HomeMy WebLinkAboutPermit Plumbing 1994-9-21
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: '126.3769
Office: 726-3759
SPRINGFIELD
.
9cf J"9D~
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: /? t) 2...
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5':?"3~ L)fr/'?~ rT , c,,/, ~/39
TAX LOT: ~ I,~ ('Jf)
SUBDIVISION:
LOT'
BLOCK:
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OWNER:<,P n}fJ y" IT t5' r? ~', ~S
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ADDRESS: '7 y-~ tv, /V '$r,. ./ /,/h ~~-? /",. ~
CITY' 'S,p /t-7 r// h ,'YZ.e,P STATE: /),t-
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DESCRIBE WORK: /Y 0 13,' ~ ~
NEW -r
PHONE: 7~- ~~?
/J,z _ ~ 7~?J
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ZIP: .:tf7~' D
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REMODEL
ADDITION
OTHER
DEMOLISH
CONST.
CONTRACTOR'S NAME ADDRESS' , CONTRACTOR #
GENERAI'~~"C t <;"d}f-IJ 'J;:;~2~/i;;'a~~t;.rR ~/ ~ 9)
".... .' /' 15-75 'So, v It .,
PLUMBING:h7e~ &m,,;7'7?l..,- ~tpl'7''''..e',~;e-Vt:-- ~67'5-o
'. / .
MECHANICAL'
ELECTRICAL: ~H7 r~Z
,
n... ./ -
,- ,,<-
QUAD AREA: ~:==; E
# OF BLDGS'
OCCY GROUP'
# OF STORIES:
WATER HEATER'
EXPIRES PHONE
t'P'i ,4} ).~ '
C,-/?-'95 ?I'f?- ';'~e4
,o~~ H-P~ ~
Af? p.,....e / n~. e;, ~ ~
~-";lfJO c -
?.y~ -$ //.?I"n ~17
W~/"De
- OFFICE USE -
L /)A?
I
LAND USF'
FLOOD PLAIN:
ZONING CODE:
# OF BDRMS:
,
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
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 after 7:00 a.m. will be made the following work day,
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o 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.
REQUIRED INSPl;CTIONS
o Rough Mechanical ~ Prior to
cover,
o Final Plumbing - When all
plumbing w9rk Is complet,e.
D RoughElectrlc~1 ....,. Prior to
cover.
D Final Electrical - \/Vohen all
electrical work Is complete. C
o Electrical Service - Must be
approved to obtain permanent
electrical power,
o 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.
o Other
o Wall/CelJlng Insulation - Prior to
cover.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
O Underfloor Plumbing/Mechanical 0 Wood Stove - Aft,er Instal.latlon.
- 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. '
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
o Insert - After fireplace approvl!Il
and Installation of unit.
~IOCklng and Set,Up - W~efl'all
blocking Is complete.
I
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
~Iumblng Connections - When
home has been connected to '
water and sewer.
o Sidewalk & Driveway - After
excavation Is complete, forms
and 'sub-base material In place,
I ~Electrlcal Connection - When
~ blocking, set-up, and plurvblng
Inspections have been approved
and the home Is connected to
the service panel.
o Fence - When completed.
..
IKI Final - After all required
T Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
D Street Trees - When all required
trees are planted. " ,
.
Lot faces
Lot ~ype .
Lot sq. ftg,
Interior
Lot coverage
Corner
Topography
Total height
.
Panhandle
Cul-de.sac
. .~:
; .... ;'.
'...
'", ',:, : ;: ,; :i?\H/\}
\ .THE PROPOSED WORK tN THE_
'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER? /L-O
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks '
HSE GAR ACC'
I P.L.
IN
Is
Iw
IE
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT. '" VALUE
Main
Gatage
Carport
Total Value
Building Permit Fee
Slale Surcharge
Total Fee
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
,
.
Residential Bath(s)
NO
Sanitary Sewer
Water
FT,
Storm Sewer
FT.
FT.
Mobile Home
Plumbing Permit
State Surcharge
..
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State ;Surcharge
Total Permit
(D)
MISCEllANEOUS PERMITS
Mobile Home
- ,
"
State Issuance
State Surcharge
..
Sidewalk
ft
Curbcul
ft
'.
Demolition
"
.
State Surcharge
.~ Az:;llM-~..,i2.Q~
Total' Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
, '
/560
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d~
. (-
/ c.., ~ 2.ID
/6J5' ~
20,6-tJ
s: 2.1"
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APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT '
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, 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:}b~
. ~Ians {~e~d By
f?f?4c;L
Daile I '
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
5&:?A>::(A7'E.. e!:?7- ~e/I"t~'__ 4~~/
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.,faJ.I)/AM g?~ 7lJ ;},F 5~......./~
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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 allwork performed shall be done in accordance
with the Ordinancl:ls 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 property, and the approved set of plans will remain
on the s 9.."' all times "mlng CO~__
SI :;:;r;;;r~.n.1? .AI '......,,'
- I
Date
VALIDATION:
RECEIPT NUMBER ilf-7X't"
Cj -~ -cry
DATE PAID
Lc:' ~ ~, ~
AMOUNT RECEIVED ~"'3 7- ,
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RECEIVED BY