HomeMy WebLinkAboutPermit Plumbing 1994-11-8
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: . / 7 ~ 2
LOT:
OWNER:
ADDRESS'
CITY:
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GU..~eNe-'
SPRINGFIELD
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JOB NUMBER
94'/?/4
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225 Fifth Street
Springfield, Oregon 97477
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BLOCK:
A L.LE:+J
STATE:
, 8 VJ-c:-
DESCRIBE WORK:
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NEW
REMODEL
ADDITION
OTHER
CONTRACTOR'S NAME
GENERAL'
PLUMBING:
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6"6~~ ~
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~ls.oY0
MECHANICAL:
ELECTRICAL'
r\9.. ,~ 6. 'E-
QUAD AREA'
II OF BLDGS:
OCCY GROUP'
II OF STORIES'
WATER HEATER:
DEMOLISH
, TAX ,LOT: ;() / <' ~
SUBDIVISION:
PHONI='
I - SO :3 ~ 4~ 4-~ J 4-11
ZIP:
~'14-61
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ADDRESS'
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c.o N~ 't -
CONST.
CONTRACTOR II
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PHONE
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EXPIRES
1/.11 -45
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S --"{ -'\5
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~ :'7 ("3137)
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- OFFICE USE -
LAND USE:
II OF UNITS:
CONSTR. TYPE: _
HEAT SOURCE:
RANGF'
.....
FLOOD PLAIN:
ZONING CODE:
II OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
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 arter 7:00 a.m. .wlll be made the following work day.
REQUIRED INSPECTIONS
D Temporary Electric
D Site Inspection - To be made
arter excavation, but prior to
setting 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 Underlloor Plumbing/Mechanical
, - Prior to Insulation or decking.
D Post and Beam - Pr,lor to 1I00r
Insulation or d~cklng.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench. '
D Rough Plumbing - Prior to
cover.
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Dry~all - Prior to taping.
, ,
D Wood Stovo - Arter Installation.
D Insert - After fireplace approval
and Installation of unit,
1
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,
D Fence - When completed.
DStreet Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing w9rk Is complet,c.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
D Other
MOBILE HOME INSPECTIONS
~
., .
" ,
, , '
1\...1' Blocking and Set.Up - Wh,en all
~blocklng Is complete. "
. .
,
~
D<1 Plumbing Connections - When
~home has been connected to
water and sewer,
~ectrlcal Connection - When
~~Iocklng, set-up, and plumbing
, Inspections have been approved
and the home Is connected to
the service panel.
~Inal - After all required
Inspections are approve!=! and,
orches, skirting, decks-, af}d
venting have been Installed.
Lot faces
lot ~yP. '
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Panhandle
-
Total height Cul-de-sac
BUILDING PERMIT
ITEM sa. FT. x $/ sa, FT, =
ty1al n
Garage
Carport
Total Value
Building Permit Fee
I
State Surcharge
Total Fee
(A)
.
( IS THE PROPOSED WORK, tN THE. '
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior t9 permit Issuance.
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Setbacks '
HSE GAR ACC
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IN
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W
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VALUE
'.
SYSTEMS DEVELOPMENT CHARGE (SDC)
, ',(B),
,P.LUMBING PERMIT
"ITEM'
Fixtures
Residential Bath(s) NO
Sanitary Sewer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
,7J+,.(.r
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
s; Z.r -r J,I.r
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits . (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
t..
. I"'
FEE
/ S If10
/ ~ .2.0
/n ~(X)
- '.
2D 0- 0
~W
'.
/,1,-:S ~O
/-i!J-_60
I APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition that the said
construc'tion shall\ In all respects, conform to the Ordinance
adopted by; the City of Springfield, includll')g 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.
Plan Check Fee:
Date Paid:
Receipt Number:
Received By: '
I
.
},
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties, within the CitY,"ml.ts which are being Improved.
, .
ADDITIONAL COMMENTS
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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 acco'rdance
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.
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 pro , and the approved set of plans will remain
on the site t al imes duri g construction.
~nature
Date
VALIDATION:
1
RECEIPT NUMBER / r 19 ,7
lygA'~
I I I
AMOUNT RECEIVED ~J.l; , ~.-o
RECEIVED BY ~ .........~
DATE PAID
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