HomeMy WebLinkAboutPermit Plumbing 1995-1-26
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RESIDENTIAL '".:"
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
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ASSESSORS MAP'
LOT'
DESCRIBE WORK' Add
REMODEL '1..'
NEW
ADDITION
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BLOCK:
STATE: ,(") r- ~
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JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION:
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6&]-"1010
, ZIP:
Q7'i77
11\1..+..<," IN_" ftJR-c.A ;Ne
o Rough MechanIcal"":' Prior to
cover.
o Rough ElectrIcal - 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.
o Well/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After I~staflatlon,
o Insert - After fireplace apprOY41
and Installation of unit.
o Curbcut & Approach - After
. forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base materIal In place.
[J Fen~e. - When .Cor:PIf3ted.
o Streel Trees - When all required
trees are. planted.
CONST,
CONTRACTOR'S NAME ADDRESS' CONTRACTOR #
GENERAL: E A- 't-I 8..J; 'r ~II... PI /:>1350 CJ,II,"J,,,~ l'"".._
PLUMBING: 1",1\",' Ftl~Y'h rIb ''1.50 CI,~",k'4 e,:,:,e.-..<
. DEMOLISH
OTHER
MECHANICAL:
ELECTRICAl'
EXPIRES
it7 '130 /0/''1/'1.5
~7 '1.30 14/9/9'05
PHONE
.3 '1'1 b '102..
'3 '1'1" ?tJL
- OFFICE USE -
QUAD AREA- LAND USE: FLOOD PLAIN:
# OF BLDGS: . OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SQUARE FOOTAGE:
To request 8nlnspectlon, you must call 726-3769. Thls-ls'8 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. ~1I1 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 Plumblng/Electrlcall
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.
o Underfloor Plumblng/Mechanlcel
-.Prlor to Insulation or decking,
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Pr!or to
deckl ng. '.
o Sanitary Sew~r - Prior to filling
trench.
o Storm, Sewer - Prior to filling
trenc~. .
o Wetor Line - Prior to filling
trench.
IN1 Rough Plumbing - Prior to
~cover.
~ Final Plumbing - When all
~plumblng wC;:Hk Is complet.c.
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - Whon all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking end Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and se'wer.
o Elect~lcal Connection - 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
venting have been Installed.
/J
Lot faces
Lot sq. Itg.
Lot coverage
Topography
Total height
Main,
Garage
C~rport
Total Value
Building Permit Fee
State Surcharge
Tolal Fee
L~t'~yP.
Interior
Corner
Panhandle
Cul.de.sac
X $/sa. FT. -
(A)
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'_IS THEPROPOSED 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.
I' PL.
IN
Is
\W
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Setbacks.
HSE GAR ACe' I
I
I
I
I
VALUE
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. '. ,
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT,
Water FT,
Storm Sewer' FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
A
(e)
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
fl
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
-I
l
FEE
ctJ()
rJO,CU
t.ld:)
r<)1.{~
TD)'AL-AMOUNT_D.!!~ (excludl ng electrical)
(A, B, Co D, and E Combined)
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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, Including 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: '
".
Plans Reviewed By
, f .
Date
Systems Development Charge is due on ~II undeveloped
properties within the City i1mlts which are being Improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefuily examined
the completed application and do hereby certify that all
Information hereon is true and correct, and I further certify
that any and ail work 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.,
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.
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Signature
Date
VALIDATION:
RECEIPT NUMBER
DATE PAir,
AMOUNT RECElvcn,
RECEIVED BY
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