HomeMy WebLinkAboutPermit Plumbing 1994-3-25
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
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ASSESSORS MAP:
LOT
OWNER'
ADDRE"'"
CITY'
.
SPRINGFIELD
.
9' 3/20 c/
JOB NUMBER
225 Fifth Street
Springfield, O'egon 97477
& ('17b'iA &
?- 2- ' TAX LOT:
r'? 5-
BLOCK' '
STATE"
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('jle:7- C/t~ 7Z'k.
-1/1/ H:b (- 77:77 A-
5~/'7) ,
C1:9~~.
SUBDIVISION'
PHONE:
4-f4 9 - 77'-:::;;;
ZIP: "7J7 ?,76
DESCRIBE WORJ<'
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NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
?x,r.
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR #
PHONE
GENERA' '
PLUMBING: ;,.L-41'AYA!.-f?7'MJ ,f/?&/h-r
MECHANICA' '
ELECTRICA' '
5St'OBf
EXPIRES
~b/q,
u;~c; ~?-
''"- OFFICE USE -
QUAD AREA- LAND USF' FLOOD PLAIN'
# OF BLDGS' # OF UNIT'" ZONING CODE:
OCCY GROUP' CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURC'" SECONDARY HEAT:
WATER HEATER: RANGF' SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, All Inspections ,equested 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.
o Underslab Plumbing/Electrical/
Mechanical - PrIor to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After fo'rms are
erected' but prior to concrete
placeme~t.
~nderground Plumbing - Prior
to filling trench,
D Un artlaor Plumbing/Mechanical
-.Prlor to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng,
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench. .
o Water Line - Prior to filling
trench.
\f7'i Rough Plumbing - Prior to
~.cover.
REQUIRED INSPECTIONS
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 Inop,
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stove - After l~stallat'lon.
o Insert - After fireplace approval
and Installation of unit,
o Curbcut & Approach - Afte'
. forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
. excavation Is complete, forms
and s.ub-base material In place.
o Fence - When completed,
o Street Trees - When'all required
trees are planted.
K/j"Flnal Plumbing - When all
~mblng work Is complet,e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete. '
o Plumbing Connections - When
home has been connected to ,
water .and sewer.
.
o Electrical 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.
Lot faces - Lot Type . Setbacks l~ THE PROPOSED WORK IN THE
Lot sq, ltg, Interlor I P.L. HSE GAR ACC I ""HISTORICAL DISTRICT, OR ON
- IN I THE HISTORICAL REGISTER?
Lot coverage Corner if yes, this application must be signed
Is I and approved by the Historical
Topography j Panhandle
~ Iw Coordinator prior to permit Issuance.
Total height - Cul.de.sac IE
APPROVED:
BUILDING PERMIT:
ITEM SQ, FT, X $/SQ, FT, = VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
I
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
I (B)
PLUMBING ~ERMIT
ITEM
FEE
/,?1 /A.J .
,
I
J
Flxtu res
Residential Bath(s)
Sanitary Sewer
Water
N'
FT.
FT,
Storm Sewer
FT,
Mobile Home
Plumbing Permit
State Surcharge!
I
, r" b75i
/':"'"J.
,--;)
/5..7,}
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellns~rt/Flreplace Unit
Dryer Vent
,
Mechanical perrillt
Issuance
State Surcharge I
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
I
I
State Issuance I
State Surcharge,
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and ~ Combined)
!
) 5. 7.r
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
Date
Systems Development 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'Clty 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 prop~rty, a the approved set of plans will remoln
on the site at I mes d/lng rnst:u~~n,
){:gnature , r: j;Jy
1/lj;/q4
Oat'"
VALIDATION:
/21Yc.-o
\/2f?,~
/:5,7r
#>t:-.
RECEiPT NUMBER
DATE PAIr'
AMOUNT RECEIVED
RECEIVED BY
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