HomeMy WebLinkAboutPermit Plumbing 1996-6-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
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SPRINGFIELD
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JOB NUMBER
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225 Fifth Street
Sprlngileld, Oregon 97477
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LOCATION OF PROPOSED WORI<" .::;- /? / 7~'Sy?AV.A2' ;>~.
ASSESSORS MAP' $-..:::7:2 -0</- 2/
OWNER: I/i/.. 7. #.n'~e~/,/7:1
ADDRESS:' ~ -:;:.>/ -J:-~??rSo/?#d
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LOT'
CITY'
,
,
BLOCK'
TAX LOT: ~~
SUBDIVISION:
PHONE' -.?"7"~ -1?:'::>$ '/
STATE:
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DESCRIBE WORK: 4/~?L ~A <r-~.a- ,~ :v V'-,//17
,
NEW REMODEL ADDITION DEMOLISH OTHER
CONTRACTOR'S NAME
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GENERAL:..(~""~
PLUMBING:
MECHANICAl'
ELECTRICAl'
~~- .-
l/~'-"'-::'.. ..- '..J .-
ADDRESS
CON ST.
CONTRACTOR'
PHONE
EXPIRES
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITf" ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER,HEATER: RANGE:' SQUARE F09TAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons reQuesled before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 8.m. will be made the (ollowlng work day.
o Temporary EI~ctrlc
O Site Inspection - To be made
after excavation, but _prior to
setting forms.
o Underslab Plumblng/Electrlca"
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 Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insufatlon or decking.
o Floor Ins~la!lon - Prior to,
decking.
'0 Sanitary Sewer - Prior to filling
trench.
n7l Storm Sewer, - Prior to filling
L.L-J trench.
o Water Line - Prior to filling'
trench.
o Rough Plumbing - Prior to
cover.
,
REQUIRED INSPECTIONS.
o Rough Mechanlcai - Prior to
cover.
D 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 Wail/Ceiling Insulation - Prior to
cover. .
o Drywall - Prior to taping.
o Wood Stovo - After l~stallatlOn.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Al,proach - After
forms are erected but prior to
placement of concrete.
O Sidewalk & Drtvew.y - Alter
excavation Is complete, forms
and sub-base material In place.
o Fence - Wnen completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing worl< Is complete.
, ,
D Final Electrical - Wnen all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approvlJd and building Is
completed.
lEI Othor _(/Ar tr/CLL
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When .11
blockln,;) Is complete.
o Plumbing Connoctlons - When
home has been connected to
. water and sewer.
o Electrical Connection - When
, blocklnU, sel.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 TY.
Lot faces
Lot sq. ltg.-
Interior
Lot coverage
Corner
Topography
Panhandle
Total heIght
Cul-de.sac
I P.L.
IN
Is
Iw
IE
BUILDING PERMIT
ITEM SO. FT. X $/SO, FT. = VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
~p~sewe\ ~ FT.
'U'7Pr '?'~?i'"'?c.
oblle Home
Plumbing Permit
Pi
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco .
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
It
It
Curbcut
Demolition
State Surcharge
. ,
.. .Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C, 0, and E Combined)
"
FEE
2 &;-. -
'7q jfY-
7"7~'
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27, c;::q?
'77
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Setbacks
HSE GAR Accl
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. IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be slgn~d
and approved by the Historical
CoordInator prior to permit Issuance.
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
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 City of Springfield, and the Laws
of the State of Oregon perlalnlng 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
01 the property, and the approved set of plans will remain
on the site at all limes during construction,
Signature ~/.':' I~:-~ _ ~q
Datet,-/9-9b ('/~ -------
'-.../
VALIDATION:
RECEIPT NUMBER 7209/
DATE PAID L'l'*7-%
o"""? --, -<?'
AMOUNT RECEIVEn, ...c. /-
RECEIVED BY __~~~
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