HomeMy WebLinkAboutPermit Plumbing 1998-4-14
OWNER: 1. /'J >- l- V J. _ /\/\" .' '" Lo I ,
, . >.l .
ADORES'" < '&--.::> .1
C ...,J ( . l
-I/' '
./ '~
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
/9.0 Z.
XASSESSORS MAP'
"'LOT: /(}A(').j
'.,"
'.,', 'f.'.
.
\-ra. "'" ~no.J> ~
t9 1'""
;
BLOCK'
~~~C ~.;.
- V
CITY'
DESCRIBE WORK:
NEW REMODEL
"_0/""
I
ADDITION
CONTRACTOR'S NAME
GENERAl'
1 ,PWMBING'
?
a: .1;,
10 B~ j)~(2."r(_ilLL./
.
MECHANICAl'
ELECTRICAl'
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER'
/(J
STATE: ~R
S'-"C1...t:-"
,
DEMOLISH
.
JOB NUMBER
q){o f"3 /
225 Fifth Street
Springfield, Oregon 97477
!?rI
. TAX LOT'
SUBDIVISION'
/!')D/')/
PHON'" 7 '-/ 7 - ~ &- S J
ZIP:
Q7---17o
~;r].,
o Rough Mechanical - Prior to
cover.
D Rough Etectrlcal - 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 Installation.
o Insert - After fireplace approvlll
and Installation 01 unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - Alter
excavation Is complete. forms
and'sub-base material In place.
o Fence - When completed. .
D.Street Trees - Whan.all required
trees are planted.
<: .., v-t) '-~ *\.-
ADDRESS
CON ST.
CONTRACTOR .
EXPIRES ~ PHONE
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS:
SECONDARY HEAT'
SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 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 INSPECTIO~S
OTHER
o Temporary Electric
D Site Inspection -. To be mado
after excavation, but prior to
setting forms.
o Underslab ,Plumbing/ Electrlcall
Mechanical - Prior to cover.
o Footing - Alter 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
. -.Prlor to Insulation or decking.
o Post end Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
~nltary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. .
o Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
- OFFICE USE -
LA~~i!SE:
NO"!~:I1:S' 'ALl:. EyoIl'lE IF ,HE WORK
'~8~~f~\l::.n ~\~ PERMI, IS NO,
AIITHOR\tEtr5f.i AA"NDONED FOR
I'lEAT JiQl.lfK:E,n IS ...
MMcl'lv[;\.J'V '
~~fu'Ol)t\'y p<:clnO., ,
o Final Plumbing - When all
plumbing 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. +1:.L.e
aJ Other~ \'f-h'r
MOBILE HOME INSPECTIONS
o Blocking end 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, skJrtlng~ decks, and
venting have been Installed.:
----------
~t~p- . ~ -,
Lot faces
Lot sq. Itg. Interior I PL.
IN
Lot coverage Corner Is
Topography \
Panhandle' Iw
Total height Cul,de,sac IE
BUILDING PER~IT\j '.,~ '~
ITEM sa, FT. x S/SO. FT. - VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s) N'
Sanitary S~wer FT. C:;O !r-
Water FT.
Storm Sewer FT.
Mobile Home
:Ij"l~ ;
'_r
"
Plumbing Permit
State Surcharge 1-.03
$<; -
~
I.r&.-+- .75
<tl7. -
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Venl Fan
N'
Wood Stovellnsert/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
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
..:.
: iM .... ,:i ~~:,'
.' ,,:iN.''''~
0/ "
I. .
\ IS THEPROPOSED WORK IN THE " '
'.'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks '
HSE GAR ACC'
APPROVED:
BUILDIN'G VhU!1E, 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 Sprlnglteld, 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 ordlnan'ces.
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
",'" .
',' ',It...
'.
"" -:'! VI"
-.. .J
By signature, I stale 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 Law.
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 site~p'tlmes dur constructloa.
0Ignature~-------'"
{/ d t7
~tP 4 - / ~ - '7 '5(- .
VALIDATION:
RECEIPT NUMBER ;2.Cj sf /9
4-1'-f-'::;'<l .
DATE PAID
AMOUNT RECEIVED $..:;1].
~
-
RECEIVED BY .