HomeMy WebLinkAboutPermit Plumbing 1997-6-3
Inspections: 726.3769 ...~
Office: 726-3759 ' ~..i'
LOCATION C;>F PROPOSED WORK: S-" 0' ,tOc;, ~-../ ~h :1i1 /[?-,
ASSESSORS MAP: / ")...~<- '3:3'- ~~,
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OWNER: ~r4 /d '<J't- ~ ctQ, ,../~ ~rllrbY'
ADDRESS: '5 0>' ~ () Lk, \1 / ~~ it; IY-
CITY: ~J:::..!"} ~~ ~ ~ STATE:
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RESIDENTIAL
PERMIT APPLICATION
, '
LOT:
DESCRIBE WORK'
NEW
REMODEL
ADDITION
OTHER
CONTRACTOR'S NAME
GENERAl'
,PLUMBING: P<:fr
MECHANICAL:
ELECTRICAL:
QUAD AREA'
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER:'
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SPRINGFIELD
.
JOB NUMBER q ":A::::>~~
225 Fifth Street
Sprlnglleld, Oregon 97477
TAX LOT:
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BLOCK:
SUBDIVISION:
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PHONE:
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ZIP: L7 '1-zr
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DEMOLISH
ADDRESS' ,
CONST.
CONTRACTOR #
EXPIRES,:':) PHONE
IQI ,~t::~~;'_tr'~
.l.LJ) (7 ?
LJil17 5~(1.r17 7('7(1'
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- OFFICE USE -
LAND USF'
,FLOOD PLAIN:
ZONING CODE'
# OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
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 alter 7:00 a.m. will be made the following work day.
REQU I RED INSPECTIONS
D Temporary Electric
o Site Inspection - To be mado
after excavation, but prior to
sellfng forms. '
D Underslab Plumbing/Electrical/
Mechanical - PrIor to cover.
D Footing - After trenches are
excavated. '
D Masonry - Steel location, bond
,beams, grouting. '
D Foundation - After forms are
erected' but, prior to concrete
placement
D Underground Plumbing - Prior
to filling trench.
D Rough Mechanical ....:. Prior to'
cover,
[ZJ Final Plumbing - When all
plumbing w9rl< Is complet~,
, ,
'0 Rough Eh3ctrlcal ....,. Prlor'to '
cover.
o Final Electrical - When all
electrIcal work Is complete.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Final Mechanical - When all
mechanical work Is complete.
o Fireplace - prior to facing
materials and framing Insp.
o Final Building - When all
required Inspections have been
approved and building Is,
completed.
o Framing - Prior to cover,
D Other
o Wail/Ceiling Insulation - Prior to
cover. '
o Drywall ,..... Prior to taping.
MOBILE HOME INSPECTIONS
O Underlloor Plumbing/Mechanical' ,
-,Prior to Insulation or decking. D Wood Stove - Alter Installation.
o Post and Beam - Prior to floor
Insulation or decking.
" -
D Floor Insulation - Prl.or,to
decking.
-
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. '
o Water Line - PrIor to filling
trench. _ , '.
rN1 Rough Plumbing -,.. Prl,or to
~ cover, .
o Insert - After fIreplace approvlll
, and Installation of unit. '
o Blocking and Set. Up - When all
, bl~cklng Is complet,e.
o Curbcut & Approach - Alter
forms are erected but prior to
placement of concrete.
o Plumbing Connections - When
home has been connected to
water and sewer.
O Sidewalk & Driveway - After
excavation Is complete, forms
, and' su~.base'materlal In place.
o Electrical Connection - When
blocking, set-up, and plumbing
, , Inspections have been approved
and the home Is connected to
the service panel. '
o Fence: -:- "'then completed.
o Final - After all required
.., Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
o ,Street Trees - When all required
trees ~re planted, ' ,
lot faces
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..
'i, iil'; ,''',,;f,U,'', ~#ijt~'i. ,
~. .
lot Type
lot sq. ftg.
Interior
-
lot coverage'
Corner '
-
Topography
Total height
-
~'
Panhandle " ,
Cul-de"sac
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BUILDING PER~IT;\1 i';,:j
so. FT. X $/so. FT. =
ITEM
Main
Garage
Carport
'0
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
" Setbacks '
I 'P.l. I HSE I GA;/ ACe'
IN" I
I s ~ I
/w
~
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary S~wer FT.
Water FT.
Storm Sewer FT.
MObile Home
Plumbing Permit
~I'~
State Surcharge
Total Charge
(C)
.
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
, Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0,' and E Combined), '
( IS THEPROPOSED WORK ~N THE _
"'HIST08ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
I
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APPROVED:
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BUILDING VAU1E, PLAN CHECK
AND BUILDING PERMIT '
Tiils perm'it 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.
If yes, this application must be signed
and approved by the, Historical
Coordinator prior tei permit Issuance,
I
.
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.
FEE
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ADDITIONAL COMMENTS
"
.
,
By signature, I stato and agree, that I have carefully examined
the completed application and do, hereby certify that all
Information hereon Is true and correot, and I further oertlfy
that any and ali work performed shall be done In accordanoe
with the Ordlnancus of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
here'ln, and, that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I fu~ther certify that only contractors and employees who
are In compllanc~ 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 pormlt oard Is located at the front
of the property, and the approved set of plans will remain
on Ihe. site el alt. 1~..6
Signatu~ I 7.~
Datee:,. ?- CJ7
\
VALIDATION:
RECEIPT NUMBER
DATE PAID
A~OUNT RECEIVED
RECEIVED BY
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