HomeMy WebLinkAboutPermit Plumbing 1999-5-17
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
..
ASSESSORS MAP:
LOCATION OF PROPOSED WORt<.
I7b>)...7]...i-
LOT'
BLOCK'
OWNER'
ADDRESS:
CITY:
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22 3 3 /)o.?:.. J~.-I.
,<:::;/J "cc:...n
a(l.Ar~ c.-t,
DESCRIBE WORK'
fA. 5" 1/ ^-.Q
NEW
REMODEL
ADDITION
ELECTRICA' .
QUAD AREA:
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER'
STAT'" .
c;:rlZ-
-. :"'II
'\::
.
971)657
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
,1-ln
TAX LOT:
SUBDIVISION:
07~(
PHON'"
7~4-P/ 9<<
ZIP'
97477
/M.e,.. t
~ 1oJ~ 1/-1 e-t
o Rough Mechanlcai, '....:. 'Prlor, to
cover,
o Rough Electrical - Prior to
cover,
o Electrical Service - Must be
approved to obtain permanent
electrical power.
ADDRESS
CONST.
CONTRACTOR'
,~
o Fireplace - Prior to facing
materials and framing Insp.
o Drywall - Prior to taping.
'.
o Wood Stovo - After Installation,
O Insert - After fireplace approval
and Installation of unit,
o Curboul .. Ar.proooh - AUor
forms are erected but prior to
placement of concrete,
o Sidewalk" Driveway - After
excavation Is complete. forms
and 'subobaso" material In place,
o Fence, - When completed.
DSt~oel Trees - When all required
trees Bre planted,
EXPIRES
PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING' / J /// .
MECHANICAI;Hm~A,N64-.5H.P'?V~/C~"~.<ltC& 77(,;, ~/
DEMOLISH
OTHER
1t9;'?J<J
-B-q-q'.6 (f 6
AFFE9ffil,glil:llI>sf,v.1 law requires you to
f~W~W rules adopted by the Oregon Utilitv
LAND: .. FLDOD PLAIN'
NO II attU11 vtUlltH. IIIUo:.t: IUllOS are Sel1U1'Th
· oRn.ll'ilIlllS~~:>-O01.0n10throlJghOAR95:2S~lNG CODE:_
CO OOQO y,YO~ may obtain copies of the rules by.
N~R~ p. 'OFBDRM&
calling "tt<"",,,,,. \",u<".llr"telePhone
HEAT BOlIlBSBnrlhFl Cl,<>nnn 111ili1y NotificcSirooNllARY HEAT:
Center is 1-800-332-2344).
RANGE: _ SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested belore 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.
REQUIRED INSPECTIONS
o Temporary Electric
O 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 Plu~blng - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
I
o Pool and B08m - Prior to floor
Insulation or dec~lng,
O Floor Insulallon - Prior 10
doo~1 ng.
o Sanitary Sewer - Prior to filling
trench, '
o Storm Sewer - Prior to filling
trench. .
,
o Water Line - Prior to filling
trench. .
o Rough Plu~blng - Prior to
cover, I
o Final Plumbing - When all
"piumblng w~)fl( Is complet.e,
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
med,anlcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building I.
completed.
o Fra;"lng - Prior 10 cover. ~ ). ~A. /,
. , L9,Other Lr,,) /Ovp'
o Wail/Ceiling Insulation - Prior to
cover, .
MOBILE HOME INSPECTIONS
D Blocking and Sel.Up - When all
blocking Is complete.
D Plumbing Connoollon8 - When
homo hoe boen conneoted to
water and sewer,
o Electrical Connection - When
blocking, set.up. and plumbing
Inspecllons 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
venting have been Installed.
('
"
......---"
Lot faces
.,
L~l~.
Interior
Lot sq. Itg.
Lot coverage
Corner
Panhandle ;.:
Topography
Total height
Cul.de.sac
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IN
Is
Iw
I'E
BUILDING PERMIT '!, .,t
ITEM SO. FT. X $/SO. FT. a VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fec
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
I
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan NO
Wood Stov~'~lrePlace Unit
O?,er Vent ~
(rA5 It/VR
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
.'
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C, 0, and E Combined)
F E';.--
I~
Ie), U?
~5'/ 7 )
~!. 2- ~
IS": ~ 0
1r.~O
I{r;. ~-
). ? :u
~
.
Setbacks. ....
HSE GAR .ACC'I
I
I
I
I
: .IS THEPROPO~ED WORK IN THE.
-HISTORICAL DISTRICT, OR ON
THE HisTORIC~L REGISTER?
If yes, this apPll.catlon must be signed
and approved by the Historical
,
" Coordinator prlbr to permit issuance,
\
APPROVED: 1.
BUILDING VAUJ'E, 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, Including the
Development Code, regulating the construction and use of
oulldlngs, 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:
Plans Reviewed By
Date
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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 accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon perlalning to the work described
herein, and that NO OCCUPANCY will be made of any
structure wllhout 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 site at,all tim':,s, ~u~~onstructlon,
Slgnaturpz;tl~ ~
Date
0-0-9 }?
VALIDATION:
RECEIPT NUMBER o $ <{() '-( I I
DATE PAID s/'7/11
AMOUNT RECEIVED J,2,QO
RECEIVED BY tJ~ l