HomeMy WebLinkAboutPermit Plumbing 1995-8-30
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
qtlice: 726.3759
LOT:
.
SPRINGFIELD
.'
Qs \Dl~-
BLOCK:
JOB NUMBER
TAX LOT:
SUBDIVISION:
PHON~'
(~i"f\O ..> ,
vrL ~l4.-f}\W
n .t-"\\~ \\~ \ STATE: (~~
l \"'O-t..o 1{ <1tQfU 0 J?
CITY:
DESCRIBE WORK:' ('~()JJ
NEW REMODl<.'\
ZIP:
U~SCtL
-
ADDITION
DEMOLISH
OTHER
CONTRACTOR'S NAME
Pj-iONE
GENERAl' j
PLUMBING:...........\ 1
MECHANICAL'
ELECTRICAL'
~vnoY _.
ADDRESS
CON ST.
CONTRACTOR'
EXPI R ES
I
qQtl-~vP
t
4lri\ - -11:3 \
QUAD AREA:
. OF BLDGS'
OCCY GROUP:
. OF STORIES:_
WATER HEATER:
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE: __
FLOOD PLAIN'
ZONING CODE:_
. OF BDRMS'
SECONDARY HEAT:
SOUARE FOOTAGE: ___
To requesl an inspecllon, you must call 726.3769. This Is a 24 hour recording, Alllnspectlons requested before 7:00 a.m. will be
made tho same working day, Inspections rOQuested aftor 7:00 a.m. will bo made tho following work day.
o Tomporary Electric
o
Silo Inspoction - To be mado
after excavation, but p"rlor to
setting forllls.
o Underslllb Plumbing/ Electricall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steer location, bond
beams, grouting.
o
Foundation - After forms are
erected but prIor to concrete
placement.
o Undorground Plumbing - Prior
to f1l1lnQ trench.
o
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o
Post and Boa~ - PrIor to floor
Insulation or docking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to rUling
tronch.
o Storm Sewor - Prior 10 filling
trench.
o Water Line - Prior to filling
trench. .
udJ Rough Plumbing - Prior 10
cover.
REQUIRED INSPECTIONS
o Rough Mochanlcal - Prior to
cover.
o Rough Electrical - Prior to
cover. '
o Electrical Servlco - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Fram.lng - Prior to cover.
.0 Wail/Coiling Insulation - Prior to
cover. .
o Drywall - Prior to laplng.
o Wood Stovo - Aftor Installation.
o Inserl - After fireplace approvlSl
and Installallon of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placemont of concrote.
o Sidewalk & Driveway - Atter
excavation Is completc, forms
and sub.base material In place.
o Fence - When com~leted.
o Street Troes - When all required
trees are planted.
~Inal Plumbing - When all
plumbIng w9.rl< Is complet.e.
o Final Electrical - When all
electrical work Is complete.
~Inal Mechllnlcal - When all
mechanIcal work Is complete.
o
Final Building - When 'all "
required Inspections have been
approved and building Is
completed.
o Olhor
MOBILE HOME INSPECTIONS
o Blocking and Sot,Up - When all
blocking Is complete,
,
o Plumbing Connocllons - When
home has been connected to
water and sewer.
o
Electrical Connocllon - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
ventlng hnve been Installed,
Lot faces
Lol Type _.
Interior
Lot sq. fig.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de-sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garago
Carport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Flxlures
Resldenllal Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
MechanIcal Permit
Issuance
Slale Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demollllon
State Surcharge
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding olectrlcal)
(A, B, C, 0, and E Combined)
:_ THE PROPOSED WORK IN 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.
Setbacks
I P.L. HSE GAR ACC
IN
Is
Iw
IE
VALUE
"
FEE
k') ,(fU
-.'{.2.0
j1oJ.D
11a .l{ J
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 O~dlnance
adopted by the City of Springfield, including Ihe
Development Code, regulating the cOf')51ruction and use of
buildings, and may be suspended or revokod at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: __
Date Paid:
Receipt Numbcr:__.__~
Recelvod By:
Plans Rcvlewcd-.8y----------
Dale
Systems Development Charge Is due on all undeveloped
'properties within tll(J City limits which are being improved.
ADDITIONAL COMMENTS
,By signature, I slale and agree, thai I have cnrolully examined
the completed application and do hereby certify that all
Informallon hereon Is true and correcl, and I further certlly
that any and all work performed shall be done in accordance
with the Ordinances oflhe City or Springfield, and the Laws
of the State of Oregon pertaIning to the work described
heroIn, and that NO OCCUPANCY will be made of any
structure without permission of Ihe Bulldll1g Safety Division.
I further cerllfy that only contractors and employees who
ara tn compliance wllh ORS 701.055 will be used on this
prolect.
I further agree to ensuro 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 fronl
of the property, and the approved set of plans will remaIn
I, (::,~::":.: '" ~~"?ll1~
Date 7;/ ~ f7 / 9rf
VALIDATION: \<X/ l
RECEIPT NUMBER ,07::> I
DATE PAID f')':--'J ( ) . y.:::;-
AMOUNT RECE,Il:!J. ...1 In . 'l.r )
.. RECEIVED BY D ~ ~ '