HomeMy WebLinkAboutPermit Plumbing 1996-2-12
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPqS,lT9.,.W~RK: _ ~ \ D
ASSESSORS MAP: \ H)'ri ri 0\L\-
LOT'
BLOCK:
OWNER:~l\Q \j\,IV}J\, . 0.~
ADDRE~,,' \c::; AI. (to. f'AjQ ~U,I\
CITY: \ . \ k01l\ ~ \ . . STATE:
DESCRIBE WORK: _\) '<<'f'\ Illi ~o No.. 0 1\ ~
NEW
REMODEL
.
~\DD~~\
JOB NUMBER
225 Fifth Slreel
mctPrlngfleld. Oregonl~7477
TAX LOT: \{ 1-W
SUBDIVISION'
PHONF'
Of CJ1Jpf \
ADDITION
DEMOLISH
OTHER
ZIP:
C\lTlB
\
CONTRACTOet'I\"\'('~r' <:
GENERAL: r )j \ ~ O.J---< "
~.Dr~~SS
CONST. .
Oi9f3\CTOR (\. \q .l((S 'lP~Cf~7
PLUMBING:
MECHANICAl .
ELECTRICAL'
- 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 requesl.an Inspection. you musl call 726.3769, This Is a 24 hour recording. All Inspections requested before 7:00 a,m. will be .
made the same working day, Inspectlons requested after 7:00 a.m. will be made the following work day.
D Temporary Electric
D Site Inspection - To be mado
after excavatlon, but prior to
setting forms.
D Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
D Footing - 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 Underfloor Plumbing/Mechanical
- PrIor to Insulation or decking.
D Post and Beam - PrIor to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanllary Sewer - Prior to tilling
trench.
D Storm Sewer - Prior to filling
trench.
D Waler Line - Prior to filling
trench.
D Rough Plumbing - Prior to
'cover.
REQUIRED INSPECTIONS
D Rough MechanIcal - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/C"elllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvll.1
and Inslallallon of unll. .
D Curbcut & Approach - After
forms are erected but prIor to
placement of concrete.
D Sidewalk & Drlvewav - After
excavation Is complete, forms
and sub-base material In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted. .
D 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.
D Final Building - When all
required Inspections have been
approved and building is
~:'eted. ~ -\l\1 SQ ~(C~
V )
MOBILE HOME INSPECTIONS
D Blocking and Sel.Up - When all
blocking Is complete.
D
Plumbing Connections - When
home has been connected to
waler 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
Inspectlons are approved 'and
porches, sklrllng, decks, and
ventIng have been Installed.
Setbacks
I PL. HSE GAR ACC
IN
Is
Iw
IE
Lot faces
Lot Type.
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-do.sac '
BUILDING PERMIT
ITEM SO, FT. X $/SO. FT.
VALUE
Main
Garage.
Carport
.,
Total Value
Building Permit Fee
Slate Surcharge'
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT,
Storm Sewer FT.
llijm~~~,tN1Q/ . _
Plumbing pt~;t\ ... /~V\ \ ~OU
Stato Surcharge -t -:9i) . -. l. '!Q.
Total Charge (C) l.'l:L1U
MECHANICAL PERMIT
Furnaco
Exhaust Hood
. Vent Fan
N'
Wood Stove/Insert! Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
\~W
, --~.
L_
< .
~l~rcharge
-. .
Total Miscellaneous Permits (E)
;--)~.LO-\
TOTAL AMOUNT DUE (excludlntJ electrical)
(A. B. C, 0, and E Combined)
. .i',~. ~ ',:; \
".i,.
:,:
..S THE PROPOSED WORK iN THE
. '''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes. this application must be signed
and approved by the Historical
~ 1 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 tll0 City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I stato and agree, that I have carefully examined
the compleled application and do hereby certily 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 Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made 01 any
structure without permission of the Building Safety DivisIon.
J 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
reAfJested at the proper time, that each address Is readable
fjo~ the street, that the permit card Is located al the lront
of the property, and the approved set of plans will remain
\ I .\
(l)n t e site at all times dur ng constructIon.
VALIDATION: (\ ~
RECEIPT NUMBE7 r;;1 n;....
DATE PAID c)l' \;+ -y
AMOUNT RECEI~ - OS ~
RECEIVED BY \l \J 1\ ./
~