HomeMy WebLinkAboutPermit Plumbing 1994-6-3
RESIDENTIAL"
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT' .
=-
, BLOCK'
J!73'
STAT'" '
075'.
.~.
~
JOB NUMBER
9<1 ()fJ'J'/
I
~"
TAX LOT" tfJ2.c{():)
SUBDIVISION: 7f'",..~ A~!"":-,,
v ~"l,-:---F I
PHONE: 6~~ ~S y~
ZIP'
43?7"~<.
DESCRIBE WORK: /1/..~/~ <:. ?~;:I}"~. ?;'!~/T~~ .~:/ ~~-r' Z-b ~ ~
NEW REMODEL ADDITION" DEMOLISH OTHER~ ~C :::;r::s-
CONST.
CONTRACTOR'S NAME ADDRESS' CONTRACTOR # EXPIRES PHONE
GENERA' '
PLUMBIN'"
MECHANICAl'
ELECTRICA' .
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS' # OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
· OF STORIES: HEAT SOURC'" SECONDARY HEAT:
WATER HEATER: RANGF' SQUARE FO,OTAGE:
To request an Inspection, you must call 726,3769. This Is a24 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.
REQUIRED INSPECTIONS
D Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D Fooling - After trenches are
excavated.' .
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected' but- prior to' concrete
placement.
D Underground Plumbing - Prior
to filling trench,
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
O Post and Beam - Prior to floor
Insulation or decking,
D Floor Insulation - Prior to
decking.
ri/l Sanitary Sewer - Prior to filling
!4-l trench.
r71 Storm Sewer - Prior to f1t1lng
~ trench. .
r.7I Water Lint' - Prtor to filling
L+-J trench.
D Rough Plumbing - Prior to
cover.
D Rough Mech~nlcal ...; Prior to
cover. .
o Roug"h'-Electrlcal ~ Prior-to
. cover. ".
o Electrical Service - Must be
approved to obtain .permanent
electrical power. :r ""}:..~
D Fireplace - prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wafl/Celllng Insulation - Prior to
cove~' .
D Drywall .,.. prl,or to taping,
D Wood Stove - After histallatlon,
D Insert - After fireplace approval
and Installation of unit.
D 'Curbcut & Approach - After
forms are erected but prior to
placement of concret.e.
D Sidewalk & Driveway - After
excavation Is completo, forms
and 'sub-base' material In place.
o F~n~e. - When cO~Pleted.
o ,Street Trees - When all required
trees are planted.
D Flnel Plumbing - When all
.plumblng W9rk Is complet,e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed,
D'Olher
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete, '
.
D Plumbing Connections - When
home has been connected to
water and sewer. '
D Electrical Connection - When
blocking, set,up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
r
""~,,,.
'.. ,
Lot TYpe
Lot faces
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul,de,sac
. "('i< \.<:i ':" ~ 'I'I';";::"'~ ~:/ ':j}~'~e1.;"~:~
.,
,
.S THE PROPOSED WORK IN THE"
""HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, thla application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks '
HSE GAR ACC
1'p'L.
IN
Is'
Iw
IE
, BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT, = VALUE
Main' '
.
Garage
Carport
"
'.
Total Value
,
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT, J;:?"=3
Water FT, ~~
Storm Sewer FT. ~"3
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanlcat Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
Sidewalk It
Curbcul It
Demolition
State Surcharge
Total Mlscelleneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and E Combined)
"
-,~
.
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, regulatlng'the construction and use of
buildings, and may be suspended or revoked at any time
upon vlotallon of any provisions 'of s~ld 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
FEE
<-/e::>
t/tP
~t7
/20,60
6.~
..,. -""~
... -
/2 9, tt:o
"
By signature, I stale and agree, that I have carefully examined
the completed appllcallon 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 OrdJnanc~s of the City of Sprlngfleid, 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 ~gree to ensure that all required Inspections are
requested at the proper lime; that each address Is readable
from the street, that the permit card Is located at the front
of the prop~ and the approved set of plans will remain
~[pi;fL 'ru"'~
-'
VALIDATION:
RECEIPT NUMBER
J,</8~
6,/r/#,
/? ,'({.O
A/,:l;::;~
DATE PAl"
AMOUNT RECEIVED
RECEIVED BY
,