HomeMy WebLinkAboutPermit Plumbing 1994-8-16
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
LOT'
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SPRINGFIELD
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53 s~' lL/f7,~ #- /,('2-
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BLOCK:
OWNER: S)rAJp/flt/J /\<<)Td../b4#,T":. J./LLA-..
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ADDRESS~ ,~~2-2. A/6 ~/l~~ ~'?
CITY: "A,.(.#'~\ STATE:
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JOB NUMBER
9fI2~f!3
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: ~)/' 3 ~
SUBDIVISION:
PHONE:
'75""2 -22~~
ZIP:
97 _<' ,,7 tJ
DESCRIBE WORK'
~/A ~-'L!~ /~} A~/c:
NEW
REMODEL
ADDITION
OTHER
CONTRACTOR'S NAME
)(GENERAL: ...i.I.L~O/lly-.r~
PLUMBING:
MECHANICAl'
ELECTRICAL:
DEMOLISH
ADDRESS'
CONST.
CONTRACTOR #
EXPIRES
I~o/ff
PHONE
92r; -€&~<i
.
332/ ~H"~1. S,E 'A-Wh/1 QtJO<t..4
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,
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical!
Mechanical - Prior to cover.
, 0 Footing - After trenches are
excavated. '
D Masonry - Steel location, bond
beams, grouting.
D Foundation .:.. After forms are
erected ,but- prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
O Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o 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. '
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical"":' Prior to
cover.
D Rough'Eh:!ctrlcal - Prior to
cover.
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.
, I
o Wail/Ceiling Insl!latlon - Prior to
cover. '
o Drywall - Prior to taping.
, '.
o Wood Stove - After Installation.
D Insert - After fireplace approvl!ll
and Installation of unit.
D Curbcut & Approach "7 After
forms are erected but prior to
placement of cOljlcrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
D Fence - When completed.
D Street Trees - When all require
trees are planted. ,
D Final Plumbing - When all
plumbing W9rk Is complete.
D Final Electrical - V\lhen all
electrical work Is complete. C
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
D Other
MOBILE HOME INSPECTIONS
~'Blocklng and Set.Up - Whefl"all
/' "-J -blocking Is complete. '
~~mblng Connections - When
/ ~~e has been connected to '
, water and sewer,
~Electrlcal Connection - When
blocking, set.up, and pluroblng
Inspections have been approved
and the home Is connected to
the service panel.
Final - After all required
'Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
"
Lot faces
Lot ~ype .
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~(. 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 to permit Issuance.
Lot sq. ftg.
Interior
I' p.L.
IN'
Setbacks '
HSE GAR ACC'
Lot coverage
Corner
Topography
Total h,elght
Panhandle
S
Cul.de-sac
W
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APPROVED:
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT, = VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Gar.age
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 constructl.on 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
Receipt Number'
Building Permit Fee
State Surcharge
Total Fee
Received By: '
(A)
r-
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
Flx~ures
.
Residential Bath(s)
NO
Sanitary Sewer
Water
FT,
FT.
FT.
Storm Sewer
Mobile Home
/ <' fJ-()
, _ F
Plumbing Permit
State Surcharge
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(C)
,7.J"
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/ c...~~O
Total Charge
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 alhvork 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/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
,
Issuahce
State :Surcharge
Total Permit
State Surcharge
Sidewalk
.f~~r,o,
J,?) c:;, o,€)
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"2-&t't::JIl>
5:2f
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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.
~nalu'e ~ II. W~ .........'.r
f{1t(P(~4{
Date
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
ft
Curbcut
ft
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
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VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
Jd.3r/~
B/)~/Ici
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State Surcharge
Total Miscellaneous Permits . (E)
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