HomeMy WebLinkAboutPermit Plumbing 1999-7-9
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP:
LOT'
.
SPRINGFIELD
BLOCK:
OWNER: ?Oy)()fl <i ~.fl.L)1 m{II"/J
ADDRF"'" Jj 1./ 3 J.j ~ F ,<,. ".J f' ,q
CITY: ~O IE' I '-'9 j II-. c.d STATE:
DESCRIBE WORK: .IJ'l.5TY'I UVI'11G'n OF A I (I
NEW
REMODEL
nR.
ADDITION
DEMOLISH
OTHER
.
JOB NUMBER
:- ~q:2?
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: t:' :::? /~
SUBDIVISION'
PHONE:
'7 AI / - .:2..),9</
ZIP:
9)1../7X
~
ADDRESS
CONST,
CONTRACTOR'
EXPIRES '::- PHONE
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICAL: B.,..,O('IVlTI'd J../qa'+l ~ 9 Ale
ELECTRICAL'l~~~ ~~cr--
QUAD AREA:
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER:
,I
1;
t".O.lbOX '{I';;' ,I
fll?Pfll OP. q,l/<Jo ~ 10\,,;11.<; &-31.Joou 541-b8:-3'')Sc;.O
I
-.--
- OFFICE USE - ~of(fl..
LAND USE: . CEo ~\?~\~J~~~~IN'
· OF UNITS~O~~,q;k~S\'\~U;.n:i\"\\S?e~aN~ODE:_
-M\~r'" . UNU..... DO'NP'
CONSTR. TYP~f'l":'\'t'\Qa.EO _."'-II.~~~ . OF BDRMS'
~\,!- rJG.OV~-
HEAT SOURCE:..""f,.h~ ~O, SECONDARY HEAT:
liV' '0001'-'
RANGE: ~~ ~ SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. Ttlls Is a 24 hour recording. AI/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.
D Temporary Electric
D Site Inspection - To be mado
after excavatlon, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches .re
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 Underlloor PlumbIng/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking. .
D Floor Insulation - Prior to
deckl ng.
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
D Water 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 Wait/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After Installation.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - After
forms are emcted but prior to
placement of concrete,
D Sidewalk & Driveway - After
excavatIon Is completo, forms
and sub.base material In place.
o Fence - When con'lpleted.
D Street Trees - Whun all required
trees are planted. .
D Final Plumbing - When all
plumbing w9r!< Is complet.e.
D Final Electrical - When all
electrical work is complete.
G Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, sel.up, and plumbing
Inspections have been approYOd
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.
. " ;::.~ t!', (;/~.:l 'IS THE PROPOSED WORK IN THE,
~"I. 'J
Lot faces Lot Type Setbacks
Lot sq. Itg. Interior I PL. HSEIGAR Accl HISTORICAL DISTRICT, OR ON
I THE HISTORICAL REGISTER?
Lot coverage Corner li._ _..1 If yes, this application must be signed
I and approved by the Historical
Topography Panhandle , S
--1 Coordinator prior to permit issuance.
Total height Cul.de.sac W
----
E APPROVED:
ITEM
SQ, FT.
X $/SQ, FT,
VALUE
4,. . 'I
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
. ( "j
BUILDING PERMIT
.~ t
Garage
"
ThIs permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the Cily 01 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.
Main
Carport
Plan Check Fee-
Date Paid:
Total Val ue
Receipt Number'
Building Permit Fee
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S!3wer
Water
FT.
FT.
FT,
Storm Sewer
Mobile Home'
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Mechanical Permit
I"'>. ,.?
-liP. "
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 of Springfield, and the Laws
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 certlfy that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Issuance
~~
State Surcharge
Total Permit
(0)
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 at II tl s during construction.
MISCELLANEOUS PERMITS
Mobile Home
Sidewalk
It
/~
- - --
State Issuance
State Surcharge
Date
Curbcut
It
Demolition
State Surcharge
VALIDATION:
Total Miscellaneous Permits (E)
RECEIPT NUMBER "3 <./?? '3
"/, ~~q'9
AMOUNT RECEIVED 26. St:?
~~/~
DATE PAID
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. D, and E Combined)
RECEIVED BY
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