set-Up - When all
blocking is complete.
D
Post and Beam - Prior to floor
insulation or decking.
D Insert - After fireplace approval
and installation of unit.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Floor Insulation - Prior to
decking.
D Curbcut & Approach - After
forms are erected but prior to
placement of concrete. .
D Sanitary Sewer - Prior to filling
trench.
D Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
D Sidewalk & Driveway - After
excavation is complete, forms
and sub-base ~aterial in place.
'." "
D Storm Sewer - Prior to filling
trench.
D Fence - When completed.
D Water Line - Prior to filling
trench.
D Final - After all required
. inspections are approved and
porches, skirting, decks, and .
venting have been'installed,
D Rough Plumbing - Prior to
cover.
D Street Trees - When all required
trees are planted. ,
Lot faces Lot Type . Setbacks . THE PROPOSED WORK IN THE
, , , ACC I HISTORICAL DISTRICT, OR ON
Lot sq. ftg. Interior p.L. HSE GAR
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 Cul-de-sac
IE I
APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. = VALUE
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 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.
Garage
Carport
Plan Check Fee:
Date Paid:
Total Value
Receipt Number'
Building Permit Fee
Received By:
State Su rcharge
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. .:2 0
~<:" ~ e;.
Water
FT.
Storm Sewer
FT.
Mobile Home
Total Charge
(C)
z S':' ~
/. ::?~
26.4~
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 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/lnsert/Flreplace 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 will remain
on the site at all ti es durin nstruction.
Signatur/~ /C~
Date S - :5 - 9/
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
VALIDATION:
Total Miscellaneous Permits (E)
/~6 -:5
, , -
5-- 7-5 /'
AMOUNT RECEIVED 2 C . ~ s:: ~
~~~.J>
RECEIPT NUMBER
DATE PAID
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
RECEIVED BY