HomeMy WebLinkAboutPermit Plumbing 1995-6-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
,.
SPRINGFIELD
LOCATION OF PROPOSED WORK: _. Lf~ $(O
ASSESSORS MAP' 19 -~'2..- 05-13
LOT:
BLOCK:
.
r:~'q50Q~
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
~O\) S?rl''''1~,:1t'9
TAX LOT' :5 ;l. C") 0
SUBDIVISION:
ZIP:-5.. 14 "") ~
OWNER: 1\) ~ r W\Go. ' G: cO f'\<. 1 ~ n PHON'"
ADDRESS :. S '\(0. ~ c..... E> r ~<.C)( ,
CITY' ~1'''''' '^~ ~~ ~ \ .y . STATE CJ r ,
DESCRIBEWORI< \_h)\\n~ ~m.\L~
NEW REMODEL ADDIT-I~~ DEMOLISH OTHER
CONTRACTOR'S NAME ADDRESS
GENERAL: t-1 ifl <:..o,,~ t.rv c.. +;0" ...b.~.
G~b~C!l"'~~6-I"'ll"L'
MECHANICAl'
ELECTRICAL: Hc,\O'\t~""-'..:6kto-h 10"'2. ~r)'\ \.",
,
,~
EXPIRES '. P ONE ~
(...11\ 'i!~52. V -'V1-9"
-~~ i+,'-(;!,ti
(j . "}~-~O.:
:JtP '2'lfo c.. '1',/f.5 (,30-,i ~ ~ ~hrJ
PLUMBING'
CON ST.
CONTRACTOR'
~ I' ?~~ t.;;tt
.. ."
QUAD AREA: .5R..~
. OF BLDGS: __1
OCCY GROUP: ~~
. OF STORIES:_'
WATER HEATER:
- OFFlf.E USE -
LAND USE: \ \c:f)
. OF UNITS: \
CONSTR, TYPE:
HEAT SOURCE:
RANGE:
FLOOD PLAIN: ,~.. ')
ZONING CODE:....uK./
. 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 INSPECTIONS
D Temporary Eloctric
D Slto Inspection - To be mado
after excavation, but prior to
setting forrns.
o
Undersli'lb Plumbing/Electrical1
Mechanical - Prior to cover.
o
Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, groutlng.
D
Foundation - After forms are
erected bu I prior to concrete
placement.
D Underground Plumbing - Prior
, to 1111In~ trench,
D
UnderUoor Plumblngl Mechanical
- PrIor to Insulatlon or decking.
D
Post and Bea~ - PrIor to floor
InsulatIon or d7cJdng.
D Floor Insulation - Prior tol
decking,
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Lino - Prior to flllin'g"
trench. '.',
I . '...
D Rough Plumbing - Prior to
cover.
D Rough Mechanical -.: P.rlor to.
cover. .... .
D Rough Electr~cal - Pr!or to
cover. .
D Electrical Service - Must be
approved to oblaln permanent
electrical power.
D
Fireplace - Prior to facing
materials and framing Insp.
D
Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stovo - After Instal/allan.
D Insert - After fireplace approvl1l
and Instalfallon of unit.
D
Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation Is compielO, 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 W9rl( 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
completed.
DOthor
MOBILE HOME INSPECTIONS
n Blocking and Sot.Up - When all
~Iocklng Is complete,
II e.lumblng Connections _ When
L....&J1)ome has been connected to
water and sewer.
~Ieclrlcal Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected 10
the service panel.
~al - After all required
inspections are approved and
porches, skirting, decks, and
ventIng have been Installed.
BUILDING PERMIT
ITEM SQ, FT. X $ISQ. FT.
Main
Garage
Carport
Tolal Value
Building Permit Fee
Slate Surcharge
TOlal Fee
(A)
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary 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 Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
~
'iJ..
--_._-~
-'"
Curbcut
It
Oemolltlon
State Surcharge "
FEE
~~~
\ s.. .uU
, ~'
\95._
5.'lO
1D~~
/
n
~%
5.~
3.\5
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrICal)cV( }j.lf.:l)
lA, B, C, 0, and E Combined)
~
i.THE PROPOSED WORK i'N 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.
APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
ThIs permit 15 granted on the express condition that the said
construction shall, In all respects, conform \0 the OrdInance
adopted by the Clly 01 Sprlnglleld, Including the
Development Code. regulating the cOr)~truction and use of
buildings, and may be suspended or revoked at any lime
upon violation of any provisions of said ordinances.
/
Plan Check Fee: . ~
Date Paid:
Receipt Number:
Received By;
--~._.
Plans Reviewed By
Date
Systems Developmenl 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 appllcallon and do hereby certify that all
Information hereon Is true and correct, and I further certify
th.at any and all work performed shall be done in accordance
with the Ordinances of Ihe City of Springfield, and the Laws
of the State of Oregon pertaining to tho work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certHy that only contractors and employees who
, are In compliance with ORS 701,055 will be used on this
project.
I further agreo to ensure thai all roqulred Inspections oro
requested at the proper lime, thatoach address Is readable
from the street, that the permit card Is located at the fronl
of the property, and the approved set of plans will remain
on the site at all tImes during construction.
Signature ~ fJue;.1 xUUlL
Dat~ LP( :o'l ct:S
VALIDATION:
RECEIPT NUMBER
/79CJ7
6/2.0/ 9J-
DATE PAl"
AMOUNT RECEIVEO
RECEIVED BY
- ,
,