HomeMy WebLinkAboutPermit Plumbing 1994-6-3
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSI~P{I~' ~~ ,
ASSESSORS MAP: \ 't>urlfr\Ct) "
LOT' <7 BLOCI<'
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JOB NUMBER ~ < - -'. !,,~
225 Flllh Street Cl400(B
Springfield, Oregon '9~477
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SUBDIVISION: Jf/{~ ~'. ~
OWNER' .?/n /~OC~A/ '
ADDRESS' -::z.'g'C'J .~ /~~~z?<3'
CITY' &~~~ ' STATF' '
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PHONE: 6~;5 ~S y~
,ZIP'
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DESCRIBE WORK' ./f/,"177'?C<:" ~?;>~ 71f1?TA,/? ,"'" t-f.. f;r.-~ j,~ Z~ L:,.;- _
NEW REMODEL ADDITION" DEMOLISH OTHER~#l}./~.c- ;/,;)
CONTRACTOR'S NAME
GENERAl'
PLUMBIN(-"
MECHANICA' .
ELECTRICAl'
ADDRESS'
CONST.
,CONTRACTOR .
PHONE
EXPIRES
- OFFICE USE -
QUAD AREA: LAND U~~' FLOOD PLAIN'
. OF BLDG"" · OF UNITS' ZONING CODE:
. OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
· OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a24 hour recording, All Inspections requesled before 7:00 a,m, will be
made the same working day, Inspections requested aller 7:00 a.m. will be made the following work day,
REQUIRED INSPECTIONS
o Temporary Electric
o Slto 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 Mesonry - Steel location, bond
,beams, grouting.
o Foundetlon - After forms are
erected'but prior to 'concrete
placement.
o Underground Plumbing - Prior
to filling Irench.
O Underlloor Plumblng/Mechenlcal
- Prior to Insulation or decking,
o Post and Beam - Prior to 1I00r
Insulation or decking. .
...:;:;-- ' ,
o Floor Insulation - Prior to
decking. ,
fI/I Sanitary Sewer - Prior to filling
J,A.J trench.
r71 Storm Sewer - Prior to ""Ing
\.4-l trench. '
r.7l Water Line - Prior to filling
~ trench.' . ..~,}
o Rough Plumbing - Prior to
cover.
o Rough Mechanlca' ...: Prior to
. cover.
D Rouo'h'.-Electrlcal ~ Prior. to
. cover. . '.
o Electrical Service - Must be
approved to obtain .,permanent
electrical power. :r ~:,.:;
o Fireplace - Prior to facing
materials and framing Insp.
o ~ramlng - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cove~ .
o Drywall .,.. Prior to taping.
o Wood Stove - After Installation,
o Insert - After IIreplace approvet
and Installation of unit.
DCurbcut & Approach - Aller
forms are erected but prior to
placement of concret.e.
o Sidewalk & Driveway - After
excavation Is completo, forms
and'sub..base'materlalln place.
o Fence - When completed,
D Street Treu8 - When all required
trees are planted.
o Final Plumbing - When all
plumbing W9rk Is complet,e.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanIcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
D'Olher
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is comptele. '
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
btocklng, 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.
''\. .","" .1
Lot faces Lot Type .
P.L.
Lot sq. fig. - Interior
Lot coverage Corner N
Topography Panhandle S
Iw
Total height Cul.de.sac
IE
Setbacks '
HSE GAR
.,
BUILDING PERMIT
ITEM
sa. FT.
x s/sa. FT, -
VALUE
Main
,
Garage
Carport
"
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDe)
(B)
PLUMBING PERMIT
ITEM'
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT, ~"3
Water FT, ~~
Storm Sewer FT. ~7
Mobile Home
...:.:~.
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Accl
I
I
(_ THE PROPOSED WORK IN THE. '
'lllllWISTOJ:lICAL DISTRICT, OR ON
THE HISlORICAL REGISTER?
If yes, this application must be signed
and approved by the Hlatorlcal
, Coordinator prior to permit Issuance.
APPROVED: '
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is gran led 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'Revlewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
~ ADDITIONAL COMMENTS
FEE
,-/p
r't:'
~t7
Ptumblng Permit
State Surcharge
Total Charge
/20.60
b.P<?
. '3 ~,-;.
12...9 . 60
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
Sidewalk fI
Curbcut fI
, '. Demolition
',State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
.
By signature, I state 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 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, sl t all times d'1'g.t<t,S sttrruuccttlhon.
~nat Jt!31~'
7....)/ f
VALIDATION:
RECEIPT NUMBER
/</~,(;
. /'
tF/.?r /')'~
/).9~
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DATE PAIr>
AMOUNT RECEIVEP
RECEIVED BY