HomeMy WebLinkAboutPermit Plumbing 1995-10-19
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
ASSESSORS MAP'
LOT'
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BLOCK:
OWNER: b /( n lJJa/ f e.rftLC/t .
ADDRESS' iBJ f? '" III (Df .r mao
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DESCRIBE WORK: h J nJ(jft //JJ/.f)rJ/ .Ie
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NEW REMODEL ADDITION
CITY:
CONTRACTOR'S NAME
GENERA' '
.-
?9~?1_
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
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,
PHONF'
7:JI.P - N9D
STATE: OR ZIP: tf'7L/7,p
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DEMOLISH OTHER
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o 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 InstallatIon.
o Insert - After fireplace approvel
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior 10
placement of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
ADDRESS
CONST,
CONTRACTOR'
PHONE
EXPIRES
PLUMBING:
MECHANICAL: I/a( IJtI) 0/-,)/JlJ #aifj~ i/~f!J mIlL/} JUof(j 1),9r; P J Z-l &-9& 7I/!..-7.67 7
ELECTRICAl' c::::: "f" .:!l c-r' ~T, '
- OFFICE USE -
QUAD AREA' LAND USF' FLOOD PLAIN'
. OF BLOGS: . OF UNITS' ZONING CODE:_
OCCY GROUP: CONSTR. TYPE' . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: _ SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requeSled before 7:00 a.m. will be
made the same workIng day, Inspections re..quested after 7:00 a.m. will be made the following work day.
o Final Plumbing - When all
plumbing w9rl< Is complet.e.
~nal Electrical - When all
~~ctrlcal work Is complete.
"'lx1' Final Mechanical - When all
~echanlcal work Is complete.
o
Final Building - When all
required Inspections have been
approved and building Is
completed.
o Temporary Electric
O Site 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 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
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
OOthsr
MOBILE HOME INSPECTIONS
o Blocking and 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, skirting, decks, and
venting have been Installed.
Lot faces
Lot Type.
Interior
Lol sq. flg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM
sa. FT.
X $/SO. FT.
Main'
Garage
Carport
Total Value
Building Permi t Fee
State Surcharge
Total Fcc
(A)
. , ';~ .""~ .~-;;:
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:.' THE PROPOSED 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.
I P.L.
IN
Is
I'w
IE
Setbacks
HSE GAR ACC I
I
I
I
I
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
tTEM
Fixtures
Residential Bath(s)
N'
Sani tary Sewer
FT.
Water
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
".
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
~/A..)
Issuance
State Surcharge
,7)+,~J
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C, 0, and E Combined)
FEE
-.0&0
/ s: a-o
, /D 6-0
/2."
~;2.o
2~,2.<7
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, 01 Springlield, 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 Ilmlls which are being Improved.
ADDITIONAL COMMENTS
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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 01 Springfield, and lhe Laws
of the State of Oregon pertaIning to tho work described
herein, and that NO OCCUPANCY will be made of any
structur~e 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 15 readable
from the street, that the permit card is located at the front
:~ t~heeP:I~~:;t;J;~~~~;;;~ will remain
Signature 'Q~//~/
Date ' ' /fl9~-
VALIDATION:
RECEIPT NUMBER
DATE PAIP
AMOUNT RECEIVEr>
RECEIVED BY
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