HomeMy WebLinkAboutPermit Plumbing 1999-9-8
Sep-OB-9901:12P
;;;..,. ..0,.:.
RESIDENTIAL
PERMIT APPLICATION
Inspec;lIons: 726-3789
Olf/ce: 726.3759
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ASSeSSORS MAP'
LOr.
--
BLOCK'
AOORES~
1-1-. ~ f\cruJ...r-.>w
'3'141 ,IM.PtiL · 0'.
~"LtI'..l[,..fr't-o\.D
OWNER'
CITY:
~~AA.....
DESCRIBE 'lVQAK'
N~W _ REMODEl-X-
CONTRACTOR'S NAME
I~~
~.
GeNERAL:
PWM8ING:~k~
~//It;-
,..JIlt.
MECHANICAL:
ELECfr:\IC-" .
QUAD AREA:
. OF BLDGS: .
OCCf GROUp.
# OF STOF\IES:_
WATEA HEATER:
STATF.
<b~
P~03
.
JOB NUMaE" q112~
225 Fifm SHoal
SprlngfloltJ, Oregon 97477
~~
"PAX~
O<j'7<m
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c:eN~......J '
SUbDIVISION:
PHONP'
~"I~ -'S'3.d-.\
AOOITION _ DEMOLISH __ OTHER
z,p, "'~1~
ADDRESS
~'>-,
S~('"~
CONST.
CONTRACTOR.
f'N''''''' ~,
.~
- OFFICE USE -
LAND Use: __,
., OF UNITS:_.
CONSTR. TYPE: _
HEAT SOURCE:_
RANGE:
E.XPIRES
PHONE
FLOOD I'LAIN:
ZONING COOE: _
., OF BDRMS: _.
SECONDARY H[;,A'r._. __._
SOUARE FOOTACE:
Ta rQQuealan lnspecllan. you mua. cedI 726-37&9. This 15 a 24 hoor recordlng. Allln~pectlons flJQuesteCJ DefO'e 7:00 a.m. will be
mad. Ihe .ame worJdng day, InaPlirCIlons requo8ted aftcr 7:00 a.m. will be made IhO followIng WQrll; day.
o 1'Itft'lporary E1octrlo
o Slle 'napecllon - To be mado
a.ftef ..c.".Uon, but prior 10
8elllng futrllll.
O Undolllob Plumblng/Eleclrlcsl'
Mochanlolll - Prior 10 cOvor.
o FOOlinG - Aft.' trenches art'
mccav.alod,
o Muonry - Sle.1 locatIon, bond
beamtt, grOl,l(1ng.
o Foundation - Ah.r lorma are
.reelod but ortor 10 concrete
placernont.
O Underground Plumbing - PrIor
10 filling trench.
O Underfloor PlumblnglMech.nlclll
- Ptlor 10 Irl$ul.Uon or clecklng.
o Posl .nef 8eam - PrIor 10 floor
Inaul.lIon 0' dOcl(lng.
o Floar In.ulaUon - PrIor 10
DOCkIng.
o Santlal)' Sew.r - PrIor to lIIUng
trlnCh.
o Slorm Sewer - PrlOt" 10 filling
tronCh.
O W.'.r Llno - Prior TO ruling
trench.
O Rough Plumbing - PrIor 10
cover,
REQUIRED INSPECTIONS
o Rough MochOlnlooJ ~ Prior 10
COvelr.
D Rough Electrical - PrIor 10
cQver.
o Eleotrtoel Service - Must be
appro~ to obtain permanent
olOClrlclI,1 power.
o Flreploco -.. PrIor to racing
mal.rlals and trnmlng Insp.
o Framing - Prior to COVQr.
D W.aIl/Colllng Inaul.Uon - Prior to
COVer.
o Drywell - PliO' to tapIng.
o Wood SloW) - After In81.IInllon.
o Inun - After llreplaco approvel
and InSlallatlon of unit.
D e...rbc:ut . Awroach - Allor
forms are ereCtOd but prior la
placlttTlCtnl 01 concrcu8.
o SldewaUe & Drhrew:'l - After
ello.vtnlon Is comploto. forms
;Ina 5ub-base mftl",I(tl In placQ.
o "onc. ~ Wlurn complotod.
D Slre.t TN.. - W"~n all to'qul...cJ
trees .... planted. .
D Final Ptumblng - Whl!n .\1
Plumbing wol1\: II Complote.
O I='lnal Electrical - When all
eleclrlc:al work r. complete.
o Flna' Mechanical - Whon all
mechanIcal work Is complete.
o P1n.1 Building ~ Whon all
tOQulred Inspoctlons have been
approved 4t1d butlCJlng I,
complo(oO.
DOlh.r
MOBILE HOME INSPECTIONS
o l!'JIocll;lng Illnd See.up - When au
blOCkIng Is complete,
o PlUmbing Conneotlons - W"an
homo hOS D.en con.-..c1e'd .to
waler BOO sewer.
o EJeelrlc8' ConneoUon - Whon
blockIng, lel.up, and plumbing
Inspocuon. have boltn approved
end tne ho",. Is connClcted (0
the aCIYlc. panel.
o FInal - AUer all tOQulred
Inspecllon. are approved and
porchos, aklrtlng, dOClus, ancl
v8nllng havo boon Inalallod.
-..
,
SuP-OS-gg Ol:12P .
.~... .""
lot lac.. LoI'T'fpe
Lol sq. Itg. Intenor
. .
Lot t:ovorago Corne'
TopograPhY Panhandlo
>
Total heIght Cul-ae.sae
P.04
:'" ~,:~;-;~.
.
i 'S THE PROPOSED WORK rN THE. .
."HISTORICAL Olsr"ICT. OR ON
. THE ~ISTOFUCAL "!QI$'TER?_
" yea, Ihls applloatlon mUlOt tMI elgned
Qnd approved by tho HI,Corlca'
Coordlnllor prior to permit haua'1CG.
S8tbtrleks
P.L I HoSE ]GiAR ACe I
~+-'I_-
; J
BUILDING PERMIT'
IT(M so. FT: X IISQ. FT. .. VAUJE
rl/hd'1
Gar.oe
Carporl
TOlal V.rue
BlIUding Pc"."ir F~~
Stale Surc".rg~
TOlar ~ee
(A)
,
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8)
PLUMBING PERMIT
ITI!M
Flxlures
Residential Bath(lI)
N'
Sillnllary S~cr
ELfl>
WAtcr
FT
FT
Slorm Sowor
MOrillo Home
P-Iulnblng Permit
SID'. Surcharge
TOlal Chtargo
CCl
MECHANICAL PERMIT
Fumx.e
E."auel Hood
Vent p."
N'
Woad Stove/lnsort/Flreplace Unit
Ol'Yet'Ve'1t
MechanIc..,,! Permll
Issua..u;.,
SUUO Surcl\atOO
Tala! Permit
In'
MISCEllANEOUS PERMITS
Mobile Homo
SIOla Isauanc.
Stato SurcMrge
Sidewalk
CurbcUI
"
"
Demolltlol'l
SllIle Surchargo
M ~ f)C
,
fotal Mlacellanoous Permlto IE)
TOTAL AMOUNT DUE lexclud"lnQ a'~clrlcal)
(A. B. C. 0, and E Coll'lblnlKf)
FEE
;lS "'._
7-5"-
-"-:7'0
~.._-
..J..?-J<:>
L!-p~',8(
j'J.li..J..S
.~PPROVE""
BUILDING ~LrJE, ~LAN CHECK
AND BUILDING PERMIT
ThiS permit 15 gr.l;nlecJ on the oxpross condition thallhe said
conslrueuon shall, In 411 r"Llfe!s, conform to th1l OrtIlna""
1u'1optod by thv CIty 01 Springfield, InCluding Ihe
OOvelopment Codo, r'ouhl!lng tho constrvctlOt'l Qtl(I uae 0'
Dulldlngl, and may be Illuapendcd or revoked al arty time
upon violation of any provhiJona 0' said ordil'ull'lcel.
r'an Chock ~..; __
Dale Pal(l;
Receipt Number:_.,
RecelvccJ By:
Plan3 Rcvlowed B;;u
0...
Systoms OevelopmOl'lt Cnargc Is due on .,,11 u"deYeloped
properties wllhln the City IInlll$ which are bl);lng Improved.
ADDITIONAL COMMENTS
By 'Ign~turo, I Glale end Qgro-, Ihlllt I havo carefUlly examIned
the complOlod appllcatlon and do hereby cerllfy 1"" All
I"formatlon hereon 18 true and O:::OJTCCI, and I further certify
1I1l1.t ony and Iolr work porformed shall bo don" in :lCCO''''...nce
with tho Otdrn.nc~" Or 11l(J City of Sprlngfiold. end Iho Laws
of the Sl.ale of Orc-gon ""rl.I'1lng 10 thQ work (Ie3':I'U)C~d
heroIn, and thal NO OCCUPANCY will be made of any
struclure wUh(lul permission 01 ,,,. Building $cIfety Dlvt,lon.
t furll'ler corlll~ that only eontractorlll Cnd employees who
lire In COlnpll",nco wIt" OAS 701.055 will be u.ed on Ihl.
project.
I further llIgl'Qe 10 ClI1GUro 1t'..lllII rOQuh.a Inspectlono .re
requested allhe proper Ume, 1"01 OBCh address It ,.adabJ.
lrom thestrCOl, 1hat the parmlt e.ard Is 10c.at9d at (he front
of the proporty. IlInd thO apProved 801 01 plans wUI remuln
ethe s~t. tl a1lllmes durtng construction.
,",0 C?.r: """"-
10_ r/~;}..!.,'1
VAI..IDATION:
RECEIPTNUM.ER~(~ :3 I
OATe PAID ..'1 - dd - C; ""
AMOUNTRECEIVEO.. $1) 30~. ~~
RECEIVED OV <<"LA. )
'" ,,':;,ep-Oa-99 01: lIP .
.. .' ".
P.02
JOURN_>RJOBNO.3, ~~.1
ATTACHMENT A
CITY OF SPRINGFIELD SYSTRMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR COMPANY:
i.I [ L /"':./", r- i.. l'> LJ l< 'V ('; ...
..... -....1 .t... -'-;'" I I~. -r n
J , / -) , < 0r.C,.dl'rL Ie" ,-I')
LOCA TTON:
DEVELOPMENT TYPE:
....;("':_'-"c~ ('ClI1'V#Vc...-r~cJ^-J
"
BUTLDTNG SIZE:
'.OT SIZE
SQ.fl.
I. STOR(vf DRAINA(iE
=c.
IMPERVIOUS SQ. FT,
_ X $0.232 PER SQ. FT.
s
e
2. SANITARYSEWER-(TIY
NO. OF PFU'S
(See Reverse Side)
I L.. _ X $48.27 PER PFU
$ 8 h L...a..G.
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER PM PEAK HOUR TRIP
x
X $486.73 PER'I'IUP
$
x
X $486,73 PER TRIP
s
4. SANITARY SEWER.MWMC
A, REIMBURSt:MENT COST:
NO. OF FEU'S I
X 14<,"16 PER FEU
S 2tf2. 7("
ll. IMPROVEMENT COST:
NO. OF FEU'S I
X ZZ. 0<) PER FEU
$ 2.Z..0\
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINlST~A TlVE FEE
<$ >
$ 10.00
TOTAL-MWMC SDC
$ l.74.8/
5. ADMINISTRATIVE FEES;
BASE Cl.:P (SUIlTOT AL ABOVE) X '~
~ II' ___', Dale: q- fl- 7&1
SDC Coordinator
ATTACH'A.WPD
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
L.4.L 4 lot'., '7
$ 0, If!
TOTALSDC
$ I, l' 00.9<:'