HomeMy WebLinkAboutPermit Plumbing 1997-10-30
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769 .,~ _ rJ
Office: 726.3759 ~JI
LOCATION OF PROPO,SED WORK: c:; l.p le () ~~
ASSESSORS MAP: Ii 0 d- "3 '34 'U (j ,SO"7) ,
OWNER' {V\ \c.hcLu LU'5l\~
ADDRESS:' ::'){obD ~114 ~
CITY: Sp::r 0~ Llri
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LOT:
DESCRIBE WORK'
NEW
REMODEL
ADDITION
DEMOLISH
CONTRACTOR~S NAME
SPRINGFIELD
BLOCK:
4! 5(c;
STATE:
()R.~~
.
~
JOB NUMBER
97 / 5 7....s-
225 Fifth Street
SprlngCleld, Oregon 97477
.#=: 5 'fa
TAX LOT:
SUBDIVISION:
'"
, PHONF'
ZIP: ct:J4'~
lAXt:bx ~~L)-b.vn
~
OTHER L--"
"
ADDRESS' ,
CONST.
CONTRACTOR #
EXPIRES '..... PHONE
".
GENERAl'
PLUMBING: p"",~~ ct~ 'SD<N\~S- YD-V~~o
NO"~~ITS: .L EXP\RE \f \ ri~ \<<>R~
lH\g<P~l\W~ lH\5 pct\M\1 \S NO
^U~AeR~~ER B~NUU\~t.D~0~
WATER HEATER: C~~D OR \5 ~ SQUARE FOOTAGE:
"'rr,;Q\OO. "
, ""\f18UUf'\' - ,
To requ3st an InspectIon, you must call 726~~9. 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.
MECHANICAl'
ELECTRICAL:
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
o Temporary Electric
o Site Inspection - To be made
after excavation. but prior to
setting forms,
D Underslab PlumbIng/ElectrIcal/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated. '
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
- OFFICE USE -
LAND US!:'
, ,
REQUIRED INSPECTIONS
o Rough Mechanical .:..;; Prior to
cover. .
D Rough Electrical - Prior to
cover.
" II
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.
D Wail/Ceiling Insulation - PrIor to
cover.
D Drywall - PrIor to taping.
o Underfloor Plumbing/Mechanical D Wood Stovo - After Installation.
- 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 filling
trench.
o Storm Sewer - Prior to filling
trench.
D Water line - Prior to filling
trench.
o Rough PlumbIng - Prior to
cover.
o Insert - After fireplace approvlll
and Installation of unit.
o Curbcut & 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.
o Fence - When completed.
..,
o Street Trees - When all required'
trees are, planted. ' ,
llrB'l3
/7fq, ~~~
l
FLOOD PLAIN:
ZONING CODE:
II OF BDRMS:
SECONDARY HEAT:
~nal Plumbing - When all
plumbing w9rl< Is complet,e.
D Final Electrical - When all
electrical work Is complete,
o 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 Sel.Up - When all
blocking Is complete. ,
o Plumbing Connecllons - When
home has been connected to
water and sewer.
,
o Electrical' Connection - When
blocking, set.up. and plumbing,
Inspecllons 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.
Lot faces
Lot~yP.
Interior
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,....", '1",'''';,,'II'l:'<W-fir'\iil''
'~.:.'.', ,'" '.... 'J.~.."'~';'\:<~J.~~':A,,'."';
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Setbacks '
HSE GAR ACC'
.'5 THEPROPOSED WORK tN THE_
'-"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If y~s, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Lot sq, ftg.,
Lot coverage
Corner
Panhandle \,'
p.L.
N
Topography
Total height
Cul.de.sac
S
W
E
APPROVED:
BUILDING PERMIT ':'j :i;~
ITEM, SO, FT, X $/SO. FT, = VALUE
BUILDING VAulE, PLAN CHECK
AND BUILDING PERMIT
Garage
Carport
"
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.
Main
Plan Check Fee:
Date Paid:
Total Value
Building Permit Fee
State Surcharge
Receipt Number'
Received By:
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) N'
-,/ I
Sanitary S~wer
Water
FT.
'..
"
"
, ,
,""
:1'
I. '
,
Storm Sewer
FT.
FT.
" t-
" ~, .
H'
I ."~',
::,t A
, .
Mobile Home
, '
,'\;
,. I'
, '
Total Charge
(C)
.p 1<:, .-
%-~ -r .lfS'"
~/(p.dO
I
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 Stovellnsertl Fireplace Unit
Dryer Vent
Mechanical Permit
Iss~ance
State Surcharge ~ V
Total Permit (D)
State Surcharge
Sidewalk
ft
ft
I further agree to ensure that all required Inspections are
l 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.
Signature ~j ~LL~
Date' 1 I),; ..~J--q -=r-
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Curbcut
Demolition
State Surcharge
VALIDATION:
Total Miscellaneous Permits (E)
RECEIPT NUMBER {)7 3 c:, c:{
DATE PAID 3AJ~~
AMOUNT RE,CEIVED lIP j~.d-6
<=K~
./<7 "1 '7
'.
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
RECEIVED BY
"