HomeMy WebLinkAboutPermit Plumbing 1997-3-24
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK: ~
ASSESSORS MAP' 1701~l.l/ ':F
OWNER: t;. ilLJj~ IJ I
ADORE''''''' tl~(
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DESCRIBE WORK:U .~ /b
NEW REMODEL ADDITION
LOT'
CITY:
CONTRACTOR'S NAME
GENERAl'
PLUMBING: ~10 fwh/
MECHANICAl'
ELECTRICA' .
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STATE: '
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DEMOLISH
OTHER
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770lf(g-
JOB NUMBER
225 Fifth Street
Sprlnglleld, Oregon 97477
TAX LOT:
CJ1) I OD
SUBDIVISION:
PHON'"
ZIP:
970/ 7 7
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ADDRESS
CONST.
CONTRACTOR'
"
EXPIRES .~ PHONE
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7r1&2--
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- OFFICE USE.-
QUAD AREA- LAND USE: FLOOD PLAIN'
. OF BLDGS' . 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 requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
O Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Eleclrlcall
Mechanical - Prior to cover.
o Fooling - After trenches are
excavated. .
o Masonry - Steel locallon, bond
beams, grouting.
o Foundation - Atter forms are
erected-but prior to concrete
placement.
o Underground Plumbing - Prior
to 1I111ng trench.
o Underlloor PlumblnglMechanlcal
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
~o ~IO~~~~Ulatlon - Prior to
Sanitary Sewer - Prior to filling
trench.
o rm Sewer - Prior to filling
trench.
o Weier Line - Prior to filling
trench.
o Rough PlumbIng - Prior to
cover.
o Rough Mechanical - Prior to
cover.
D 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 approv~r
and Installation of unit.
o Curbcut & Approach - After
forms Bre erected bul prior to
placement of concrele.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
o Street Treos - When all required
trees are planted.
o Final Plumbing - When all
plumbIng w9rl< Is complet.c.
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.
OOthor
MOBILE HOME INSPECTIONS
o BlockIng and Sel.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connecllon - When
blocking, se,-up, and plumbing
Inspocllons 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 havQ been Installed.
~~
Lot faces
Lot Type .
Interior
Lol sq. Itg.
Lot coverage
Corner
Topography
Total height
Panhandle;
Cul-de-sac
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BUILDING PERMIT
ITEM sa. FT.
i, "~
X S/SO. FT. =
Main
Garage
Carport
Tolat Value
Building Permit Fee
State Surcharge
Tolal Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDe) ,
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'(ArHE PROPOSED WORK iN THE_
~TORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
, Coordinator prior to permit Issuance.
,
.y
,
I P.L.
IN
Setbacks
HSE GAR Accl
I
I
S
W.
IE
VALUE
"
(B)
PLUMBING PERMIT
ITEM FEE
Fixtures
Residential Bath(s) N'
Sanitary S~wer FT. ?if)
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
. Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sldewatk
It
Curbcul
fl
Demolition
Slate Surcharge
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (exctudlng electrical)
(A. B, C, O. and E Combined)
tfO ,ffU
2. ()V
flU'
U :J(I)
'13 J-()
APPROVED'
". '.'~" ~I
BUILDING VALOE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition Ihat Ihe said
constructlon shall, In all respects, conform to the Ordinance
adopted by the City of 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.
Plan Check Fee'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properlles wllhln the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify thaI all
Informatlon hereon Is true and correct, and I further certify
thai any and all work performed shall be done in accordance
with the Ordinances of Ihe City of Springfield, and Ihe Laws
of the State of Oregon pertaining to the work described
herein. and that NO OCCUPANCY wilt 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 ensuro that all required Inspections are
requested at the proper time, Ihal 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 \/11 times during construction.
Slgnatur.vc~L~
Datp t ~h>:h/
VALIDATION:
RECEiPT NUMBER ,'2 '-:Juuto
DATE PAlO '7 ~ ;; tj - CJ'/
AMOUNT RECEIVED Lf 5.~
([W
RECEIVED BY